Form Sd-100 - School District Income Tax Return - 2001

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Mail to:
SD-100
2001
SCHOOL DISTRICT INCOME TAX
P.O. BOX 182389
COLUMBUS, OHIO 43218-2389
Social Security Number(s)
SCHOOL DISTRICT INCOME TAX RETURN
Must Be Filled In Below
Your first name
Initial
Last name
Your social security number
Filing Status—check only one
c
Single or Head of Household
If a joint return, spouse’s first name
Initial
Last name
Spouse’s social security number
c
Married filing joint return
c
Married filing separately, enter
Home address (number and street)
Apt. #
Ohio county
q
spouse SS# ______________
City, town or post office, state, and zip code
Enter the School District
School District Residency
c
1. Full-year resident
SD #
number for this return
Check one: Taxpayers must file a sepa-
c
2. Part-year resident of SD # at right (explain on back)
rate return for each school district affected
(see page 7 of booklet)
c
3. Nonresident of SD # at right (explain on back)
(see list and rates in SD-100 booklet).
,
,
.
Ohio adjusted gross income reported on line 3 of Ohio Form IT-1040 or IT-1040EZ.
0 0
1
1
If you filed your Ohio income tax by telephone, see instructions on page 2.
,
,
.
0 0
2
2
Part-year/nonresident income deduction (complete reverse side)
,
,
.
0 0
3
3
School district adjusted gross income (subtract line 2 from line 1)
,
.
0 0
4
4
Exemptions (multiply the number of your exemptions _____ times $1,150)
,
,
.
0 0
5
5
School district taxable income (subtract line 4 from line 3)
,
.
0 0
6
6
School district tax (multiply the amount on line 5 by the tax rate from SD-100 booklet: ___%)
.
0 0
7
7
Senior citizen credit ($50 limit per return)
,
.
0 0
8
8
School district tax less credit (subtract line 7 from line 6)
,
.
0 0
9
9
School district tax withheld (attached W-2’s must show and agree with SD number above)
,
.
0 0
10
10
SD-100ES ($
), SD-40P ($
), and 2000 credit carryover ($
)
,
.
0 0
11
11
Total payments (add line 9 and line 10)
,
.
0 0
12
12
If line 11 is less than line 8, subtract line 11 from line 8 and enter the
AMOUNT YOU OWE4
,
.
0 0
13
13
If line 11 is greater than line 8, subtract line 8 from line 11 and enter your overpayment
,
.
0 0
Enter the amount of school district overpayment on line 13 you want CREDITED TO 2002 4
14
14
4
,
.
0 0
15
15
Subtract line 14 from line 13 and enter the amount you want
REFUNDED
Make your check payable to School District Income Tax. If the balance due is less than $1.01, payment need not be made, and if the overpayment is less than $1.01, no refund will be issued.
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the
best of my knowledge and belief, it is true, correct, and complete.
FOR DEPARTMENTAL USE ONLY
________________________________________________________________________________________________________________
9a ______________________ U-______
Your signature
Date
_________________________________________________________________________________________________________
12a ______________________
______
Spouse’s signature (if filing jointly, both must sign, even if only one had income)
Telephone number (optional)
___________________________________________________________________________________________________________
Preparer’s signature and address

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