FORM R-B CITY OF DAYTON, OHIO BUSINESS Income Tax Return
Tax Year Ending December or Fiscal Year Ending_________________
Business Name Federal ID#
DBA
Address Your phone #
City/State/Zip Preparers phone #
Do you have an employee withholding account with Dayton Yes ____ No ____
Did you file a Dayton Return last year? Yes ____ No ____ (For Office Use Only)
Federal Filing on form 1120 1120A 1120S 1120X 1065 Documentation MUST be attached (Do not report Schedule C on this form)
DATE STAMP
1 TOTAL Taxable Income 1
2 Items NOT deductible 2
3 Items NOT taxable 3
4 Enter Excess of line 2 or 3 (Show negative amounts in parentheses) 4
5 Adjusted NET income (Line 1 plus or minus Line 4) 5
6 Amount allocable to Dayton (If Schedule Y is used) 6
7 AMOUNT SUBJECT TO DAYTON TAX 7
8 Dayton Tax Due @ 2.50% 8
9 Estimated Payments 9
10 Prior Years overpayments 10
11 TOTAL CREDITS 11
12 Penalty and/or Interest Total Penalty/Int 12
13 BALANCE DUE (Subtract Line 11 from Line 8. Add Line 12 as required) 13
14 IF OVERPAYMENT < REFUNDED < CREDIT TO NEXT YEAR 14
15 ESTIMATED TAX for year ESTIMATED INCOME Dayton Tax @ 2.50% = 15
16 1st quarterly estimated due April 15th 16
17 Credit from Prior Year 17
18 Balance of Quarterly Payment Due 18
19 TOTAL DUE (Add Line 13 __________ and Line 18 __________) 19
SCHEDULE X Reconciliation with Federal Income Tax Return (ORC 718)
ITEMS NOT DEDUCTIBLE ADD ITEMS NOT TAXABLE DEDUCT
A Capital Losses - IRC 1221/1231 only K Capital Gains - IRC 1221/1231 property dispositions
B Expenses incurred in the production of non-taxable income except to extent gains apply as described in IRC 1245/1250
C Income Taxes, City and State (If Deducted as Expenses) L Federally reported intangible income such as, but
D Net Operating Loss Deduction per Federal Return not limited to interest, dividends, patent & copyright income
E Payments to Partners/Officers per Federal form 1065/K-1 M Not Previously Deducted Sec 179 Expense
F Retirement Plan Payments (Keogh, IRA, Tax Sheltered Annuity) N Other Items not Taxable (explain)
G Portion State of Ohio Franchise Tax based on Income
H Rental Activities (Partnership, S-Corp, LLC, etc.)
I Other Items not Deductible (explain)
J Total Lines A through I O Total Lines K through N
SCHEDULE Y (proration of Schedule C income for non-residents only) A B C
Located Everywhere Located in Dayton Percentage (B/A)
Step 1: Average Value of Real & Tangible Personal Property
Gross Annual Rents 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 Paide
Total Percentages (From Column C)
Average Percentage (Total Percentages / Number of Percentages Used)
READ BEFORE SIGNING: The undersigned declare this return and attached schedules to be a true and complete return for the taxable year stated and that the figures used herein are the same as used for Federal
Tax purposes, adjusted to the requirements of the Dayton city tax ordinances represented by this return. I understand that if I am under withheld in the following tax year (by $200.00 or 10% of tax due) I will
be charged Penalties and Interest if I fail to make required estimated tax payments.
If this return was prepared by a tax professional, may we contact them directly? □Yes □ No
Tax Preparer Signature Tax Payer Signature Date
Tax Preparer Phone # Date
Mail Return with PAYMENT DUE to: City Of Dayton PO Box 643700 Cincinnati, OH 45264-3700
Mail Return with ZERO BALANCE DUE To: City Of Dayton PO Box 1830 Westerville,OH 43086 1830 -
Mail Return with REFUND REQUEST to: City Of Dayton PO Box 1830 Westerville,OH 43086-1830
In the event your check is returned unpaid for insufficient funds or uncollected funds, we may electronically debit your account for the principal amount of the check.
Rev 1-2018