Individual Income Tax Return - City Of Marysville - 2013

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CITY OF MARYSVILLE, OHIO
THE CITY OF MARYSVILLE
YOUR SOCIAL SECURITY #
Income Tax Division
INDIVIDUAL INCOME
2013
209 S. Main St., P.O. Box 385
Marysville, Ohio 43040
Year
TAX RETURN
Telephone: (937) 645-7350
SPOUSE SOCIAL SECURITY #
FILE ON OR BEFORE APRIL 15, 2014
Fax: (937) 645-7351
Do you own rental property?
Yes
No
If renting residence, give name and
address of property owner.
Resident
Partial Year Resident
Move In Date
Move Out Date
Non Resident
Sole Proprietor
Name and Address: Indicate above change(s) by checking
Name
Address Effective Date:
Single
Married filing joint return (even if only had one income). Check if you filed a joint
or separate
return last year.
FILING STATUS
Married filing separate return. Enter spouse’s social security number above and full name here.
Check only one
W-2 INCOME ONLY FILERS CHECK HERE IF YOU WOULD LIKE THE INCOME TAX DIVISION TO CALCULATE YOUR RETURN
ATTACH W-2’S AND SIGN BELOW, MAIL BEFORE MARCH 16, 2014
INCOME
1.
Total W-2 wages. Complete Worksheet A on reverse. W-2's MUST BE ATTACHED .................................... 1
$
If none, see
2.
2106 Expenses. See instructions. FEDERAL FORM 2106 MUST BE ATTACHED ........................................ 2
$
exemption form
3.
TAXABLE WAGES. SUBTRACT LINE 2 FROM LINE 1 ...................................................................................... 3
$
enclosed.
4.
Other income. From Schedule C, E or O on reverse. SCHEDULES MUST BE ATTACHED.......................... 4
$
5.
TOTAL INCOME. ADD LINES 3 AND 4 .............................................................................................................. 5
$
6.
Adjustments. From Schedule X on reverse ........................................................................................................ 6
$
7.
MARYSVILLE TAXABLE INCOME. SUBTRACT LINE 6 FROM LINE 5 ............................................................ 7
$
TAX
8.
MARYSVILLE INCOME TAX. MULTIPLY LINE 7 BY 1.5% (.015) ...................................................................... 8
$
TAX WITHHELD,
9.
Marysville income tax withheld. From W-2 or Worksheet A on Reverse .................. 9
$
PAYMENTS
10. Prior year credits (Carried forward from 2013 or prior) .............................................. 10
$
AND CREDITS
11. Current year estimated payments (Paid as of
) ................................ 11
$
12. TOTAL PAYMENTS AND CREDITS. ADD LINES 9 THROUGH 11 .................................................................. 12
$
13. BALANCE DUE. If line 8 is more than 12, enter balance due here (No tax due if less than $5.01) .............. 13
$
BALANCE
DUE, REFUND
14. Penalty. 10% of balance due, applicable only if Line 13 is greater than $100.00 .......................................... 14
$
OR CREDIT
15. Interest. 2% per month or fraction thereof, applicable only if Line 13 is greater than $100.00 .................... 15
$
16. Total due. Carry to line 25 below (No tax due if less than $5.01) .................................................................... 16
$
17. OVERPAYMENT. If line 8 is less than line 12, enter overpayment here .................... 17
$
18. AMOUNT FROM LINE 17 TO BE REFUNDED (No refund if less than $5.01) .......... 18
$
19. AMOUNT FROM LINE 17 TO BE CREDITED TO NEXT YEAR (No credit if less than $5.01) 19
$
20. AMOUNT FROM LINE 17 TO BE DONATED TO THE CITY ...................................... 20
$
2014
DECLARATION OF ESTIMATED TAX FOR YEAR
First Quarter Estimate should be paid with this return. You will receive reminder notices for 2nd, 3rd and 4th quarter payments.
ESTIMATE FOR
Complete only if you are required to make estimated payments.
NEXT YEAR
21. Total income subject to tax ................................................................................................................................ 21
$
22. Estimated balance due (Multiply Line 21 by tax rate of 1.5% (.015)) .............................................................. 22
$
23. Credit from line 19 above .................................................................................................................................. 23
$
24. Unpaid estimated tax (subtract line 23 from line 22) ........................................................................................ 24
$
25. Amount due with this return 1st quarter payment (Line 24 divided by 4)........................................................ 25
$
TAX DUE
26. Enter balance due from line 16 above (no tax due if less than $5.01) ............................................................ 26
$
27. TOTAL TAX DUE. ADD LINE 25 AND LINE 26. PLEASE MAKE CHECKS PAYABLE TO CITY OF MARYSVILLE 27
$
If this return was prepared by a tax practitioner, check here if we may contact him/her directly with questions regarding the preparation of this return.
The undersigned declares that this return (and accompanying schedules) is a true, correct and complete return for the taxable period stated and that the figures used herein
are the same as used for Federal Income Tax purposes.
FOR TAX DIVISION USE ONLY
SIGNATURE OF PREPARER, IF OTHER THAN TAXPAYER
DATE
NAME AND ADDRESS OF PREPARER
TELEPHONE NUMBER
SIGNATURE OF TAXPAYER
DATE
SIGNATURE OF SPOUSE (IF JOINT RETURN)
TELEPHONE NUMBER

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