Return with attachments 
2022NR                                                   due by April 18, 2023

                             Part 1 - Account Information
Account                               SSN
                                    Spouse SSN
Name
Resident 
Address

Mailing 
Address
Phone                                           Email

This form is to be used by individuals who did not live in the City of Newark in 2022 and are 
reporting income tax was earned in the City and not subject to withholding tax.  If you moved out of 
                    Newark in 2022 please use form 22LF.

                    Part 2 - Taxable Income  & Tax Calculation
                    Round to the nearest whole dollar - do not enter cents

                                    A - W-2 Income
1        Enter wages from W-2s
                    Include only wages earned in Newark not subject to withholding

         Taxable wages (Line 1 Wages)                    2

                                B - Miscellaneous Income
3        Tips (not included on W-2)
4        Work-related bonuses/awards
5        Covenant not to compete
6        Other - attach explanation

         Total miscellaneous income (add 3 - 6)          7

                              C - Income from Schedules
8        Schedule C
9        Schedule E 
10       1099 - Misc
11       Loss                         x 0.5 =

         Total of schedules (add 8 - 12) if loss enter 0 12

Newark Taxable Income (Box 2 + Box 7 + Box 12)           13

Newark Tax (Box 13 X 0.0175)                             14
                                    Continue on back

                         Part 3 - Credit Calculation

Newark Tax ( Bring forward from Box 14)                       15
                         A - Withheld Tax/Other Credits

16        Newark tax withheld on W-2s

          Total credits - from line 16                        17

Newark Tax after credits (Box 15 - Box 17)                    18

If Box 18 is $200 or more, you may be required to file a 2023 Estimated Tax Return.             See 
                         form 23ET for additional information.

                         B - Estimated Tax Payments

19        Estimated 2022 tax payments
20        Taxes carried forward from a prior year

          Total estimated tax payments (add 19 + 20)          21

            Part 4 - Payment/Overpayment Information

2022 Tax Payment Due (Box 18 less Box 21)                     22
                         If Box 22 is less than $10.01 - no payment due

            Make checks payable to Newark City Income Tax

2022 Overpayment (indicate how to apply below)                23
            If Box 23 is less than $10.01 - no credit or refund

          Credit Account                                     Refund 

          I hereby declare that the information stated above is true, correct and complete.

Signature                Date                      Signature                               Date

                                                              May we contact this preparer?
Signature of Preparer (if different from taxpayer) Date       (Circle) Yes                 No

Mail to:                                                      Questions?
                                                              740-670-7580  phone
Newark City Tax Office                                        740-670-7581  fax
PO Box 4577                                                   citytax@newarkohio.net
Newark, OH  43058-4577

                       Schedule C - Self Employment Allocation

                                               Formula

Steps                                                       Everywhere               Newark City %
1     Average cost of real & tangible personal property
      Gross annual rentals multiplied by 8
                       Total Step 1
2     Gross receipts - sales/work/services performed
3     Employee wages, salaries and compensation
4     Total percentages
5     Average percentage - Step 4 divided by the number of steps used - carry to line 2 below

                       Allocation of Schedule C Income to Newark

1     Enter net profit or loss from business or profession             1

2     Enter average percentage from Step 5 in formula                  2

3     Multiply Box 1 by Box 2 and enter on Line 8 of Return            3

                       Print and include a copy of this page with your annual return.