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                                           Checkbox 5: Non-Resident                        MyAccount walks you through filing 
General      Instructions                  You must provide a list of all addresses        your  form  and provides you with a 
Proof of exemption must be submitted       where you lived for the years included          confirmation  number when you are 
when required  (see the Specific           in this form.  Use the Moves Worksheet          done. 
                                                                                            
Instructions below).                       in the  Instructions and attach  to your 
                                                                                           Submit Paper Documents 
Failure to respond may result in a tax     submission.                                     If submitting a paper tax return with this 
liability  finding  based  on  information Exact  move  dates  are  not  necessary,        form, you must submit the following, if 
supplied to us by the Internal Revenue     but the  addresses should be within a           applicable: W-2s, 1099s, Federal Form 
Service or  may result in  a subpoena      week or two of your actual move dates.          2106, Federal Schedules C, E, F and K-
being  issued,  requiring  you  to  appear Provide documentation proving you               1, and the 1st page of federal Form 
and produce documents for inspection.      lived at each address such as copies of         1040.  Documents will not be returned.  
Any  penalties  and  interest  owed  will  utility  bills,  property  tax  bills,  leases, Mail your documents to: 
continue to accrue until returns are filed deeds, or print-outs of property transfer       REGIONAL INCOME TAX AGENCY 
                                           records  from  the  County  Auditor’s           PO BOX 94801 
and any tax due is paid.                    website.                                        Cleveland, OH 44101-4801 
Specific Instructions                      If you lived in another RITA municipality 
Checkbox 1: No Taxable Income              during any of the years covered by this         Contact RITA 
You must provide acceptable proof          form,  you are  still required to file an       Tax forms, instructions,  and the 
such as a copy of page 1 of your federal   Individual Tax return for the year(s) in        answers to  many questions can  be 
Form 1040 for any year you claim you       question.   A current list  of RITA              found at www.ritaohio.com. 
had no taxable income.                     municipalities    can      be   found   at
                                                                                           Phone:    (800) 860-7482 
Note that you  cannot claim an             www.ritaohio.com.  Click on the RITA            TDD:      (440) 526-5332 
exemption from filing for no taxable       Municipalities   link. 
income for any year for which you had      If you are (were) not a resident  of  a         Moves Worksheet 
a rental loss, pass-through partnership    RITA municipality for any or all of the         Use this worksheet to report your move 
loss, or self-employment loss.             year(s) covered by this form, you must          history for the years  covered by this 
                                           still file a return if you earned income in     form.  Attach a separate sheet if more 
Checkbox 2: US Armed Forces                a  RITA  municipality  and  did  not  have      space  is needed. 
If you would have met the requirements     tax withheld from those earnings to that         Move In Date     Move Out Date 
of reason 1 except you received one or     municipality  and/or  if  you  own  rental 
more  W2  forms,  but  those  W2  forms 
                                           property or conduct business in a RITA 
reported     only military     pay and                                                      Street Address 
                                           municipality  and reported losses for 
allowances  for  the  year,  check  this 
                                           federal tax purposes. 
reason  for  your  exemption.   Civilian    
employees of the armed forces are not      Checkbox 6: Deceased                             City, State, ZIP 
eligible for this exemption.               Enclose a copy of the death certificate. 
                                            
Checkbox 3: Age Exempt                     Checkbox 7: Filing Jointly                       Move In Date     Move Out Date 
This exemption  is not available in all    Check this reason if you  are not 
RITA      municipalities.      Go    to    exempt and are filing jointly. Complete 
www.ritaohio.com and click on the RITA     your spouse’s  information in the                Street Address 
Municipalities  link to look  up your      address section of this form. 
municipality to see if this exemption       
                                                                                            City, State, ZIP 
applies  to your municipality.             How to Respond 
Checkbox 4: Retired                        Efile Using RITA’s FastFile. 
                                                                                            
You must provide acceptable proof          FastFile is easy, fast & secure. FastFile 
                                                                                            Move In Date     Move Out Date 
such as a copy of page 1 of your federal   does not require a  user  name or 
Form 1040 for any year you claim you       password.  You do need to have all your 
                                           tax documents in front of you for any            Street Address 
had retirement income only.                year you  are  FastFiling as once you 
Note that if you are retired from your     start  a  return  it  must  be  finished  in  a 
                                                                                            City, State, ZIP 
main  place  of  employment  but  have     single   session. 
picked up a job in retirement, this 
exemption will not apply to any year in    FastFile  walks  you  through  filing  your      
                                           return and provides you with a                   Move In Date     Move Out Date 
which you receive a W2.                    confirmation  number when you are 
This exemption will also not  apply to     done. 
any year in  which you own rental                                                           Street Address 
property or report a partnership gain or   Efile Using RITA’s MyAccount 
loss on your federal return.               MyAccount requires you to setup a user 
                                           name and password.  You do not need              City, State, ZIP 
                                           to complete a return in a single session. 
                                                                                            






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