Form Co-12 - Corporation, Partnership Or Fiduciary Income Tax Return - 2012, Schedule X/schedule Y - Business Allocation Percentage Formula
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1
2THIS IS NOT A FEDERAL RETURN
Form CO-12
File this Return with the Mantua Income Tax Dept., P.O. Box 775,
(Tax Office Use Only)
Income Tax
Mantua, Ohio 44255, on or before April 15, 2013 or within 105 days
Processed by __________
Mantua, Ohio
after the close of a fiscal year.
Cash _______
(Tax Office Use Only)
Check _______
2012
2012
CORPORATION, PARTNERSHIP OR FIDUCIARY
Cashier's Stamp
Paid with this Return
INCOME TAX RETURN
Mantua, Ohio, Income Tax
$ _________
For Taxable Period from January 1, 2012 through December 31, 2012 or Fiscal Period
from _________________, 20_____, through _________________, 20_____.
Taxpayer's Name:_______________________________________ FEIN: ____________________________
Address:_____________________________________________
City/State/Zip:_________________________________________
NET INCOME COMPUTATION
COLUMN B
COLUMN A
Allocable to
.
As shown by
Mantua, OH
Federal Return
(*See Note)
.
.
1. Net Income per Federal Return. (Attach Copy)
$
$
.
.
2. Add items not deductible under Mantua Tax Ordinance (Schedule X)
$
$
.
.
3. Deduct items not taxable under Mantua Income Tax Ordinance (Schedule X) $
$
.
.
4. Adjusted Net Income
$
$
.
5. ________% (as determined by Schedule Y) of line 4,
$
X X X X X X
6. Less Allocable Net Loss per previous __________ income tax return
.
.
7. Amount Subject to Mantua Income Tax (line 5, Col. A or line 4, Col. B)
$
$
.
.
8. Mantua Income Tax, one and one-half per cent (1-1/2%) of line 6
$
$
9. Less: Payments made on account of Declaration of Estimated Mantua Income
.
.
$
$
Tax, or amount of tax paid on prior return IF this is an amended return
10. Unpaid Balance of Mantua Income Tax, which amount must be paid with
.
.
$
$
the filing of this return
.
.
11. Overpayment of Mantua Income Tax
$
$
12. Use "X" to indicate whether overpayment is to be refunded ______,
or applied against your 2013 Declaration _______.
No refund will be made until 2013 Declaration is filed. For amounts under $1.00 no tax due nor refund made.
*NOTE - If Business Allocation Percentage Formula (Schedule Y) is used, disregard Column B
CERTIFICATION
The undersigned Officer or Partner (or Chief Accounting Officer) of the Business for which this return is made,
declares that this return is to the best of his knowledge and belief, a true, correct and complete return.
___________________________
___________
___________________________
___________
(Signature of Firm or person, other
Date
(Signature of Taxpayer)
Date
than taxpayer, preparing return)
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