Form Br - Lordstown Income Tax Return printable pdf download

Form BR

File With

VILLAGE OF

LORDSTOWN

Income Tax Department

1455 Salt Spdngs Road, S.W.

' Lordstown, Ohio44481

FISCAL YEAR DATES

LORDSTOWN INCOME TAX RETURN

ORDINANCE NO. 41-77. EFFECTIVE DATEOF 7NN7

AMENDED ORDINANCE 65.91

FILING REQUIRED EVEN IF NO TAX DUE ON OR BEFORE APRIL 15

(330) 824-2627 . FAX: (330) 824-3703

PRINCIPAL BUSINESS ACTIVITY

CORPORANON N

PARTNERSHIP tr

SOLE PROPRIETOR tr

BENTAL PROPERW N

IF OTHER, EXPLAIN

BUSINESS TELEPHONE

FEDERAL I.D.#

IF YOU HAVE MOVED DURING CURRENT YEAR PLEASE GIVE DATE

MOVED IN

MOVED OUT

TOTAL INCOME FROM PAGE 2 OR ATTACHED COPIES OF FEDERAL RETURNS & SCHEDULES

.......

INCOME

ADJUST.

MENTS

INCOME

2a.

b .

3a.

b .

4 .

c .

o ,

ITEMS NOT DEDUCTIBLE

(FBOM LINE M SCHEDULE X IFROM PAGE 2D

...... ADD $

I T E M S N O T T A X A B L E ( F R O M

L I N E Z S C H E D U L E X

I F R O M P A G E 2 D

. . . . . . D E D U C T $

DIFFERENCE BETWEEN LINES 2a AND b TO BE ADDED TO OR SUBTRACTED FROM LINE 1 .. . . .

A D J U S T E D

N E T I N C O M E ( L I N E

1 P L U S O R M I N U S L I N E 2 c l F S C H E D U L E X

l S U S E D ) .

. . . , . . . . . . . :

AMOUNT OF LINE 3a ALLOCABLE ( -o/o

FROM LINE 5 SCHEDULE Y) . . . . .

A M O U N T S U B J E C T T O L O R D S T O W N

I N C O M E T A x ( L I N E 3 a O B 3 b )

. . . . . . . . . . . . . , , . . . . . . . .

LORDSTOWN TM 1O/O OF LINE 4 .. , . ,

CREDITS:

(a) PAYMENTS AND CREDITS ON PREVIOUS YEARS DECLARATION OF ESTIMATED TAX . . $

( b ) P R I O R Y E A R O V E R P A Y M E N T . .

. $ -

( c ) T A X E S P A I D O T H E R C O M M U N I T I E S

T O l o / c .

. . . . . $ -

(x) TOTAL CREDITS ALLOWABLE

. . . ( + o R - )

TAX DUE

TO NEXT YEAR ESTIMATE

lF LINE 5 GREATER THAN LINE 6x PAYMENT OF BALANCE MUST ACCOMPANY TH|S RETURN:

(Late Payment of Taxes Due Subject to Penalty and Int€rest)

8. OVEBPAYMENT

TO BE REFUNDED $

OR CREDITED $

9 .

1 0 .

DECLARATION OF ESTIMATED TAX FOR YEAR

TOTAL INCOI4E SUBJECT TO TAX $

LESS EXPECTED TAX CREDITS

MULTIPLY BY TAX RATE OF I% FOR GROSS TAX OF ....

A. OVERPAYMENT

FROM PRIOB YEAR(S)

B. OTHER (EXPLAIN)

c . T o T A L C R E D T T S

. . . . . . . .

1 1 . N E T T A X D U E ( L | N E I L E S S L | N E 1 0 C ) . . .

. : . . . : . . . . . . .

1 2 . F I R S T Q U A R T E R D U E W I T H T H I S D E C L A R A T I O N ( N O T L E S S T H A N T + O F L | N E 1 1 ) . . . .

. . . . .

1 3 . B A L A N C E O F E S T I M A T E D T A X D U E

. . . . " . . . . $

1 4 . r o r A L o F r H r s p A y M E N r ( L r N E T p L U s L ' N E 1 2 )

. . . . . . . . . . . . . . . . . . . . $ l i l i . ; t t i l i : f '

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, IF PREPARED BY A PERSON OTHER THAN TAXPAYER, THE DECLARATION

IS BASED ON ALL INFOR-

MATION OF WHICH PREPARER HAS ANY KNOWLEDGE.

Signature ot Taxpayer or Agent (Required)

Telophone Number

Titta, lf Signing for a Business

.Effi,ffi,H.

Signature ot Per$n Prsparing it Other Than Taxpayer

LORDSTOWNCOPY

Form Br - Lordstown Income Tax Return

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