Income Tax Return Form - Massillon Tax Department - 2004
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1
2File this return with MASSILLON TAX DEPARTMENT on or before April 15, 2005 or within
MAKE CHECK OR MONEY ORDER
TAX OFFICE USE ONLY
4 months after close of a fiscal year or period. Requests for extensions must be submitted
PAYABLE TO:
in writing and filed on or before April 15, 2005 or Fiscal Deadline.
“CITY OF MASSILLON”
PROCESSED
City of Massillon, Ohio Income Tax Return
One James Duncan Plaza SE
BY:
P.O. Box 910
For Calendar Year ending December 31, 2004, or
Massillon, OH 44648-0910
2004
Phone (330) 830-1709
CASH
VISA
MC
Fax (330) 830-2687
for the
months ending
CHECK
M/O
FIN
Indicate Filing Status:
Corporation
S Corporation
Partnership
Other
Principal Business Activity:
CORPORATE RETURN
Is the business entity a resident
(
) Yes
(
) No
Moved INTO MASSILLON on
PREV. ADDRESS
OR Moved OUT OF MASSILLON on
PRESENT ADDRESS
PRINT NAME AND ADDRESS IF MISSING (indicate changes)
PHONE (
)
FAX (
)
FILING REQUIRED EVEN IF NO TAX DUE OR NET OPERATING LOSS
1.
Massillon Taxable Income (Page 2 Line 6)
1. $
2.
Massillon City Tax (1.8% of Line 1)
2. $
3.
CREDITS
3(A) Municipal tax paid to other cities
3A. $
3(B) Payment of Declaration of Estimated Tax
3B. $
3(C) TOTAL CREDITS (A plus B)
3C.$
BALANCE DUE (If Line 2 exceeds Line 3C enter difference here)
4. $
4.
Overpayment claimed (If Line 3C exceeds Line 2)
5.
5. $
6.
Credit to 2005 Estimate (If no Estimate due use Line 7)
6. $
7.
TO BE REFUNDED (If Estimate due, use Line 6)
7. $
8.
LATE FILING PENALTY - ENTER $25.00 FINE
8. $
9.
INTEREST - 1% PER MONTH - EFFECTIVE THE FIRST DAY OF EACH MONTH
9. $
10. $
10.
LATE PAYMENT PENALTY - 1% PER MONTH FOR 1st SIX MONTHS - 1.8% PER MONTH THEREAFTER
MUST BE PAID IN FULL WITH THIS RETURN
11.
Total amount due -
11. $
NO TAXES OF LESS THAN $5.00 SHALL BE COLLECTED OR REFUNDED
MANDATORY DECLARATION OF ESTIMATED TAX FOR 2005
1.
TOTAL INCOME SUBJECT TO MASSILLON TAX $
MASSILLON TAX @ 1.8%
1. $
2.
LESS CREDITS:
A. OVERPAYMENT ON PREVIOUS YEAR’S RETURN
2A. $
B. PREVIOUS PAYMENTS IF THIS IS AN AMENDED DECLARATION
2B. $
C. OTHER (SPECIFY)
2C. $
TOTAL CREDITS
$
3.
NET TAX DUE (LINE 1 LESS TOTAL LINE 2)
3. $
4.
AMOUNT PAID WITH THIS RETURN (NOT LESS THAN 1/4 x line 3) REMITTANCE PAYABLE TO “CITY OF MASSILLON”
4. $
5.
BALANCE OF TAX (NOT MORE THAN 3/4 x line 3)
5. $
METHOD OF PAYMENT
$
EXPIRATION DATE
/
/
®
Check
(Amount Authorized)
I CERTIFY I HAVE EXAMINED THIS RETURN (INCLUDING ACCOMPANYING SCHEDULES AND STATEMENTS)
AND TO THE BEST OF MY KNOWLEDGE, I BELIEVE IT IS TRUE, CORRECT, AND COMPLETE.
Signature of Person Preparing, If Other Than Taxpayer
Date
Address or Name and Address of Firm
Signature of Taxpayer or Agent Required
Date
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