Form R - Income Tax Return - City Of Ontario
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1
2Form R
CITY OF ONTARIO
INCOME TAX RETURN
File with
Make Check or Money
FILING REQUIRED EVEN IF
Order
NO TAX DUE
City of Ontario Income Tax
For the Calendar Year
Payable to:
P.O. Box 166
Or Fiscal Period
City of Ontario
Ontario, Ohio 44862
To
th
On or before April 15
or 3 ½ months
TELEPHONE: Home_____________________________
NAME OF EMPLOYER________________________________
Business____________________________
ADDRESS: Street _____________________________________
City_____________________________________
TAXPAYERS NAME AND ADDRESS
ACCOUNT NO._______________________________________
-----
SOCIAL SECURITY NUMBER
TAXPAYER________________________________________
SPOUSE___________________________________________
IF MOVED SINCE THE PREVIOUS FINAL RETURN WAS DUE GIVE DATE:
INTO CITY________________________ OR OUT OF ________________________
As long as all W-2’s and a copy of your Federal Return are attached you do not need to fill out this form past this line
Note: Page 2 must be completed if you have taxable rental property or business income.
1.WAGES, SALARIES, TIPS AND OTHER EMPOYEES COMPENSATION (ATTACH ALL W-2’s)……….. $_____________
2. OTHER TAXABLE INCOME OR DEDUCTIONS FROM PAGE 2……………………………………………$_____________
3. TAXABLE INCOME: LINE 1 PLUS LINE 2……………………………………………………………………$_____________
4. MUNICIPAL TAX
1.00 % of line 3 ………………………………………………………………………….$_____________
5. CREDITS:
A.
TAX WITHHELD BY EMPLOYER……………………………………..$________________
B.
ESTIMATED TAX PAID…………………………………………………$________________
C.
CREDIT FOR TAXES PAID TO OTHER CITIES………………………$________________
D.
PRIOR YEAR OVERPAYMENTS……………………………………….$________________
E.
OTHER CREDITS………………………………………………………..$________________
F.
TOTAL CREDITS………………………………………………………. $________________
6. TAX DUE (IF LINE 4 IS GREATER THAN LINE 5F, PAYMENT OF BALANCE
MUST ACCOMPANY THIS RETURN). ………………………………………………………….……………$________________
7. PENALTY……………….$_________________
PLUS INTEREST……$_____________
$________________
8.AMOUNT DUE BEFORE ESTIMATED TAXES……………………………………………………………….$
9. OVERPAYMENT: REFUNDED… $_________________
OR CREDITED TO EST. TAXES………….$_______________
DECLARATION OF ESTIMATED TAX FOR YEAR
10 .INCOME SUBJECT TO TAX….$____________ TIMES TAX RATE OF 1.000 FOR GROSS TAX OF __________________
11. LESS EXPECTED TAX CREDITS:
A.
TAX WITHHELD BY EMPLOYER……………………………………………..$________________
B.
PAYMENTS ON TAXABLE INCOME TO ANOTHER MUNCIPALITY…….$________________
C.
TOTAL CREDITS………………………………………………………………...$________________
12. NET TAX DUE (LINE 10 LESS LINE 11C)……………………………………………………………………$_______________
A.
OVERPAYMENT FROM PRIOR YEAR(S)…… ……………………………………………..…….…..$_______________
13. AMOUNT PAID WITH THIS DECLARATION (1/4 LINE 12, LESS LINE 12A)……………………………$_______________
14. BALANCE OF ESTIMATED TAX.. ………………………………………….…………..$______________
DE
Total Amount Due $_____________________ (Line 8) + $________________ (Line 13) =
I certify that I have examined this return (including accompanying schedules and statements) and to the best of my knowledge and
belief, it is true, correct & complete. If prepared by person other than taxpayer, the declaration is based on all information of which
preparer has any knowledge.
_____________________________________________________
_____________________________________________
Signature of Preparer
Date
Signature of Taxpayer
Date
____________________________________________
Signature of Taxpayer
Date
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