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City of New Philadelphia
Income Tax Department
150 East High Ave, Suite 041 · New Philadelphia, OH 44663
Hours: Mon-Fri 8:00am - 4:30pm (330) 364-4491
BUSINESS QUESTIONNAIRE/WITHHOLDING ACCOUNT APPLICATION
Please complete the application & mail. Or fax to: (330) 364-9851. Scan & email to: vdaniels@newphilaoh.com
The City of New Philadelphia imposes an income tax of 1.5% (.015) on all qualifying wages, salaries, commissions, other compen-
sation and other taxable income earned or received by residents 18 years or older. Non-residents are taxed at the same amount
for work done or services performed or rendered within the municipality. The 1.5% tax also applies to net profits of corporations,
individuals, partnerships, and unincorporated businesses engaged in business activity within the municipality.
Business Name___________________________________Address__________________________________
City/State/Zip_____________________________________________________________________________
Federal ID#_______________________________ Telephone_______________________________________
Contact Person______________________________________ Email_________________________________
Business Description________________________________________________________________________
On what date did you begin doing business in New Philadelphia? _____/_____/________
IRS Accounting Period (check one) __Calendar Yr. end Dec. 31 __Fiscal Year ending____________________
Number of employees____________ Do you anticipate hiring additional employees? __yes __no
Do you employ sub-contractors or other workers who are subject to city income tax? __yes __no
If yes, please attach a list with their names, addresses and social security numbers.
TYPE OF BUSINESS OWNERSHIP (check one)
__Individual Proprietorship (owner’s SS#________________________________) __Corporation
__Partnership __LLC __Non-Profit Corporation __Association __Other (please explain below)
________________________________________________________________________________________
If the net profit New Philadelphia Income Tax Return is filed as a partnership, association or other unincor-
porated joint business venture, how will the balance due be paid?
__Paid in Full by the Business __Paid Separately by the Individual Members
Please list the name(s) and addresse(s) of the owner(s) of the individual proprietorship or partnership:
Name______________________________________ Address_____________________________________
City/State/Zip____________________________________________________________________________
Name______________________________________ Address_____________________________________
City/State/Zip____________________________________________________________________________
If additional space is required, please attach separate documents
