Form Ir-25 - City Income Tax Return For Individuals

IR-25

CITY INCOME TAX RETURN FOR

BEGINNING

FOR THE YEAR

ENDING

INDIVIDUALS

Your social security number

Name (Spouse’s Name) and Current Address

Filing Status - check only one

Single

Married-Filing Joint

Spouse’s social security number

Married-Filing Separate

•

Did you change residence during 2000?

YES

If YES, enter date of move

•

Should your account be inactivated?

YES

If YES, explain:

•

Did you file a City return in 1999?

YES

Employer(s) and address where work performed

GROSS WAGES

Part A

•Occupation or nature of business:

(+)

•Trade name:

(+)

•City of Residence

(+)

•City of Employment/Income #1

LESS FEDERAL FORM 2106

(-)

(if applicable - you must attach a copy)

•

City of Employment/Income #2

NET WAGES (enter in Column 2 below)

(=)

•

City of Employment/Income #3

ATTACH ALL FORMS W-2 AND APPLICABLE FEDERAL SCHEDULES AND/OR DOCUMENTATION

Part B

TAX CALCULATION

A Declaration of Estimated City Tax (form IT-21) is REQUIRED for all individuals whose tax is not fully withheld.

Income from wages, salaries, commissions, etc. list by city in which income was earned or services performed, otherwise list by city of residence. If this is your only source of taxable income, complete

Section A only to determine your tax. Taxpayers engaged in business should not complete Section A until after Sections B, C and D are completed.

Column 2

Column 3

Column 4

Column 5

Column 6

Column 7

Column 1

TAX

INCOME FROM WAGES,

INCOME FROM NET PROFITS,

LESS TAX WITHHELD (W-2)

TOTAL NET

TAX DUE

NET TAX DUE

RATE

CITY

SALARIES,

RENTS AND OTHER TAXABLE

OR PAID TO CITY WHERE

TAXABLE INCOME

COMMISSIONS, ETC.

INCOME

INCOME WAS EARNED

2.0%

COLUMBUS

1.65%

WORTHINGTON

2.0%

GROVE CITY

2.0%

GROVEPORT

2.0%

OBETZ

2.0%

CANAL WINCHESTER

1.0%

MARBLE CLIFF

1.0%

BRICE

(UFR)

1.0%

LITHOPOLIS

(UFR)

1.0%

HARRISBURG

*ALTERNATE CITY

*Columbus, Canal Winchester, Grove City, Groveport, Obetz and Worthington residents use alternate city line for additional tax due to city of residence as a result of having paid a lesser tax to city of employment

(be sure to indicate city and tax rate).

**NOTE: residents of Harrisburg and Lithopolis may only take credit for taxes paid or withheld to their resident city (Column 6). UFR = Universal Filing Requirement - residents must file a return.

1. TOTAL NET TAX DUE (TOTAL OF COLUMN 7).............................................................................................................................................................................

2. LESS CREDITS FOR DECLARATION PAYMENTS AND OVERPAYMENT FROM PRIOR YEAR RETURN ONLY (NOT W-2)

3. BALANCE DUE (LINE 1 LESS LINE 2). NO PAYMENT NECESSARY IF LIABILITY IS LESS THAN $1.00 ................................................................................

4. PENALTY: 10% $_____________ + INTEREST .75% PER MONTH $_____________ + LATE FEE $_____________ = .....................................................

(see instructions)

5. TOTAL AMOUNT DUE: REMITTANCE PAYABLE TO CITY TREASURER MUST ACCOMPANY THIS RETURN (ATTACH CHECK OR MONEY ORDER)

6. OVERPAYMENT CLAIMED (IF LINE 2 EXCEEDS LINE 1) ..............................................................................................................

A. Enter the amount from Line 6 you want CREDITED to your next year tax estimate.................................

B. Enter the amount from Line 6 you want REFUNDED (must be greater than $1.00)

Part C

INCOME FROM SOURCES OTHER THAN WAGES, SALARIES, COMMISSIONS, ETC.

(COMPLETE REVERSE SIDE OF FORM FIRST).

CITY

Column 8

Column 9

Column 11

Column 10

INSERT APPLICABLE CITIES

RENTAL INCOME (OR LOSS) FROM

TOTAL OTHER INCOME

INCOME (OR LOSS) FROM

OTHER INCOME FROM

BELOW

SCHEDULE E (PART I), PAGE 2

(OR LOSS)

SECTION C, PAGE 2 OR SCHEDULE Y

SCHEDULE E (PART II), PAGE 2

If net result of Column 11 is a loss, enter zero in Column 3 - See Instructions VIII

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 are the same as used for Federal income

tax purposes, and understands that this information may be released to the tax administration of the city of residence and the I.R.S.

Due on or before April 15th.

Signature of

See instructions for due date, penalty, interest and late filing fees.

Taxpayer:

Date:

NOTE: DO NOT SEND CASH THROUGH U.S. MAIL

Make checks payable to: City Treasurer

Signature of

Mail to:

Columbus Income Tax Division

Date: