Worksheet W-2 - Wage And Tax Statement - City Of Amherst - 2003

CITY OF AMHERST

2003

INCOME TAX DEPARTMENT

(440) 988-4212 FAX (440) 988-3749

480 PARK AVENUE, AMHERST, OH 44001

DUE DATE APRIL 30, 2004

FOR INCOME TAX DEPARTMENT USE ONLY

OR

FISCAL YEAR FILERS MUST FILE ON OR BEFORE THE 30TH DAY OF

TAX

AUD

THE FOURTH MONTH AFTER THE CLOSE OF THAT FISCAL YEAR.

FISCAL PERIOD______TO______

INT

CASH

PEN

CK NO.

TOTAL

PAID

DUE

CR TO 2004

REFUND

FULLY RETIRED WITH NO EARNED INCOME

Date

IF YOU MOVED DURING THE TAX YEAR, COMPLETE THIS BLOCK

Date moved into Amherst

Previous Address

Your Name and Address as they appear on our records: Make any Necessary Corrections

Date moved out of Amherst

Your Social Security No. or Federal ID

Spouse’s Social Security No.

Present Address

W-2 WORKSHEET

SEE INSTRUCTIONS BEFORE COMPLETING

COLUMN 1

COLUMN 2

COLUMN 3

COLUMN 4

COLUMN 5

GROSS WAGES–HIGHEST

2106 EXPENSES, REDUCES

OTHER CITY TAX WITHHELD LIMIT 1%

CITY WHERE EMPLOYED

AMHERST TAX WITHHELD

WAGE ON W-2

CREDIT ALLOWED IN COL. 5

OF COL. 2 MINUS COL. 3

A.

B.

C.

D.

E. TOTALS

ATTACH A COPY OF 1040 (1ST PG. ONLY), ALL APPLICABLE W-2S, FEDERAL SCHEDULES, EXPLANATIONS ETC…

INCOME

1. Total W-2 wages from column 2 ................................................................................................................1 $

2. 2106 Expenses from column 3 ..................................................................................................................2 $

3. TAXABLE WAGES. SUBTRACT LINE 2 FROM LINE 1

........................................................................3 $

4. Other income. From schedule C, E or H on reverse ................................................................................4 $

5. TOTAL AMHERST INCOME. ADD LINES 3 AND 4

..............................................................................5 $

TAX

6. AMHERST INCOME TAX. MULTIPLY LINE 5 BY 1-1/2% (.015) ..............................................................6 $

7. Amherst income tax withheld from column 4 ..............................................7 $

TAX

8. Prior year credits..........................................................................................8 $

WITHHELD,

9. Estimated payments ....................................................................................9 $

PAYMENTS

10. Credit for taxes withheld to other cities from column 5..............................10 $

AND

11. Credit for taxes paid to other cities (limit 1%). See instructions ..............11 $

CREDITS

12. TOTAL PAYMENTS AND CREDITS. ADD LINES 7 THROUGH 11 ............

12 $

13. BALANCE DUE. If line 6 is more than 12, enter balance due here ......................................................13 $

BALANCE

14. Late Filing Penalty. $25, if applicable ......................................................................................................14 $

DUE,

15. Interest. 1-1/2% per month, if applicable ................................................................................................15 $

REFUND

16. TOTAL DUE. Add lines 13 through 15. Carry to line 26 below (No tax due if less than $3.00)..............16 $

OR

17. OVERPAYMENT. If line 6 is less than line 12, enter overpayment here ..17 $

18. AMOUNT FROM LINE 17 TO BE REFUNDED

....18 $

CREDIT

(No refund if less than $3.00)

19. AMOUNT FROM LINE 17 TO BE CREDITED TO NEXT YEAR................19 $

DECLARATION OF ESTIMATED TAX FOR 2004 (NOT MANDATORY)

ESTIMATE

20. Total estimated income subject to tax $

Multiply by tax rate of 1-1/2% (.015) ..............20 $

21. Subtract any estimated income tax to be withheld or paid to other cities ..............................................21 $

FOR

22. Balance of city income tax declared. Subtract line 21 from line 20 ........................................................22 $

NEXT

23. Tax due before credits. Enter at least 25% of line 22 ..............................................................................23 $

YEAR

24. Less credits. Enter line 19 from above ....................................................................................................24 $

25. Net estimated tax due. Subtract line 24 from line 23 ..............................................................................25 $

26. Enter balance due from line 16 above (No tax due if less than $3.00) ..................................................26 $

TAX DUE

27. TOTAL TAX DUE. ADD LINES 25 & 26. PLEASE MAKE CHECKS PAYABLE TO AMHERST INCOME TAX DEPT. ..............27 $

If this return was prepared by a tax practitioner, check here if we may NOT contact him/her directly with questions regarding the preparation of this return.

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.

SIGNATURE OF PREPARER, IF OTHER THAN TAXPAYER

DATE

SIGNATURE OF TAXPAYER

DATE

NAME AND ADDRESS OF PREPARER (PLEASE PRINT)

TELEPHONE NUMBER

SIGNATURE OF SPOUSE (IF JOINT RETURN)

TELEPHONE NUMBER