Form Fr 1352 - Individual Income Tax Return Batavia - 2016

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FORM FR
1352
INDIVIDUAL - 2016
INCOME TAX RETURN
MAKE CHECK OR MONEY ORDER TO:
Taxpayer's Social
VILLAGE OF BATAVIA
Security No.
BATAVIA
HomeTelephone No.
BusinessTelephone No.
Due Date 04/18/2017
389 E Main St
Filing is required even if no tax is due
Batavia OH 45103
Spouse's Social
Include copies of all W-2 forms
Security No.
Federal Schedules are requested
Spouse's
Web address:
Name
Voice 513-732-2740 Fax 513-732-5696
HomeTelephone No.
BusinessTelephone No.
Filing Status
IF YOU HAVE MOVED DURING
Name
TAX YEAR - GIVE DATES
RESIDENT
Single
INTO
/
/
Married filing joint
NON-RESIDENT
And
Married filing separate
/
OUT OF
/
IF YOU RENT, PLEASE GIVE LANDLORDS INFORMATION
Address
NAME
ADDRESS
Income
1 Wages, salaries, tips,etc.
1
2 Other taxable income
2
3 Total taxable income (add lines 1 and 2)
3
Tax and Credits
4 Batavia tax due before credits (1.000% of line 3)
4
5 Estimated tax payments made to Batavia
5
6 Taxes withheld and paid to Batavia
6
7 Overpayment from prior year(s)
7
No credit for taxes paid to another city.
8 Total credits (add lines 5 through 7)
8
Refund
( Issued if greater than 10.00 )
9 If line 8 is greater than line 4, subtract line 4 from line 8. This is the amount you overpaid
9
10 Amount of line 9 to be credited to next years estimate
10
11 Amount of line 9 to be refunded
11
Tax Due
( if greater than 10.00 )
12 If line 4 is more than line 8, subtract line 8 from 4, this is the tax amount you owe
12
13 Penalties and interest
Late File __________
Late Pay __________
Late Estimate_______
Interest __________
13
Declaration of Estimate For 2017
14 Estimated income
14
15 Estimated tax due. Multiply line 14 by 1.000%
15
16 Taxes to be withheld and paid to Batavia
16
17 Prior credit applied to estimated tax payments (From line 10)
17
18 Net estimated tax due (subtract line 16 and 17 from 15)
18
19 Minimum amount due for first quarter (multiply line 18 by 25%)
19
Amount You Owe
20 Total amount due (add lines 12, 13 and 19)
20
Tax Office Use Only : Tax Office Use Only : Tax Office Use Only
The undersigned certifies that they have examined this return and any accompanying schedules and to the best of their knowledge it is
correct and complete.
Taxpayer's Signature
Date
Spouse's Signature
Date
Tax Preparer's Signature
Date
(If other than taxpayer)
Phone No.
May VILLAGE OF BATAVIA discuss this return with the preparer shown above ___Yes ___No

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