Form 37b - Individual Income Tax Return - 2010
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37B
Regional Income Tax Agency
Cleveland
800.860.7482
2010
RITA Individual Income Tax Return
Columbus
866.721.7482
For use by taxpayers who did not move, have only
Youngstown
866.750.7482
W-2 income, and live in full credit municipalities
TDD
440.526.5332
Filing Status:
Your social security number
Spouse’s social security number
Single or Married Filing Separately
3
Joint
2
1
Your first name and middle initial
Last name
If you have overpaid, indicate your choice:
Refund
Credit
3
2
1
If a joint return, spouse’s first name and middle initial
Last name
If this is an amended return, check here:
If you are exempt from filing, check this
Current home address (number and street)
Apt #
box and complete the back of this form:
RITA’s e-File
City, state, and ZIP code
Easy, Fast, Free & Secure
Daytime phone number
Municipality you lived in for the tax year
Section A
In Column A, put the actual name of the municipality (city or village) in which you or your spouse physically worked. If you did not work in a
municipality, enter “None” in Column A. DO NOT enter school district tax in Column E.
Column A
Column B
Column C
Column D
Column E
Column F
Tax Due Before
Allowable Credit for
Local/City Tax
Workplace Municipality
Wages
Tax Rate
Withholding
Tax Withheld
(Name of city or village where
(Greater of Box 1, 5 or
of resident
Withheld
Multiply Column B times
Lesser of
you worked)
18 from W-2)
municipality
By Employer
Column C
Column D or Column E
Enter the total of Column B on Line 1 below, and enter
Totals
the total of Column F on Line 3 below.
Stop here if you do not expect to owe tax, you had only W-2 income, and you want RITA to complete your return for you.
STOP
Sign below and mail this return to RITA with copies of your W-2s. If we determine that you owe tax, you will receive a bill for the tax
due plus any penalty and interest due for late payment. Due to processing volumes, there may be a delay before the bill is issued.
Section B
1
Total W-2 wages from Section A, Column B
1
2
Tax due before withholding. Multiply Line 1 by the tax rate of your resident municipality from the tax
2
table. Enter the tax rate of your resident municipality here:
%
3
3
Total credit allowable for withholding from Section A, Column F
4
Tax due after withholding (Subtract Line 3 from Line 2). If less than zero, enter -0- and see the
4
instructions about filing a Form 10-A to claim your refund
5
5
2010 estimated tax payments made to RITA by check, credit/debit card, or e-payment
6
6
Credit carried forward from 2009
7
Total estimated tax payments and credit carryovers (add lines 5 & 6)
7
8
Balance due. If line 7 is less than line 4, subtract line 7 from line 4
8
9
Amount to be Credited. If Line 7 is greater than line 4 and you want a credit, subtract Line 4 from
Line 7. You may not split an overpayment between a credit and a refund.
9
10
Amount to be Refunded. If Line 7 is greater than line 4 and you want a refund, subtract Line 4 from
Line 7. You may not split an overpayment between a credit and a refund. Allow 90 days
10
11
Enter 2011 estimated tax in full. If left blank, RITA will calculate for you.
11
12
Enter full estimate from Line 11 or first quarter estimate (1/4 of line 11) less credit, if any, from line 9
12
13
TOTAL DUE by April 18, 2011. Add Lines 8 and 12. Make check payable to R.I.T.A.
13
Under penalties of perjury, I declare that I have examined this return, and to the best of my knowledge and belief, it is
Mail with payment and W2s to:
true, correct, and accurately lists all amounts and sources of municipal taxable income I received during the tax year.
Regional Income Tax Agency
PO Box 94652
Cleveland, OH 44101-4652
Mail with W2s & without payment to:
Your Signature
Date
Preparer’s Signature
Date
Regional Income Tax Agency
PO Box 94653
Cleveland, OH 44101-4653
Spouse’s Signature if a joint return
Date
Preparer’s Address
Id Number
May RITA discuss this return with the preparer shown above?
Yes
No
Preparer Phone #:
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