Fillable City of Northwood BUSINESS/INDIVIDUAL Resident Non-Resident Part Time (Fairfield County)

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City of Northwood BUSINESS/INDIVIDUAL Resident Non-Resident Part Time (Fairfield County)

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City of Northwood
Income Tax Division
6000 Wales Rd.
Northwood, OH 43619
Phone (419) 693-9326
Fax (419) 690-1691
Email: taxaud@ci.northwood.oh.us
Web: www.ci.northwood.oh.us
BUSINESS/INDIVIDUAL
City of Northwood
DUE ON OR BEFORE APRIL 15
or the IRS DUE DATE.
**Mandatory ling for ALL OR PARTIAL Resident even if No Tax is Due**
ENTER
NAME AND
ADDRESS
Account # ______________________________________
SS#(Taxpayer)___________-___________-___________
SS#(Spouse)___________-___________-___________
Phone#__________________________________
Tax Oce use ONLY
Filed Date: ________________________________________
Check: # _________________$ __________________
Cash: $ __________________
Resident Non-Resident Part Time Resident If you moved in or out of Northwood during the current year, please provide the date of Move
Moved In: ___________________________________________________________________ Moved Out: ___________________________________________________________________
1. TotalQualifyingWages(generallyfoundinBox5ofFormW-2)(AachW-2Forms) ................................. 1 $ _________________
ForW-2’scompletePartConpage2
2. LessNon-TaxableWagesfromPartC(LosstoCarryForward)................................................................... 2 ($ )
3. OtherIncomeor(loss)Fromgamblingincome,FederalSchedulesC,E,F,K-1,and1099-MISC
(MustaachALLFederalSchedules) ........................................................................................................... 3 $
________________
4. Northwood Taxable Income (Add Lines 1 and 3) ........................................................................................
4 $
________________
BusinesslossesmaynotbeusedtoosetW-2wagesorothercompensaon.
5. Itemsnotdeducble(fromLineM,ScheduleXfrompage2) ...............................................................Add 5 $
6. Itemsnottaxable(fromLineZ,ScheduleXfrompage2) .................................................................Deduct 6 $
7. DierencebetweenLines5and6tobeaddedorsubtractedfromLine4. ................................................. 7 $
8. Adjustednetincome(Line4plusorminusLine7ifScheduleXisused)..................................................... 8 $ _________________
9. AmountofLine8apporoned(_____________%fromStep7,ScheduleY, page2) ..................................  9 $ _________________
10. Lessallocablelossperpreviousincometaxreturn(submitschedule) ........................................................ 10 
11.AmountSubjecttoNorthwoodIncomeTax (Lines4or9minusLine10). ................................................. 11 $ _________________
12. NorthwoodIncomeTax(MulplyLine11by
1.5%[.0150]) ......................................................................... 12 $ _________________
13. Credit:
a. Northwood tax withheld per W-2(s) ........................................................................................................ 13a $
b.OthercitytaxwithheldonW-2wages(Limited1.5%) ............................................................................. 13b $
c.EsmatedTaxespaidtoNorthwood ........................................................................................................ 13c $
d.PriorYearOverpayment .......................................................................................................................... 13d $
14. TotalPaymentsandCredits(TotalofLines13athrough13d) ...................................................................... 14 $ _________________
15.TotalTaxDue............................................................................................................................................ 15 $ _________________
16. LateFilingFeeof$25permonthorfraconofamonth,nottoexceed$150. ........................................... 16 $ _________________
17. Penalty __________ Interest __________ .............................................................................................. 17 $ _________________
18.TotalBalanceDue(TotalofLines15through17)(Enterdifferenceonlyif$10.00ormore)..................... 18 $ _________________
19. Overpayment(IfLine14isgreaterthan12,enteroverpayment) ............................................................... 19 $ 
Enteroverpayment:a.Toberefunded$__________b.Creditedtonextyear$______________
(Amountslessthan$10.00willnotberefunded)
20. Totalesmatedincomesubjecttotax$____________MulplybyTaxRateof1.5% ............................... 20 $ _________________
21. EsmatedTaxesWithheldfromWages ....................................................................................................... 21 $ _________________
22. TaxdueaerWithholding(Line20minusLine21)STOPifthisamountislessthan$0.00 ....................... 22 $ _________________
23. Lesscredits(fromLine19babove)
..............................................................................................................
23 $ _________________
24.Netestimatedtaxdue(Line22minusLine23ifgreaterthanzero)........................................................... 24 $ _________________
25. Amountpaidwiththisdeclaraon(notlessthan22.5%ofLine24)* ......................................................... 25 $ _________________
*Subsequent esmated payments are due by the 15th of June, September and December
26. TOTAL AMOUNT DUE - Combine Line 18 above with Line 25 ............................................. 26 $
Theundersigneddeclaresthatthisreturn(andaccompanyingschedules)isatrue,correctandcompletereturnforthetaxableperiodstatedandthatthegures
used herein are the same as used for Federal Income Tax purposes
Signature of Taxpayer or Agent Date
SignatureofpreparerifotherthanTaxpayer Date SignatureofSpouse(iflingjointreturn)Date
Checkhereifwemaycontacttheabovepreparerwithquesonsregardingthepreparaonofthisreturn.
Part A - Tax Calculaon
Part B - Tax Calculaon
Declaraon of Esmated Tax for the Year Required if esmated tax liability is $200 or greater
($ )
TAX RETURN
EIN#________-__________________________
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2016
Change Tax Year if Necessary
2017
………………………..
………………………..
………………………..
………………………..
………………………..
K-1 (1065 or 1120(S)…………...………….
K-1 (1065 or 1120(S)………....…………….
Other Income …………………………
Total: EntertotalonPage1,(Loss)onLine2orProfitonLine3
Total Wages
Box 5 should match
Box18oftheW-2
Name of Employer City or TWP Employed
Northwood Tax
Withheld
Box 19 of the W-2
Other City Tax w/held (Credit from column
Box 19 of the W-2
(C4)
Allowed up to 1.5%)
Part C - Salaries, Wages and Tips
Worksheet to be completed by Taxpayers who received multiple W-2’s. Attach copies of ALL W-2(s)
used to compute your income/withholdings
(C1) (C2) (C3) (C4) (C5) (C6)
Totals:
Enter Total on Page 1
Line 13a
Enter Total on Page 1
Line 13b
Enter Total on Page 1
Line 1
Part C (continued) - Other Compensation
Use this section for income shown on Federal Schedules C, E, F, K-1, and 1099-MISC
Profit (Loss)
* If Rental Property is located within the City of
Northwood, a current tenant listing must
accompany this tax return. The tenant list must
include name, move IN/OUT date and phone
number.
Schedule X - Use this reconciliation for income reported as Other Income on
Page 1 Line 3.
Schedule C
Schedule C
Schedule E*
Schedule F
Schedule E*
ITEMS NOT DEDUCTIBLE ADD
a. Capital Losses (1221 or 1231 included) ...................... $
b.
Taxes based in income ...................................................
c. Guaranteed payments for accruals to or
for current or former partners or members
5% of amount deducted as intangible income ............
d. Amounts for qualified self-employment retirement ......
e
.
Plans, health insurance plans and life
..........................
f. Other (explain)
m. Total Additions (Enter total on Page 1 Line 5) ..............
ITEMS NOT TAXABLE DEDUCT
n. Capital Gains ................................................................ $
o. Interest Income ............................................................
p. Dividends ......................................................................
q. Income from copy rights and patents .........................
r. Other Income (explain)
y. Total Deductions (Enter total on Page 1 Line 6) ............
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STEP1
Originalcostofrealandtangiblepersonalproperty
STEP2
STEP3
STEP4
Totalpercentages
STEP5
$
$
TotalWagesallocatedtoNorthwood
Pleaseexplainanydifference:
No
Areanyemployeesleasedintheyearcoveredbythisreturn? Yes
Ifyes,pleaseprovidethename,address,phonenumberandEINnumberoftheleasingcompanybelow:
Name: Address:
EIN#:
ScheduleY-BusinessAllocationFormula
Grossannualrentalspaidmultipliedby"8"
TotalSTEP1
Grossreceiptsfromsalesmadeand/orworkorservicesperformed
Wages,salariesandothercompensationpaid
Schedule(See Y-1**)
A. Located
Everywhere
B. Locatedin
Northwood
C. Percentage (B/
A)
LeasedEmployees
Extensionpolicy: Extensionsmay, uponrequest,begrantedforfilingoftheannualreturn.Extensionrequestsmustbemadeinwritingandreceivedby
thistaxofficeonorbeforetheduedateofthereturn.
Averagepercentage(dividetotalpercentagebynumberofpercentagesusedandenteron
Page1Line9)
**ScheduleY-1ReconciliationtoFormW-3
(either from Federal Return or apportionment formula)
T
otal Wages shown on Form W-3 (Withholding Reconciliation)
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City of Northwood BUSINESSINDIVIDUAL Resident Non-Resident Part Time (Fairfield County)

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Completed 4 April 2021

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