2010 Nonresident Refund Tax Return - City Of Cincinnati
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12010
Nonresident Refund Tax
Click on the fields below and type in
Return
your information. Then print the form
and mail it to our office.
City of Cincinnati
To Expedite Processing, Please Do Not Staple
Refund Desk: (513) 352-2558
THIS SPACE IS FOR OFFICIAL USE ONLY
Use this return if you were a nonresident or part-year resident of Cincinnati and you are filing for a
refund of taxes withheld by your employer.
Full-year residents should use the Resident Refund Tax Return.
805 Central Avenue Suite 600, Cincinnati, OH 45202-5799
Mail Completed Forms to: P.O. BOX 5489 CINCINNATI, OH 45201-5489
Account # _____________________
Social Security # _______________________
Name
Email: _________________________
Address
City/State/Zip
If your account information is incorrect, please show the correct information above and check this box.
Residency Status (Check Only One)
Nonresident
Part-year Resident ( From ___ /___/___ To ____/____/____)
Dayt
Address and city where the
work was performed
Daytime Telephone Number
Please complete both the address and daytime telephone number blocks.
W-2 Earnings
(Gross Wages, Tips, Salaries, Commissions and Other Compensation) Include copies of all W-2 forms
1.
$
If you have additional taxable income, please use our regular individual tax return.
$
2.
Less Unreimbursed Employee Business Expenses
{Include a copy of the Federal Form 2106 (EZ)}
$
3.
Adjusted Earnings
(LINE 1 MINUS LINE 2)
.
%
$
4.
Amount of Line 3 Allocable to Cincinnati from Schedule L-2-C
$
5.
Cincinnati Income Tax 2.1% (.021) Of Line 4
$
6.
Total Cincinnati Tax Withheld By Employers(s)
Total Income Taxes Paid To Another Municipality Or County
7.
$
(Part-year Residents Only)
$
8.
Total Taxes Paid
)
(ADD LINES 6 AND 7
$
Amount To Be Refunded
9.
(Less than $5 will not be refunded)
I CERTIFY THAT I HAVE EXAMINED THIS RETURN INCLUDING ACCOMPANYING SCHEDULES AND STATEMENTS AND TO THE BEST OF MY
KNOWLEDGE AND BELIEF IT IS TRUE, CORRECT AND COMPLETE AND THE FIGURES USED HEREIN ARE THE SAME AS FOR FEDERAL INCOME
TAX PURPOSES.
PAID PREPARER SIGNATURE
PTIN
SIGNATURE OF TAXPAYER
DATE
May the City Tax Division
discuss this return with the
NAME OF FIRM OR EMPLOYER
SIGNATURE OF SPOUSE
DATE
preparer shown to the left?
(
) YES
(
) NO
ADDRESS OF FIRM OR EMPLOYER
TELEPHONE NUMBER
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