Individual Tax Return Form - City Of Huber Heights - Division Of Taxation - 2016 Page 2
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2WORKSHEET A - SALARIES, WAGES, TIPS, AND OTHER COMPENSATION
(To be completed by taxpayers who receive W-2 income from more than one source)
**Attach copies of all W-2s used to compute your local income to this Return
Employer
City Where Employed
W-2 Wages – Box 5
Huber Heights Tax
Other City Tax
Withheld
Withheld Up to 2.25%
Totals (Enter Total W-2 Wages on Line 1, enter Huber
Heights tax withheld on Line 9a, enter other City tax
0.00
0.00
0.00
withheld on Line 9c) on Page 1.
WORKSHEET B - BUSINESS INCOME or LOSS
**Attach copies of all Federal Forms and Schedules used to compute your local income to this Return**
1.
NET PROFIT/LOSS FROM BUSINESS (SCHEDULE C) AND FARMING (SCHEDULE F)
a.
Total Business Income or (Loss) per Form 1040, line 12 (Attach all Federal Schedules C)
a.__________________
b.
Total Farm Income or (Loss) per Form 1040, line 18 (Attach all Federal Schedules F)
b.__________________
c.
Total (add a + b.)
c.__________________
0.00
d.
Percentage Taxable to Huber Heights (Full Year Resident enter 100%)
d.__________________
e.
Amount Subject to Tax (Multiply c. x d.)
Total Tax – B-1
e.__________________
0.00
f.
Tax Paid to Another City for Non W-2 Income (Not to Exceed Tax Rate of 2.25%)
f.___________________
g.
Percentage Credit Allowed by Huber Heights (Multiply f. x d.)
Total Credit – B-1
g.__________________
0.00
2.
SUPPLEMENT INCOME AND LOSS (Attach all Schedules E)
a.
Net Rental Income or (Loss)
a. __________________
b.
Net Income (Loss) from Partnerships, S Corporation, Estates and Trusts, Other
b. __________________
c.
Total Schedule E Income (Loss) (add a. + b.)
c. __________________
0.00
d.
Percentage Taxable to Huber Heights (Full Year Residents Enter 100%)
d. __________________
e.
Amount Subject to Tax (Multiply c. x d.)
Total Tax – B-2
e. __________________
0.00
f.
Tax Paid to Another City for Non-W-2 Income (Not to Exceed Tax Rate of 2.25%)
f.___________________
0.00
g.
Percentage of Credit Allowed by Huber Heights (Multiply f. x d.)
Total Credit – B-2
g.___________________
3.
TOTAL OTHER INCOME NOT INCLUDED ABOVE (Attach all Applicable Documentation)
a.
Total 1099-Misc Income not Included in Federal Schedule C
a. __________________
b.
Other (Explain)
b. __________________
c.
Amount Subject to Tax (Add a. + b.)
Total Tax – B3
c. __________________
0.00
4.
TAXABLE INCOME (Total B-1 + Total B-2 + Total B-3)
TOTAL Tax
__________________
0.00
(Note: If loss, the loss will be entered in the tax system and can be used within 5 years to offset similar (non W-2) income.)
5.
Credit Allowed for Non-W-2 Income (Total B-1 + B-2 + B-3)
Total Credit
___________________
0.00
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