Income Tax Return Form - Springfield Income Tax Division

CITY OF SPRINGFIELD

2007 INCOME TAX RETURN

DIVISION OF TAXATION

Due by April 15, 2008

P.O. Box 5200

SPFLD, OH 45501

eld.oh.us

Telephone: (937) 324-7357

INDIVIDUAL FILING ONLY

Fax: (937) 328-3471

If you moved during the year: Date moved in

moved out

If you moved during the year: Date moved in

moved out

Former Address

Telephone

PART A

I AM NOT REQUIRED TO FILE

SEE INSTRUCTIONS I AM NOT REQUIRED TO FILE

SEE INSTRUCTIONS

STATE REASON

TAXPAYER

SPOUSE

ACCT #

PART B

ATTACH W-2’S AND FEDERAL SCHEDULES ON REVERSE SIDE

INCOME

1. $

TOTAL WAGES AND COMPENSATION (See W2 Sample)

1. $

TOTAL OTHER INCOME (From Worksheet B on reverse side, Not Less Than -0-)

NET ADJUSTMENTS (From Worksheet C on reverse side)

TOTAL TAXABLE INCOME (Add lines 1 through 3)

5. $

SPRINGFIELD CITY TAX - 2% (Multiply line 4 by .02)

5. $

PAYMENTS AND CREDITS

6. $

ESTIMATED PAYMENTS / PRIOR YEAR OVERPAYMENT CREDIT

6. $

WITHHELD FOR SPRINGFIELD (From W-2)

OTHER CITY TAX CREDIT OR J.E.D.D. TAX CREDIT (From Worksheet D on reverse side)

TOTAL PAYMENTS AND CREDITS (Add lines 6 through 8)

10. $

BALANCE OF TAX DUE (line 5 minus line 9)

10. $

11. $

OVERPAYMENT

11. $

_____ CREDIT TO 2008 _____ REFUND

OFFICE USE ONLY

PART C

The undersigned declares that this return (and accompanying schedules) is a true, correct and complete return for the taxable period stated and that the figures used herein are the

same as used for Federal Income Tax purposes, and if an audit of Federal return is made which affects tax liability shown on this return, an amended return will be filed within 3 months.

TAXPAYER

(Date)

SPOUSE

(Date)

Social Security Number

Preparer’s signature (other than taxpayer)

(Date)

Address (and Zip Code)

F.E.I.N. or Soc. Sec. No.

If this return was prepared by a tax practitioner, may we contact your practitioner directly

with questions regarding the preparation of this return?

YES