Questionnaire - City Of Bowling Green, Ohio Income Tax Division

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CITY OF BOWLING GREEN, OHIO
W
INCOME TAX DIVISION
304 NORTH CHURCH STREET
BOWLING GREEN, OH 43402-2399
PHONE (419)354-6212
FAX (419)354-5122
e-mail:
Name:
-
Street Address:
City State Zip:
MEMO FROM THE TAX COMMISSIONER:
We want you to know that BG has a flat rate income tax of 1.92%. And everyone must file a tax return, unless the
lo
tax is properly withheld by a Bowling Green employer on all taxable income.
-
Please complete the questionnaire below and return to our office if you need to register with us to receive tax forms.
QUESTIONNAIRE
Where did you live before?
You have lived at current address since:
If you moved from a BG address to your current address, when did you move into your previous address?
City where you work:
Name of your employer:
Since:
Do you pay tax to another city?
Is that tax withheld?
Spouse's Name
Since:
Name of spouse's employer
Is that tax withheld?
City where spouse works:
Does spouse pay tax to another city?
Do you own all or part of a farm
business
or rental property
anywhere?
Aside from the income named above, pensions, military pay, interest and dividends, list other taxable income sources:
Other working members of this household, their social security number and their place of employment:
Sign
Your Social Security #
(First)
(Middle)
(Last)
Spouse's Social Security #
Telephone #
Please make any comments, or provide additional information, on the other side of this page. Thank you.

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