Acct
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Mail To: City of Canfield
FILING REQUIRED EVEN IF NO TAX IS DUE
Income Tax Department
104 Lisbon Street
Canfield, OH 44406
TAXPAYER(S) NAME AND ADDRESS
PHONE:
PH: 330-533-1101
FAX: 330-533-2668
NAME:
Date moved into City of Canfield______________________________________
ADDRESS:
Previous Address __________________________________________________
Date moved out of City of Canfield____________________________________
CITY: STATE: ZIP:
If name change, give previous name___________________________________
SOCIAL SECURITY # OR FEDERAL ID #:___________________
SPOUSE SOCIAL SECURITY #:_________________________
W-2/W-2G WORKSHEET
From To
1.Total W-2 wages from column 3 ………….……….…………….……………………......……….….…………………………………..……..…..…….………
1
2.
Income other than wages (from pg. 2, line 29) (Attach applicable schedules) NOTE: NO LOSS CAN OFFSET W2 WAGES.… 2
3. TOTAL CANFIELD INCOME:
ADD LINES 1 AND 2 ……..……….….……….….…………………………………….…….……………………...………...
3
TAX
4. CITY OF CANFIELD INCOME TAX- MULTIPLY LINE 3 BY 1.0% (0.01) ……..…………...………………………………….....…......................
4
5. CANFIELD income tax withheld from column 4 …………………………..………….………..….…………………
5
6. Prior year credits carried forward………………………………...…………………...…..…….…………..……….…
6
7.
Estimated payments paid for 2019 income tax………………………………………..………….………………… 7
8. Credits for taxes withheld to other cities from column 6 and pg. 2, line 10B …….………..….….…
8
9. TOTAL PAYMENTS AND CREDITS: ADD LINES 5 THROUGH 8 ……….….…………….….....………………
9
10. BALANCE DUE.
If line 4 is greater than line 9, enter balance here, otherwise go to Line 14 …………………………..……………..…
10
11. Late filing and late payment penalty (see instructions) …………………………………...………………..…...………………………………………
11
12. Interest (see instructions) …………………………………………………………………….…..……………..……………….………..……………………………
12
13. TOTAL DUE.
Add lines 10 through 12. Carry to line 24 below (No tax due if $10.00 or less) …..…………..............................
13
14. OVERPAYMENT.
If line 4 is less than line 9, enter overpayment here …………..………………………
14
15. AMOUNT FROM LINE 14 TO BE REFUNDED (no refund if $10 or less) ….....…………………………
15
16.
AMOUNT FROM LINE 14 TO BE CREDITED TO 2020 (no credit if $10 or less) ………………………
16
17. Total estimated income subject to tax $________________________ Multiply by tax rate of 1.0% (0.01)………..……………
17
18. Estimated taxes to be withheld for Canfield ……………………………..…..……….…………………………..
18
19.
Estimated taxes to be withheld for other cities (limited to 0.5% (0.005) of wage……………... 19
20. Balance of city income tax declared. Subtract lines 18 & 19 from line 17……………………………….……...…………………………………
20
21.
1st Quarter estimated taxes due. Multiply line 20 by 25% (0.25)........………………….…………………...….………………………………
21
22.
Less credit for 2019 overpayment. Enter line 16 ...…….…………………………………………………..………….………………………………… 22
23. Net estimated tax due with return - subtract line 22 from line 21 (If less than zero, enter $0.00) …….………………………………
23
24. Enter balance due from line 13 above (No tax due if $10.00 or less) …………………..………….…....………...……………………………
24
25. TOTAL TAX DUE. ADD LINES 23 & 24. PLEASE MAKE CHECKS PAYABLE TO "CITY OF CANFIELD"
……………..……………………
25
If this return was prepared by a tax practitioner, check here if we may contact him/her directly with questions regarding the preparation of this return.
IF YOU MOVED OR HAD ANY CHANGE IN STATUS DURING 2019, COMPLETE THE FOLLOWING:
3
5
4
CANFIELD TAX
WITHHELD
OTHER CITY TAX
WITHHELD
QUALIFYING WAGES
ON W-2/W-2G
(greater of Box 5 or 18 )
PRINT EMPLOYER'S NAME
2019 CITY OF CANFIELD INCOME TAX RETURN
FOR CALENDAR YEAR 2019 OR FISCAL PERIOD ______________ TO ________________
CALENDAR YEAR TAXPAYERS FILE ON OR BEFORE APRIL 15, 2020 FISCAL FILERS FILE WITHIN 105 DAYS OF PERIOD END
CITY WHERE
EMPLOYED
W-2/W-2G
COPIES
MUST BE
ATTACHED
Dates wages were
Earned
1
2
DECLARING EXEMPTION: Please fill out exemption
certificate o
n page 2 and sign on this page
6
CREDIT ALLOWED FOR
OTHER CITIES
(if other city tax was withheld,
max credit = wages in B
ox 18
on W2 x 0.005)
ATTACH A COPY OF 1040, ALL APPLICABLE W-2s/W-2Gs, FEDERAL SCHEDULES, 1099s, EXPLANATIONS, ETC…
TOTALS
$
$
INCOME
$
$
$
$
$
$
TAX WITHHELD,
PAYMENTS
AND CREDITS
BALANCE DUE,
REFUND,
OR CREDIT
$
$
$
$
$
$
$
$
$
DECLARATION OF ESTIMATED TAX - TAXPAYERS OWING MORE THAN $200.00 ARE REQUIRED TO SET UP AND PAY
$
$
ESTIMATE
FOR NEXT YEAR
TAX DUE
The undersigned declares under penalty of perjury 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.
$
$
$
$
$
$
DATE
DATE
SIGNATURE OF PREPARER, IF OTHER THAN TAXPAYER
NAME AND ADDRESS OF PREPARER (PLEASE PRINT)
DATE SIGNATURE OF TAXPAYER
SIGNATURE OF SPOUSE (IF JOINT RETURN)TELEPHONE NUMBER
Amt
Chk #
$ $
m. Income from Patents & Copyrights…………………………………………
h. Other (explain)……………………………………………………………………………………….
i. Total Additions (enter on line 27a)
…..........................................................
$ $
STEP 1 Avg. Original Cost of Real & Tangible personal property
Gross annual rentals paid multiplied by 8
Total Step 1
STEP 2 Gross receipts from sales made and/or work or services performed %
STEP 3 Wages, salaries, and other compensation paid %
STEP 4 Total percentages %
STEP 5 Average percentage (Divide total percentages by number of percentages used)
Carry to line 28b below %
$
ADD $
DEDUCT $
$
$
$
29. Amount subject to Canfield Income Tax (Carry to Page 1 Line 2)…...................................................................................................................................................................
$
I have no taxable income because of the reason indicated below:
RETIRED - I received only pension, social security and/or interest or dividend income for the entire year.
UNDER 18 for the entire year of _________. My date of birth is ____/____/____ (Attach copy of driver's license).
ACTIVE MEMBER OF THE U.S. ARMED FORCES for the entire year of _______.
NO EARNED INCOME for the entire year of ________. (Public assistance, SSI, Unemployment, etc. is not considered earned income).
SCHEDULE OF INCOME FROM OTHER THAN WAGES
INCOME OR LOSS FROM
FEDERAL SCHEDULE
FORM OR SCHEDULE TAX CREDIT ALLOWED FOR TAX PAID
TO OTHER CITIES
(LIMITED TO 0.5% OF INCOME)
RETURNS WILL NOT BE ACCEPTED WITHOUT COPIES OF FEDERAL SCHEDULES C, E, F, FORMS 1120, 1120S, FORM 1065 WHEN APPLICABLE. MUST INCLUDE ALL PAGES,
SCHEDULES & STATEMENTS
(Attach copy of form and any referenced schedules)
5. FORM 1120, 1120S, 1065, 1041
3. SCHEDULE F - FARM INCOME (Attach copy of Schedule F)
4. SCHEDULE K-1 (Residents enter profit/loss from entities that do not pay Canfield tax on entire distributive share
)
(Attach copy of K-1)
1. SCHEDULE C - BUSINESS INCOME
(Attach copy of Schedule C)
2. SCHEDULE E - RENTAL INCOME (Residents enter profit/loss from ALL properties. Nonresidents enter
only profit/loss from Canfield properties)(Attach copy of Schedule E)
7. Previous Year Net Losses (Starting in 2018, losses from tax years beginning on or after 1/1/17 can be used at 50%
for 5 years- Attach schedule)
6. TOTAL OF LINES 1 THROUGH 5
DEDUCT
ITEMS NOT TAXABLE
a. Capital Losses (Excluding Ordinary Losses)…..............................................
b. Interest and/or other expenses incurred in the production of non-
taxable income …..................................................................................
c. Taxes based on income (Including Franchise Tax)…....................................
10. TOTAL INCOME (LOSS) (Combine Lines 8 & 9. INDIVIDUAL TAXPAYERS STOP HERE and enter income from 10A
on pg.1, line 2 and enter amount from 10B on pg.1, line 8.) (Businesses enter amount from 10A on line 26 below.)
10A
SCHEDULE X
RECONCILIATION WITH FEDERAL INCOME TAX RETURN (NOT FOR INDIVIDUAL NON-BUSINESS USE)
ADD
ITEMS NOT DEDUCTIBLE
10B
8. SUBTRACT LINE 7 FROM LINE 6
9. MISCELLANEOUS INCOME - 1099 MISC, ETC.
(Attach copy of supporting document)
d. Net operating loss carry forward from Federal Return…............................
retirement plans, health insurance and/or life insurance…........................
f. Officers Compensation not included in W-2 wages….............................
….......................................................................................................
j. Capital Gains (Excluding Ordinary Gains)…....................................
k. Interest Income…..........................................................................
l. Dividend Income….........................................................................
n. Other (explain)…...........................................................................
b. LOCATED IN
CANFIELD
c. PERCENTAGE
(b
÷ a)
SCHEDULE Y
BUSINESS ALLOCATION FORMULA
e. Amounts paid or accrued on behalf of owners/partners for qualified sef employed
g. Five percent (5%) of intagible income reported on lines k, l, & m…...........
27.
a. Items Not Deductibe.....................................................................................................................................................................
b. Items Not Taxable….....................................................................................................................................................................
c. Enter excess of Line 26a or 26b…............................................................................................................................................................................................................
o. Total Deductions (enter on line 27b)…......................................
….......................................................................................................
….......................................................................................................
EXEMPTION CERTIFICATE (Signature is required on page 1)
26. Total from Schedule of Income From Other Than Wages above (Line 10A)…...................................................................................................................................................
28. a. Adjusted Net Income (Line 26 plus or minus 27c)…...............................................................................................................................................................................
b. Amount allocable to Canfield. If Schedule Y is used then, _______________% of Line 28a….................................................................................................................
a. LOCATED
EVERYWHERE
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