2002
INCOME
TAX RETURN 2002
Due on or Before April 15, 2003. FISCAL YEAR______to________
(Business
Only)
(740)983-2541
Fax: (740)983-4531 5023
S. Union Street, South Bloomfield,
Ohio 43103
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Office Hours: Monday, Tuesday, Wednesday, & Friday 7:00 a.m. until
2:00 p.m. Thursday 8:00 a.m.-2:00 p.m.
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NAME___________________________________________
SOCIAL SECURITY #_________-________- _________
________________________________________ FEDERAL ID#______________________________
_________________________________________
(For
business use)
Did
you move during the tax year: Yes
Date in:_____________Date out:__________
No
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1. Enter wages, commissions, bonuses and all earned income - Use local wages (From W-2)
If box is not completed, use wages, tips, etc..Thrift plans & 401K, etc. are taxable when earned. ............................................ 1. ____________
2. Other income from line 15 below.....NOTE: Losses are not deductible........... 2. ____________
3. South Bloomfield taxable income......(Add lines 1 and 2)..................................... 3. ____________
4. South Bloomfield taxes - (Before Credits) - Multiply line 3 times .005 or .5%)... 4. ____________
5. South Bloomfield taxes withheld...(Taxes paid to other cities do not qualify).. 5. ____________
5a. Number of W2's attached:__________________________________
6. South Bloomfield estimated tax payments. Include credits from prior years...... 6. ____________
7. South Bloomfield taxes paid....(Total of lines 5 and 6)........................................... 7. ____________
7a: Late charges of $10.00 after 4/15/03 ................. 7 a:___________
8. If line 7 is less than line 4, enter BALANCE DUE and pay this amount............... 8. ____________
9. If line 7 is greater than line 4 enter over payment (applies to South Bloomfield taxes) 9. ___________
10. Amount of Line 9 to be REFUNDED to you..................................................... 10.____________
11. Amount
of Line 9 to be CREDITED to next years’ tax
liability......................... 11.____________
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OTHER INCOME -
(attach copies of federal schedules)
12. Net Profit or Loss from Business or Profession not already included on Line 1 (IRS Schedule C) 12._____________
13. Total Income or Loss from rents.....................................(IRS Schedule E) .......................13.______________
14. Other Income not included above...................................(IRS Schedule F, etc.)................14.______________
15. TOTAL OTHER INCOME (add lines 12-14).......Enter here and on line 2 above............15.______________
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The undersigned declares that this return and all accompanying schedules are true, correct and complete for the taxable period stated and the figures used herein are the same as used for Federal Tax Purposes.
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X______________________________________________________ ____________________________________
Payers Signature
Date Preparer’s
Signature (if other than taxpayer)
PLEASE RETURN ORIGINAL TAX RETURN TO SOUTH BLOOMFIELD TAX OFFICE KEEP COPY FOR YOUR RECORDS!