Form 37a - Individual Income Tax Return Page 2
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2*FORM37AF03B*
DECLARATION OF EXEMPTION
FORM37AF03B
DECLARATION OF EXEMPTION
I AM NOT REPORTING TAXABLE INCOME BECAUSE:
1.
I had NO TAXABLE INCOME for the entire tax year of 2003.
(please attach a copy of page 1 of your 2003 Federal Form 1040 EZ, 1040 A, or 1040)
2.
I was a member of the ARMED FORCES of the United States and had no other taxable income the entire tax year of 2003.
3.
DATE OF BIRTH
I was under 18 for the entire tax year of 2003.
(see special notes)
MO
DAY
YR.
4.
I am a RETIRED individual, receiving only pension, social security, interest or dividend income for all of 2003.
RETIREMENT DATE
MO
DAY
YR.
5.
Prior to January 1, 2003, I moved from a RITA municipality.
DATE OF MOVE
Previous Address
MO
DAY
YR.
Address
City
State
Zip Code
DATE OF DEATH
6.
Taxpayer is DECEASED
MO
DAY
YR.
7.
I am FILING JOINTLY with spouse
SPOUSE NAME
SPOUSE SOCIAL SECURITY NUMBER
SPECIAL NOTES:
ARLINGTON HEIGHTS
MOGADORE
- Individuals under 16 years of age are exempt
- Full-time post secondary education students may
AVON LAKE
be eligible for a tax credit.
NEWTOWN
- Individuals under 16 years of age are exempt
GARFIELD HEIGHTS
- Under 18 exemption does not apply
OAKWOOD
- Individuals 62 years of age and older are entitled to a wage
exemption
- Full-time high school or undergraduate college stu-
LAKEWOOD
dents working within the State of Ohio are exempt
OTTAWA
- Full-time college students who do not reside within the city
more than 16 weeks per year are exempt
- Individuals under 19 years of age and earning no
LOCKLAND
more than $600.00/yr. are exempt
REYNOLDSBURG
- Under 18 exemption does not apply
- Individuals 65 years of age or older on December 21, 2003
- Income of the mentally retarded or developmentally
with gross taxable income of $1,200.00 or less are exempt
disabled while working for less than minimum wage
MARYSVILLE
is exempt
RIVERSIDE
- The first $1,000.00 of income earned by the mentally
retarded or developmentally disabled while working for less
- Under 18 years of age exemption does not apply
SAINT PARIS
than minimum wage is exempt
MILFORD CENTER
- Under 18 years of age exemption does not apply
SHEFFIELD LAKE
- Students under 19 years of age are exempt
- The first $1,000.00 of income earned by the mentally
- Individuals under 16 year of age are exempt
WINTERSVILLE
retarded or developmentally disabled while working for less
than minimum wage is exempt
- Under 18 years of age exemption does not apply
YELLOW SPRINGS
-Individuals under 16 years of age are exempt
Page 2
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