Individual Tax Return Form - City Of Monroe - 2005
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2City of Monroe
Individual Tax Return
Income Tax Division
2005
P. O. Box 629
Monroe, Ohio 45050
OR
Phone: (513) 539 -7374
FISCAL PERIOD _______ TO _______
Fax: (513) 539 -6209
Calendar Year Taxpayers file on or before April 15
Website:
THIS SPACE IS FOR OFFICIAL USE ONLY
th
th
Fiscal Year Due on 15
Day of 4
Month After Year End
Spouse’ s Name __________________
Account Number:
Spouse’ s SSN ______ -____-_______
Phone Number ___________________
Part Year Resident From______ to _______
Did You File a Return Last Year?
IF INFORMATION ABOVE IS INCORRECT, PLEASE MAKE CORRECTIONS
YES
NO
Part A
Tax Calculation
(Attach front page of Federal Form 1040)
1.
Total Qualifying Wages (Attach W -2 Forms) For multiple W -2s complete Worksheet A on page 2………………
$
2.
Less Employee Deductions (Attach Form 2106)………………….………………………………………………………
$
3.
Taxable Wages Before Adjustment. (Line 1 minus Line 2)………………………………………………………………
$
4.
Less Nontaxable Income (part year or non -residents only) (provide calculations)…………………………………….
$
5.
Taxable Qualified Wages (Li ne 3 minus Line 4)………………………………………………………...…………………
$
Other Income or (Loss) From Federal Schedules C, E, F, K -1, 1099-MISC (See Worksheet B Line 6)
6.
$
(Attach copies of all Federal Schedules) ………………………………………………………………………………..
7.
Monroe Taxable Income (Li ne 5 plus Line 6) Losses on Line 6 do not offset W -2 Income from Line 5 ………...
$
8.
Monroe Income Tax (Multiply Line 7 by 1% [.01])………………………………………………………………….……...
$
9 a.
Monroe Tax Withheld (per W -2s)…………………………………………...
$
9 b.
Estimates Paid (including credit from previous year)……………………..
$
9 c.
Other Local Taxes Paid (Allowed up to 1% credit)………………..………
$
10.
Total Payments and Credits (Lines 9a + 9b + 9c)…….…………………………………………………………………..
$
11.
Tax Due (Subtract Line 10 from Line 8)………………………………………………… ………………………………….
$
12.
Overpayment (Line 10 greater than Line 8)………………………………..
$
13.
Amount to be Refunded
$
(Amounts less than $5.00 will not be refunded)……...
14.
Credit to Next Year…………………………………………………………...
$
Part B
Declaration of Estimated Ta x for 2006
15.
Total estimated income subject to tax………………………………………………………………………………………
$______________________
16.
Monroe Income Tax Declared (Multiply Line 15 by 1% [.01])…………………………………………………….………
$______________________
17.
Estimated Taxes Withheld from Wages…………………………………………………………………………………….
$______________________
18.
Tax due after Withholding (Line 16 less Line 17) STOP if this amount is less than $0.00..…………………………..
$______________________
19.
Declaration Due (25% of Line 18)…………………………………………………………… ……………………………...
$______________________
20.
Less credits (from Line 14 above)…………………………………………………………………………………………...
$______________________
21.
Net estimated tax due if Line 19 minus Line 20 is greater than zero* …………………………………………………...
$______________________
22.
TOTAL AMOUNT DUE —Combine Line 11 above with Line 21 (
)
$______________________
Make checks payable to the City of Monroe
$
*Subsequent estimated payments are due by the 15th of June, September and December .
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.
SIGNATURE OF TAXPAYER
SIGNATURE OF PERSON PREPARING IF OTHER THAN TAXPAYER
DATE
DATE
SIGNATURE OF SPOUSE
NAME AND ADDRESS OF PREPARER
PHONE NUMBER
DATE
q
Check here if we may contact the above preparer with questions regarding the preparation of this return.
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