Original Tax Return - City Of Rittman, Ohio Department Of Taxation Page 2

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MANDATORY DECLARATION OF ESTIMATED TAX FOR NEXT YEAR IF MORE THAN $100.00
NAME______________________________________________________________________________________________
1. Estimated income subject to municipal tax $_____________multiply by tax rate______% Estimated tax ____________
2. LESS TAX TO BE WITHHELD
a. By Employer.....................................................................................$_______________
b. By an Employer in_____________(name of city (See Instructions) $_______________
c. Overpayment on previous year's return (Line 9).............................. $_______________
d. Total Credits (a, b, and c)............................................................... $_______________
3. Balance of Estimated Tax (Line 1 minus Line 2)..............................................................................$_________
4. First quarter estimate paid with this return (not less than 1/4 of Line 3).......................................... $_________
5. TOTAL ENCLOSED (AMOUNT DUE ON LINE 14 PLUS 1ST QUARTER ESTIMATE ON LINE 4)....$_________
Make remittance payable to City Of Rittman
___________________________________________
____________________________________
Signature of Preparer
Signature of Taxpayer

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