Form Ir - Income Tax Return - City Of Springdale

FORM IR (RESIDENT)

DUE ON OR BEFORE

DID YOU HAVE W-2 INCOME?

APRIL 15, 2010

DID YOU OWN RENTAL PROPERTY?

FILE WITH

DID YOU PARTICIPATE IN A BUSINESS,

PARTNERSHIP OR S-CORPORATION?

SPRINGDALE TAX COMMISSION

FILING REQUIRED EVEN IF NO TAX IS DUE

11700 SPRINGFIELD PIKE

IF YOU ARE A NEW RESIDENT, FILING FOR THE FIRST TIME OR

SPRINGDALE, OHIO 45246

HAVE MOVED SINCE THE LAST FILING DATE, PLEASE FURNISH

LATE FILING WILL RESULT IN PENALTY AND INTEREST CHARGES

PHONE (513) 346-5715

CURRENT ADDRESS, MOVE IN OR MOVE OUT DATE AND

COMPLETE LINE 20B

FAX (513) 346-5756

EXTENSION REQUEST MUST BE RECEIVED BEFORE THE DUE DATE

MOVE IN:

_________________________________

ACCOUNT NO.

A FEDERAL EXTENSION DOES NOT AUTOMATICALLY APPLY TO SPRINGDALE

MOVE OUT: ________________________________

TAXPAYER NAME(S) AND ADDRESS

(CORRECT IF NECESSARY)

SOCIAL SECURITY NO.(S)

OFFICE USE ONLY

LOCAL TELEPHONE NO.

2009 SPRINGDALE TAX RETURN

Did you file a Federal 1040? Yes _____ (Attach Copy Page 1)

OFFICE USE ONLY

No _____ (Circle Reason) Federal Extension / Retired / No Income / Other (explain)____________________

$____________ __________

1. W-2 QUALIFYING WAGES (USUALLY BOX 5 OF W-2) (ATTACH W-2 FORM(S) AND PAGE ONE OF THE FEDERAL 1040)……………….

$____________ __________

2. OTHER INCOME OR DEDUCTIONS FROM LINE 21 OF PAGE 2 (ATTACH DOCUMENTATION AS NOTED ON PAGE 2)………………………………………………………………………………

$____________ __________

3. TAXABLE INCOME (LINE 1 PLUS OR MINUS LINE 2) ………………………………………………………………………………………………………………………………………………………..

$____________ __________

4. SPRINGDALE TAX (1.5% of LINE 3)……………………………………………………………………………………………………………………………………………………………………………………

5. TAX PAYMENTS AND CREDITS (REFLECTED THRU JAN. 7)

__________

A. TOTAL TAX WITHHELD BY EMPLOYER(S) FOR THE CITY OF SPRINGDALE - FROM W-2(S)…………………………………………………………………

$____________

__________

B. 2009 ESTIMATED TAX PAID TO THE CITY OF SPRINGDALE………………..….….…………………………………………………….

$____________

__________

C. TOTAL CREDIT FOR TAX PAID TO ANOTHER CITY - FROM WORKSHEET "B" ON PAGE 2….…..…...........................................................

$____________

__________

D. PRIOR YEAR TAX OVERPAYMENT ………………………...……..……….................................................................$____________

$(__________) (__________)

E. TOTAL TAX PAYMENTS AND CREDITS (ADD LINES 5A THROUGH 5D)…………………………….…………………..…………………..

$___________ __________

6. IF LINE 4 IS GREATER THAN LINE 5E, ENTER THE DIFFERENCE ON THIS LINE…….…...…….… 2009 TAX DUE APRIL 15, 2010

$___________ __________

7. IF LINE 5E IS GREATER THAN LINE 4, YOU MUST MARK THIS BOX FOR A REFUND OR

REFUND

$___________

CREDIT WILL BE APPLIED TOWARD 2010 ESTIMATED TAX……………….....…..…...……....………….………...............2010 CREDIT

NOTICE: NO TAXES OR REFUNDS OF LESS THAN $3 SHALL BE COLLECTED OR REFUNDED.

DECLARATION OF 2010 ESTIMATED INCOME TAX (THIS SECTION IS REQUIRED TO BE COMPLETED)

FAILURE TO PAY 70% OF YOUR 2010 ESTIMATED TAX BY JANUARY 31, 2011 MAY RESULT IN PENALTY AND INTEREST CHARGES.

$____________ __________

8. ESTIMATED 2010 INCOME SUBJECT TO TAX $___________________ MULTIPLY BY 1.5% = 2010 ESTIMATED TAX………………………

$(__________) (__________)

9. ESTIMATED 2010 CREDIT FOR TAX PAID TO A CITY AND/OR WITHHELD BY EMPLOYER(S) (not to exceed line 8)…………………………………………

$_____________ __________

10. ESTIMATED 2010 TAX DUE AND PAYABLE BY JANUARY 31, 2011 (LINE 8 MINUS LINE 9)……………………………………………………………………………………………………….

$___________

11. AMOUNT PAID WITH THIS DECLARATION, NO LESS THAN 1/4 OF LINE 10 (reduced by line 7 credit above)…………………………………………………………………………………………

OFFICE

RETURN FILED

_________ MONTHS LATE

INTEREST DUE $___________________

PENALTY DUE $____________________

USE

70% TAX PAID

_________ MONTHS LATE

INTEREST DUE $___________________

PENALTY DUE $____________________

ONLY

TOTAL PENALTY AND INTEREST DUE……………………………………………………………………………………………………………………………………………………………

12.

TOTAL TAX, PENALTY AND INTEREST DUE……………………………………………………………………………………………………………………………………………………

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 AND COMPLETE. IF PREPARED BY A

PERSON OTHER THAN THE TAXPAYER, THE DECLARATION IS BASED ON ALL INFORMATION OF WHICH PREPARER HAS ANY KNOWLEDGE.

TO PAY BY CREDIT CARD

: ENTER NUMBER, EXPIRATION DATE FULLY AND ACCURATELY.

MUST BE SIGNED BY THE CARDHOLDER.

__I__I__I__I__I__I__I__I__I__I__I__I__I__I__I__I__I

SIGNATURE OF TAXPAYER OR AGENT (REQUIRED)

DATE

__I__I__I__I__I__I__I__I__I__I__I__I__I__I__I__I__I

SIGNATURE OF PERSON PREPARING IF OTHER THAN TAXPAYER

DATE

__________/___________________$_____________

ADDRESS

TELEPHONE NO.

_______(H)_______________(W)________________

____________________________________________

MAY WE DISCUSS THIS RETURN WITH THE PREPARER?

Yes

Form Ir - Income Tax Return - City Of Springdale - 2009

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