Form Br - Business Earnings Tax Return - 2011

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Form BR – 2011________________________________________________________________________________
NECESSARY INFORMATION
2011
NORWOOD
2011
NECESSARY INFORMATION
BUSINESS EARNINGS TAX RETURN
1. Check type of Organization:
5. Federal I.D. or Social Security No.
DUE ON OR BEFORE APRIL 16, 2012
( ) Sole Proprietor ( ) Partnership
( ) Corporation ( ) Other_______
or Fiscal Period
_________________________________
2. Date Business Started or was
6. Telephone No.___________________
Incorporated____________________
Beginning_____________, 20___ Ending____________, 20___
If Moved During Year Give Date :
3. Did you have any Employees in 2011?
File this Return and REMITTANCE with
IN_____________ OUT_____________
TAX COMMISSIONER
7.
Yes ( )
No ( )
Final Return ? ____Yes ____No
4645 MONTGOMERY ROAD
4. Are All Places of Business Subject to
8. If yes, answer #9 and/or #11, page 2
NORWOOD, OH 45212-2689
(
Norwood Earnings Tax included in
Additional questions on back, page 2)
OFFICE 513-458-4590 FAX 513-458-4581
This Return? Yes ( ) No ( )
POST OFFICE BOX #
IS NOT
ACCEPTABLE
IDENTIFYING ADDRESS
IF NOT SHOWN, TYPE OR PRINT NAME AND ADDRESS CLEARLY
_________________________________________________________________________________________________________________
1. ADJUSTED FEDERAL INCOME (ATTACH COPY OF FEDERAL RETURN)Include Schd. Z Pg. 2
$__________________
2. a. Add items not deductible (From line H Schedule X, Page 2)…………… ADD
$________
b. Deduct items not taxable (From line M Schedule X, Page 2)…………… DEDUCT $________
c. Difference between 2a & 2b to be added or subtracted from Line 1 (+ or -) .……………………..
$__________________
3.
ADJUSTED NET INCOME
a. PROFIT/LOSS (Line 1 Plus or Minus Line 2c, if Schedule X is used)…………………………….
$__________________
b. Amount of Line 3a Apportioned (_______% from Line 5 Schedule Y, Page 2)…………………...
$__________________
c. Less allocable net loss from previous Norwood tax returns (3 year limit)……………………………
$__________________
4. AMOUNT SUBJECT TO NORWOOD EARNINGS TAX (Line 3b less Line 3c)…………………...
$__________________
5. NORWOOD TAX : AT THE RATE OF 2.0% of Line 4…………………………………………….
$__________________
6. CREDITS:
a. Deduct payments made on Declaration of Estimated Norwood Tax………………….$_________
b. Prior year Overpayments………………………………………………………………$_________
c. TOTAL CREDITS ALLOWABLE…………………………………………………………………
$__________________
7. BALANCE OF TAX DUE (Line 5 less Line 6c)……………………………………………………….
$__________________
8. OVERPAYMENT: _________________________
PLEASE REFUND_______ OR APPLY TO 2012 ESTIMATED TAX_______
DECLARATION OF ESTIMATED TAX FOR YEAR 2012
(QUARTERLY PAYMENTS MANDATORY IF ESTIMATED LIABILITY IS $100.00 OR HIGHER)
9.
TOTAL INCOME SUBJECT TO TAX $_______________MULTIPLY BY RATE OF 2.0% FOR GROSS TAX OF $____________________
10. LESS TOTAL CREDITS:
a.
OVERPAYMENT FROM PRIOR YEAR………………………………………………….$__________
b.
AMOUNT OF 2012 ESTIMATE PAID……………………………………………………$__________ =
$___________________
11. AMOUNT PAID WITH THIS DECLARATION (NOT LESS THAN ¼ OF LINE 9 LESS LINE 10)……………..
$___________________
12. TOTAL OF THIS PAYMENT (LINE 7 PLUS LINE 11) MAKE CHECK PAYABLE TO: CITY OF NORWOOD
$___________________
I DECLARE, under the penalties of perjury, that this return (including any accompanying schedules and statements) has been examined by me and is, to the
best of my knowledge and belief, a true, correct and complete return, made in good faith, for the taxable period stated, pursuant to the Norwood Earnings Tax
Ordinance and Regulations issued thereunder; the undersigned agrees to furnish or make available to the Commissioner of Taxation, a certified or photostatic
copy of the Federal Income Return, or detailed schedule as attached to the Federal Income Return, filed with the Director of Internal Revenue Service for the
period involved as part of this return.
__________________________________________________________ Signature__________________________________________________________
(Signature of person preparing the return)
(Taxpayer, Partner, Fiduciary, President or other principal officer)
__________________________________________________________ _________________________________________________________________
(Name of firm or employer, if any)
(Date)
(Title)
(Date)

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