2017 Individual Income Tax Return - City if Fairfield, Ohio

This fillable "Individual Income Tax Return" is a document issued by the Ohio Department of Taxation specifically for Ohio residents.

Download the PDF by clicking the link below and complete it directly in your browser or through the Adobe Desktop application.

ADVERTISEMENT
CITY OF FAIRFIELD
FORM IR
File with Fairfield Income Tax
701 Wessel Drive
INDIVIDUAL INCOME TAX RETURN 2017
Fairfield OH 45014-3611
Your Social Security Number
(513) 867-5327
OR
Fax (513) 867-5333
FISCAL PERIOD ___________ TO _____________
___________________________________________
Forms available on Internet at
CALENDAR YEAR TAXPAYERS FILE ON OR BEFORE APRIL 17TH
www.fairfield-city.org
AND FISCAL YEAR TAXPAYERS FILE BY THE 15TH DAY OF THE
Spouse’s Social Security Number
FOURTH MONTH AFTER THE CLOSE OF THE PERIOD.
PLEASE PROVIDE NAME AND CURRENT ADDRESS IN SPACE BELOW
___________________________________________
Resident
Part-Year
Non Resident
Date moved in ____________
Sole Proprietor
Date moved out ___________
City of Employment _________________________
Phone#___________________________________
IF TAXPAYER AND SPOUSE ARE FULLY RETIRED AND/OR WITHOUT TAXABLE INCOME, PLACE AN “X” IN THE BOX, COMPLETE SIGNATURE SECTION BELOW.
Attach a copy of 1040,1040A,1040EZ
FILING STATUS
OFFICE USE ONLY
$ ___________________
$ ___________________
$ ___________________
$ ___________________
$ ___________________
$ ___________________
$ ___________________
$ ___________________
$ ___________________
$ ___________________
DECLARATION OF ESTIMATED TAX FOR 2018 (WILL NEED TO BE COMPLETED IF LINE 6 IS $200.00 OR MORE)
ESTIMATE FOR 2018 1ST QUARTER DUE APRIL 17, 2018
OFFICE USE ONLY
$ ___________________
12. Total income subject to tax $__________ multiply by tax rate of 1.5% (.015)..........................................12
$ ____________________
$ ___________________
13. Estimated income tax to be withheld for Fairfield, or paid to other cities..................................................13
$ ____________________
$ ___________________
14. Estimated tax due (Line 12 minus Line 13).
..... 14
$ ____________________
If less than $200.00 estimated payments are not required
$ ___________________
15. First quarter estimated tax payment 25.0% (.25) of Line 14*....................................................................15
$ ____________________
*First quarter estimated tax payment should be paid with this return. Use enclosed estimate forms for 2nd, 3rd and 4th quarters.
$ ___________________
16. Prior year tax credit from Line 11B above ................................................................................................16
$ ____________________
$ ___________________
17. If Line 16 is greater than 15, enter 0, otherwise enter amount of Line 15 less Line 16............................17
$ ____________________
$ ___________________
18. TOTAL TAX DUE (Lines 10 and 17) Make checks payable to FAIRFIELD INCOME TAX ......................18
$ ____________________
Credit Card (Check One)
Discover
Master Card
Visa No. _____________-_______________-_______________-______________
Expiration Date _______/_______/__________ 3 Digit Code (Back of Card) _________________
SIGNATURE(S) REQUIRED
The undersigned declares that this return (and accompanying schedules) is true, correct and complete for the taxable period stated and that the figures used herein are the same as used for Federal Income Tax purposes.
For Tax Division Use Only
May we discuss this return with your tax practitioner?
Yes
No
_________________________________________________________________________________________
Signature of Taxpayer
Date
_________________________________________________________________________________________
Signature of Taxpayer
Date
_________________________________________________________________________________________
Signature of Preparer, If other than taxpayer
Date
_________________________________________________________________________________________
Name & Address of Preparer
_________________________________________________________________________________________
City, State, Zip
Phone Number
CITY OF FAIRFIELD
FORM IR
File with Fairfield Income Tax
701 Wessel Drive
INDIVIDUAL INCOME TAX RETURN 2017
Fairfield OH 45014-3611
Your Social Security Number
(513) 867-5327
OR
Fax (513) 867-5333
FISCAL PERIOD ___________ TO _____________
___________________________________________
Forms available on Internet at
CALENDAR YEAR TAXPAYERS FILE ON OR BEFORE APRIL 17TH
www.fairfield-city.org
AND FISCAL YEAR TAXPAYERS FILE BY THE 15TH DAY OF THE
Spouse’s Social Security Number
FOURTH MONTH AFTER THE CLOSE OF THE PERIOD.
PLEASE PROVIDE NAME AND CURRENT ADDRESS IN SPACE BELOW
___________________________________________
Resident
Part-Year
Non Resident
Date moved in ____________
Sole Proprietor
Date moved out ___________
City of Employment _________________________
Phone#___________________________________
IF TAXPAYER AND SPOUSE ARE FULLY RETIRED AND/OR WITHOUT TAXABLE INCOME, PLACE AN “X” IN THE BOX, COMPLETE SIGNATURE SECTION BELOW.
Attach a copy of 1040,1040A,1040EZ
FILING STATUS
OFFICE USE ONLY
$ ___________________
$ ___________________
$ ___________________
$ ___________________
$ ___________________
$ ___________________
$ ___________________
$ ___________________
$ ___________________
$ ___________________
DECLARATION OF ESTIMATED TAX FOR 2018 (WILL NEED TO BE COMPLETED IF LINE 6 IS $200.00 OR MORE)
ESTIMATE FOR 2018 1ST QUARTER DUE APRIL 17, 2018
OFFICE USE ONLY
$ ___________________
12. Total income subject to tax $__________ multiply by tax rate of 1.5% (.015)..........................................12
$ ____________________
$ ___________________
13. Estimated income tax to be withheld for Fairfield, or paid to other cities..................................................13
$ ____________________
$ ___________________
14. Estimated tax due (Line 12 minus Line 13).
..... 14
$ ____________________
If less than $200.00 estimated payments are not required
$ ___________________
15. First quarter estimated tax payment 25.0% (.25) of Line 14*....................................................................15
$ ____________________
*First quarter estimated tax payment should be paid with this return. Use enclosed estimate forms for 2nd, 3rd and 4th quarters.
$ ___________________
16. Prior year tax credit from Line 11B above ................................................................................................16
$ ____________________
$ ___________________
17. If Line 16 is greater than 15, enter 0, otherwise enter amount of Line 15 less Line 16............................17
$ ____________________
$ ___________________
18. TOTAL TAX DUE (Lines 10 and 17) Make checks payable to FAIRFIELD INCOME TAX ......................18
$ ____________________
Credit Card (Check One)
Discover
Master Card
Visa No. _____________-_______________-_______________-______________
Expiration Date _______/_______/__________ 3 Digit Code (Back of Card) _________________
SIGNATURE(S) REQUIRED
The undersigned declares that this return (and accompanying schedules) is true, correct and complete for the taxable period stated and that the figures used herein are the same as used for Federal Income Tax purposes.
For Tax Division Use Only
May we discuss this return with your tax practitioner?
Yes
No
_________________________________________________________________________________________
Signature of Taxpayer
Date
_________________________________________________________________________________________
Signature of Taxpayer
Date
_________________________________________________________________________________________
Signature of Preparer, If other than taxpayer
Date
_________________________________________________________________________________________
Name & Address of Preparer
_________________________________________________________________________________________
City, State, Zip
Phone Number
City of Fairfield Individual Income Tax Return 2017 - Page 2
All appropriate Federal schedules and forms MUST be attached. A return is NOT complete unless schedules and forms are included.
OTHER TAXABLE INCOME OR DEDUCTIONS
Other Taxable Income (attach Form)
19. Taxable income not reported on a W-2, or W-2G form (1099MISC – not on Schedule C, including gambling winnings)
19. $____________________
(Income on 1099-INT, 1099-R, 1099-DIV, and W2-P is not taxable.)
Schedule C/F (Business Operations and or Farm Operations) Profit/Loss (attach Federal Schedules)
20. Schedule C or F
A.
Business Name __________________________________________________________________
20A. $____________________
Business Address ________________________________________________________________
Date Started _____________________
Date Ended ___________________________________
B.
Business Name __________________________________________________________________
20B. $____________________
Business Address ________________________________________________________________
Date Started _____________________
Date Ended ___________________________________
C.
Total Schedule C Profit/Loss ………………………………………………………………………..................................... 20C. $____________________
Schedule E (Rental and/or Partnership) Profit/Loss. S-Corporations are excluded from individual’s income. (attach Federal Schedule and K-1s.)
21. Rental Property – Losses without an exact location will be disallowed.
A.
Address _______________________________________________________________________
21A. $____________________
City/State/Zip ____________________________________________________________________
B.
Address ________________________________________________________________________
21B. $ ___________________
City/State/Zip ____________________________________________________________________
C.
Address ________________________________________________________________________
21C. $ ___________________
City/State/Zip ____________________________________________________________________
D.
Address ________________________________________________________________________
21D. $ ___________________
City/State/Zip ____________________________________________________________________
E.
Total Rental Profit/Loss ………………………………………………………………………............................................. 21E. $ ___________________
22. Partnership Income/Loss – Applicable losses without exact locations will be disallowed.
A.
Partnership Name/ID ____________________________________________________________
22A. $ ___________________
Address ________________________________________________________________________
B.
Partnership Name/ID ____________________________________________________________
22B. $ ___________________
Address ________________________________________________________________________
C.
Partnership Name/ID ____________________________________________________________
22C. $ ___________________
Address ________________________________________________________________________
D.
Total Partnership Profit/Loss......................................................................................................................................... 22D. $ ___________________
23.
Total business profit/loss (Line 20C, Line 21E and Line 22D). If a loss, the amount can be carried forward
for a maximum of three (3) years to offset future business profit and CANNOT be used to offset W-2 wages. ....... 23. $ ___________________
Prior business loss from previously filed tax returns. Limited to the last three (3) years ……............................... 24. $ ___________________
24.
25.
Net business profit; if Line 23 is less than zero or less than Line 24, enter zero (0.00).
Otherwise subtract Line 24 from Line 23……………..………………………………………………............................ 25. $ ___________________
Other Deductions [Non-Resident Wages and or Employee Business Expenses (Form 2106) include forms]
26.
Deductions and non-taxable income (see instruction sheet for details)
A.
______________________________________________________
26A. $ ________________
B.
______________________________________________________
26B. $ ________________
C.
______________________________________________________
26C. $ ________________
D.
Total deductions and non-taxable income …………………………………………......................................... 26D. $ ___________________
27.
Total other taxable income or deductions (Line 19 plus Line 25 minus Line 26D) Enter this amount on Line 2*........27.
$ ____________________
**Note:
Losses are not deductible from wage income. Only Employee business expenses (attach Form 2106) and/or wages
earned outside the City of Fairfield while a non-resident are allowed to be deducted from wages.
ADVERTISEMENT
Page of 2