Income Tax Return - Village Of Brewster - 2015

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Village of Brewster Income Tax Return For the Calendar Year of 2015
Filing Deadline April 18, 2015
Name
SSN
Address
Spouse
SSN
PLEASE ATTACH APPLICABLE W-2 FORMS
Did you reside in Brewster all year?
Yes ____
No _____
If not, Move in date
/
/
,
Move out date
/ /
W-2 Income: List Gross Income by employer, attach all W-2’s
AMOUNT
_______________________________________________ ___________________
$ _______________
_______________________________________________ ___________________
$ _______________
_______________________________________________ ______________ _____
$ _______________
_______________________________________________ ______________ _____
$ _______________
Total (A)
$ _______________
Business, Professional and Rental Income: attach Federal Schedule C or E
_______________________________________________ ___________________
$ _______________
__________________________________________________________________
$ ______________
______________________________________________________________ ____
$ ______________
Total (B) $ ______________
C. Total Gross Income (A plus B) ……………………………………………………………..
(C) $ ______________
D. Total Brewster Income Tax Due (C times .0100) ………………………………..…
(D) $ ______________
E. Brewster Income Tax Withheld …………………………………………………………………
(E) $ ______________
F. Credit for Taxes Paid NOT TO EXCEED 1% PER W-2 ……………………………….
(F) $ ______________
G. Total Credits (E plus F) ……………………………………………………………………………..
(G) $ ______________
H. Tax Owed (D minus G) ……………………………………………………………………………..
(H) $ ______________
I. Amount Paid with Return ………………………………………………………………………….
(I) $ ______________
J. Interest (@ 2% per month for failure to timely pay, $25 min) ………………….
(J) $ ______________
Balanced Owed ……………………………………………………………………………………….
$ _________________
I hereby certify the above is true, correct and complete pursuant to the Brewster Ordinances and regulations.
Signed________________________________________________
Date ___________________
Signed________________________________________________
Date ___________________
Deliver or mail to: Village of Brewster Income Tax, 302 S. Wabash Ave., Brewster, Ohio44613
Income Tax Administrator Steve Hartman Phone (330)-767-4214 or 330-466-5254

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