FORM IR
FILE WITH
INDIVI DU AL
–
–
2011
READING EARNINGS TAX RETURN
2011
CITY OF READING
FEDERAL EXTENSION
INCOME TAX BUREAU
DUE ON OR BEFORE APRIL 15, 2012
1000 Market Street
COPIES MUST BE
Reading, Ohio 45215-3283
FILING IS REQUIRED EVEN IF NO TAX IS DUE
RECEIVED BY 4-15-12
(513) 733-0300
$25.00 FIRST YEAR / $50.00 SECOND YEAR /
FAILURE TO FILE:
FAX (513) 842-1016
$100.00 THIRD AND SUBSEQUENT YEARS
RETURNS WILL NOT BE PROCESSED WITHOUT ATTACHING APPLICABLE FORMS
TAXPAYER’S NAME & ADDRESS
SS# TAXPAYER ______________ SS# SPOUSE ______________
CURRENT EMPLOYER ___________________________________
ADDRESS ______________________________________________
_______________________________________________________
PHONE # HOME (____) ____________ WORK (____) ___________
IF YOU HAVE MOVED SINCE YOUR LAST FILING, GIVE DATE:
INTO READING ____/____/____ OUT OF READING ____/____/____
1. QUALIFYING WAGES - USE BOX 5 - MEDICARE WAGES - ON W2
(ALL W2S MUST BE ATTACHED) ________
$
_______________
2. OTHER TAXABLE INCOME AND/OR DEDUCTIONS FROM LINE 18 PAGE 2 – SEE INSTRUCTIONS ____________
$
_______________
NOTE: P
2
(
)
AGE
MUST BE COMPLETED IF YOU HAVE TAXABLE RENTAL PROPERTY
SCHEDULE E
OR BUSINESS INCOME
(
) (INTEREST, DIVIDEND, CAPITAL GAINS, UNEMPLOYMENT, AND RETIREMENT INCOME NOT
SCHEDULE C
TAXABLE)
NOTE: YOU MAY NOT OFFSET W2 INCOME WITH ANY SCHEDULE LOSS
3. TAXABLE INCOME: LINE 1 PLUS OR MINUS LINE 2 ________________________________________________
$
_______________
4. READING TAX: 2% [.020] OF LINE 3 _____________________________________________________________
$
_______________
5. CREDITS
a, TAX WITHHELD BY EMPLOYER FOR READING
______________________________
$ ____________
b. 2011 ESTIMATE TAX PAID TO READING
______________________________
$ ____________
c. 2011 TAX PAID CITY / VILLAGE OF __________________________________________
$ ____________
(NOT TO EXCEED 2% [.020] OF THAT PORTION TAXED PER W-2 – SEE INSTRUCTIONS
d. PRIOR YEAR OVERPAYMENTS
_____________________________________
$ ____________
$
______________
e. TOTAL CREDITS (add 5a thru 5d & enter here) __________________________________________________
______________
6. IF LINE 4 IS GREATER THAN LINE 5E, BALANCE MUST ACCOMPANY THIS RETURN - 2011 TAX DUE
7. OVERPAYMENT - REFUND $ ____________ OR CREDIT $ ____________ TO NEXT YEAR’S ESTIMATE (IF LINE
5e IS GREATER THAN LINE 4)
No taxes of less than $5.00 shall be collected or refunded (if your total tax liability is less than $5.00)
By Law, all Refunds & Credits in excess of $10.00 are being reported to the I.R.S. on 1099-G
DECLARATION OF ESTIMATED TAX FOR YEAR 2012
8. TOTAL INCOME SUBJECT TO TAX $ __________ MULTIPLY BY TAX RATE OF 2% [.020] FOR GROSS TAX OF
$
______________
9. LESS EXPECTED TAX CREDIT
a. TAX WITHHELD BY EMPLOYER FOR READING
______________________________
$ ___________
b. PAYMENT OR TAX WITHHELD FOR OTHER CITY ______________________________
$ ___________
$
______________
(NOT TO EXCEED 2% [.020] OF THAT PORTION TAXED)
10. NET TAX DUE FOR 2012 (LINE 8 MINUS LINE 9 TOTAL) ____________________________________________
$
______________
a. OVERPAYMENT FROM PRIOR YEAR (FROM LINE 7 ABOVE) ___________________________________
$
(_____________)
11. AMOUNT PAID WITH THIS DECLARATION (NOT LESS THAN ¼ OF LINE 10, LESS LINE 10a) ______________
$
______________
12. TOTAL OF THIS PAYMENT (LINE 6 PLUS LINE 11)_________________________________________________
$
______________
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.
TO PAY BY CREDIT CARD:
______________________________________________________
VISA:
__ __ __ __ / __ __ __ __ / __ __ __ __ / __ __ __ __
Signature of Taxpayer
Date
MASTERCARD:
__ __ __ __ / __ __ __ __ / __ __ __ __ / __ __ __ __
______________________________________________________
DISCOVER:
__ __ __ __ / __ __ __ __ / __ __ __ __ / __ __ __ __
Signature of Taxpayer
Date
EXP. DATE: ___ / ___
CV CODE: __ __ __ AMOUNT: $__________
______________________________________________________
______________________________________________________
Signature of Person Preparing if Other Than Taxpayer / Phone
Cardholder Signature