Individual Tax Return Form - 2016
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1
22016
PLEASE CHECK IF A
INDIVIDUAL TAX RETURN
CITY OF TOLEDO
(TOLEDO RESIDENTS ONLY)
REFUND
DIVISION OF TAXATION, ONE GOVERNMENT CENTER STE 2070, TOLEDO, OH 43604-2280
CREDIT TO 2017
PHONE 419-245-1662 • WEBSITE: EMAIL: INCOMETAX@TOLEDO.OH.GOV
AMENDED
RETURN DUE ON OR BEFORE APRIL 18, 2017
RETURNS NOT FILED/POSTMARKED BY THAT DATE ARE SUBJECT TO A LATE FILING FEE.
ACCOUNT #
FIRST NAME AND MIDDLE INITIAL
LAST NAME
PRIMARY SOCIAL SECURITY NUMBER
______________________________________________
_____________________________________
______________________________________
SPOUSE’S ACCOUNT #_____________ ____________________________
SPOUSE’S SOCIAL SECURITY NUMBER _____________________________
JOINT RETURN—SPOUSE’S FIRST NAME AND INITIAL
LAST NAME IF DIFFERENT THAN SPOUSE’S
_____________________________________________________________
______________________________________________________________
HOME ADDRESS NUMBER AND STREET
IF SPOUSE’S IS DIFFERENT LIST HERE
STREET _____________________________________________________
STREET ________________________________________________________
CITY ________________________STATE _________ ZIP ___________
CITY ___________________________
STATE _______ ZIP ____________
May we leave detailed message on phone or email
■
PHONE NUMBER _____________________________________________
EMAIL _________________________________________________________
DID YOU CHANGE RESIDENCE DURING 2016
YES
NO
IF YES ENTER DATES MOVED IN ____________ OUT _______________
■
■
Part year residents see instructions on how to enter income
SHOULD YOUR ACCOUNT BE INACTIVATED?
YES
NO
IF YES, EXPLAIN _______________________________________________
■
■
SHOULD SPOUSE’S ACCOUNT BE INACTIVATED?
YES
NO
IF YES, EXPLAIN ________________________________________________
■
■
OCCUPATION OR NATURE OF BUSINESS__________________________
TRADE NAME __________________________________________________
FILING STATUS
SINGLE INDIVIDUAL
MARRIED FILING JOINT RETURN
MARRIED FILING SEPARATE RETURNS
■
■
■
NAME OF SPOUSE (if filing separately) _______________________________________________________________________________________________
SOCIAL SECURITY NUMBER OF SPOUSE __________________________ SPOUSE’S TOLEDO ACCOUNT NUMBER _____________________________
ATTACH PAGE 1 OF FEDERAL FORM 1040 OR 1040EZ AND APPLICABLE FEDERAL SCHEDULES AND/OR DOCUMENTATION TO THE BACK OF THIS RETURN.
ATTACH W2’S WHERE INDICATED ALONG THE SIDE OF THIS RETURN FOR ALL CITIES WITH WITHHOLDING SHOWN.
PAYMENT OF CHECK OR MONEY ORDER (IF AN AMOUNT IS OWED), FOR CREDIT CARD INFORMATION VISIT OUR WEBSITE.
PART A
SECTION 1. COMPENSATION FROM WAGES – ATTACH W-2’S
(USE ADDITIONAL FORM IF NECESSARY FOR MORE W-2'S)
TAXPAYER
(A)
(B)
(C)
(D)
(E)
OR
NAME OF EMPLOYER
CITY WHERE EMPLOYED
TOLEDO TAX
OTHER CITY
GROSS WAGES (BOX 5)
SPOUSE
WITHHELD
TAX WITHHELD
OF W2 SEE INSTRUCTIONS
T or S
______________________________________________________________________________________________________________________________
______________________________________________________________________________________________________________________________
______________________________________________________________________________________________________________________________
______________________________________________________________________________________________________________________________
PART A SECTION 1
COLUMN TOTALS
................................................... (C) $ __________ (D) $ ______________________ (E) $ ________________
PART A
SECTION 2. UNREIMBURSED EMPLOYEE BUSINESS EXPENSES --SCHEDULE 2106
ADJUSTMENTS TO TOLEDO TAXABLE WAGES (ONLY USE THIS SECTION IF YOU HAVE UNREIMBURSED EMPLOYEE BUSINESS EXPENSES) (SEE
INSTRUCTIONS) if filing a joint return and both spouses have unreimbursed employee business expenses please see instructions for how to com-
bine and report those figures) You must attach a copy of your W2 Form, Schedule A and Form 2106 as filed from your Federal 1040.
1. Did you have tax withheld for another city on the income for which you are claiming unreimbursed employee business expenses? If yes, go to line 5b below
and see instructions for Worksheet computation; otherwise go to line 2
2. Enter total wages for the job for which you are claiming unreimbursed business expenses ....................................... 2. $ ______________________________
3. Enter business expenses from Federal Form 2106 ..................................................................................................... 3. $ ______________________________
4. Enter 2% of Federal Adjusted gross as shown on Schedule A of your Federal return ................................................ 4. $________________ ______________
5. a. Subtract line 4 from line 3 ....................................................................................................................................... 5. $ _____________________________
If line 5a is less than zero enter -0- otherwise enter on Part C line 12
5. b. Note: Toledo residents if you had other cities taxes withheld on this income use the 2106 Worksheet (Adjustment of Credit for Other Cities Withholding)
from instructions and attach it to back of this return when filing. Enter amount from 2106 Worksheet found in instructions (see website) $_________________
and also enter this amount on Part D line 27b
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