2022                                 www.ashlandincometax.com                                                                      2022
INDIVIDUAL                              ASHLAND CITY INCOME                                                                      INDIVIDUAL
                                                  TAX RETURN
       TAX OFFICE USE ONLY                                                                                                       IF YOU MOVED DURING THE
                                     FILING IS REQUIRED, EVEN IF NO TAX IS DUE                                                   TAX YEAR, GIVE DATES:
TOTAL PAID          $________
                                                                                                                                 INTO ASHLAND       /    /
CHECK #             _________           ___ RESIDENT             ___ NON-RESIDENT                                                OUT OF ASHLAND        /    /

NAME(S):                                                                          TAXPAYER SOCIAL SECURITY #  __________________________

ADDRESS:                                                                          SPOUSE SOCIAL SECURITY #     __________________________

PHONE NO: ________________        EMAIL_________________________________________                                                 ______________ ACCOUNT NO.

                             EXEMPTION FORM : IF EXEMPT- STOP HERE, SIGN, DATE AND MAIL
□  UNEMPLOYED                     □ RETIRED                                               □ ACTIVE MILITARY
□   UNDER 18 YRS OF AGE - BIRTHDATE:  ______________          □ OTHER: ___________________________
1. WAGES, SALARIES & TIPS (BOX 5 ON W-2 OR HIGHEST WAGE ON W-2) (ATTACH ALL W-2S)                                                1. $______________________
2. OTHER INCOME: Federal Schedule C, E, K-1, 1099s, GAMBLING & MISC                                                              2. $______________________
   (ATTACH ALL SCHEDULES & TENANT ROSTERS) (1099RS ARE NOT TAXABLE)
   (BUSINESS OR RENTAL LOSSES CANNOT OFFSET W-2 WAGES)
3. NET OPERATING LOSS (SEE WORKSHEET A), IF ANY                                                                                  3. $______________________
4. ADJUSTED BUSINESS INCOME (LINE 2 MINUS LINE 3)                                                                                4. $______________________
5. TOTAL INCOME (LINE 1 PLUS LINE 4)                                                                                             5. $______________________
6. ASHLAND INCOME TAX (2% OF LINE 5)                                                                                             6. $______________________
7. A. ASHLAND INCOME TAX WITHHELD BY EMPLOYERS                 7A. $_________________
    B. TAXES PAID TO OTHER CITIES (LIMIT 1% OF BOX 18)                     7B. $_________________
    C. ESTIMATED TAXES PAID / PRIOR YRS OVERPAYMENT             7C. $_________________
          D. TOTAL CREDITS (ADD A, B AND C)                                                                   7D. $______________
8. TAX DUE (LINE 6 MINUS 7D)                                                                                                     8. $______________________
9. A. OVERPAYMENT CLAIMED IF LINE 8 IS NEGATIVE                      9A. $_________________
    B. ENTER AMT OF LINE 8 YOU WANT APPLIED TO NEXT YR          9B. $_________________
    C. ENTER AMT OF LINE 8 YOU WANT REFUNDED                          9C. $_________________
10. INSUFFICIENT ESTIMATED TAXES PAID PENALTY     (15% OF ESTIMATES UNPAID FOR 2022)                                             10. $_____________________
11. INTEREST (.42% PER MONTH OF LINE 8)                                                                                          11. $_____________________
12. LATE FILING PENALTY ($25 PER MONTH UP TO A MAXIMUM OF $150)                                                                  12. $_____________________
13. TOTAL INTEREST AND PENALTIES (ADD LINES 10-12)                                                                               13. $_____________________
14. AMOUNT DUE FOR 2022                 No payment or refund for amount under $10.00                                             14. $_____________________
                               DECLARATION OF ESTIMATED TAX FOR 2023 TAX YEAR
                    THIS SECTION MUST BE COMPLETED IF AMOUNT FOR TAX YEAR 2022 IS AT LEAST $200.00
15. ESTIMATED TAXABLE INCOME FOR 2023                                       15. $_______________
16. ESTIMATED TAX DUE (MULTIPLY LINE 15 BY 2%)                                          16. $_______________
17. TAXES TO BE WITHHELD & PAID TO ASHLAND                             17. $_______________
18. TAXES PAID TO OTHER CITIES (LIMIT OF 1%)                                      18. $_______________
19. TOTAL OF LINES 17 & 18                                                                            19. $______________
20. NET ESTIMATED TAX DUE (LINE 16 MINUS LINE 19)                                                                                20. $_____________________
21. FIRST QUARTER ESTIMATE (MULTIPY LINE 20 BY 22.5%)                  21. $_______________
22. LESS OVERPAYMENT FROM 9B                                                        22. $_______________
23. AMOUNT DUE FOR FIRST QUARTER (LINE 21 MINUS LINE 22)                                                                         23. $_____________________
24. TOTAL AMOUNT DUE ( ADD LINES 14 & 23) - PAY IN FULL WITH RETURN                                                              24. $_____________________
I CERTIFY, TO THE BEST OF MY KNOWLEDGE, THAT THIS RETURN, SCHEDULES & STATEMENTS ARE TRUE & CORRECT. (Signature(s) Required)
Taxpayer's Signature _____________________________________________________                                                       Date _______________
Spouse's Signature ______________________________________________________                                                        Date _______________
Preparer's Signature _________________________ Date ________   Company Name ______________ Phone No _________
       I (WE) AUTHORIZE THE INCOME TAX DEPT TO DISCUSS THIS RETURN & ENCLOSURES WITH THE PREPARER ABOVE                          □ Check Here

                                                              WORKSHEET A
                                                    2017            2018   2019                   2020         2021                   2022
NOL Carryforward
50% of NOL
Loss Used This Year (Limit 50%)
NOL Available for Next Year
                                                              INSTRUCTIONS
RESIDENCY STATUS: You must complete the residency status information.
NAME, ADDRESS, PHONE NUMBER and EMAIL: Please make any changes on the form.
IDENTIFICATION NUMBERS: Enter Social Security Number of taxpayer and spouse.
LINE 1 - WAGES - Enter Medicare Wages located in Box 5 of W-2, include salaries and tips. If no wages appear in Box 5, use the highest
                     wages that appear on the W-2.*
                               * All copies of W-2's MUST be attached to the tax return.
LINE 2 - OTHER INCOME - Federal Schedules C, E, K-1, 1099s, Gambling & Lottery Winnings.**
                     Business or rental losses cannot offset W-2 wages.
                              ** All Schedules & Tenant Roster must be attached to the tax return.
LINE 3 - NET OPERATING LOSS - See Worksheet A
LINE 4 - ADJUSTED BUSINESS INCOME - Line 3 minus Line 2.
LINE 5 - TOTAL INCOME - Line 1 plus Line 4, if Line 4 is positive. If Line 4 is negative, carry down Line 1.
LINE 6 - ASHLAND TAXABLE INCOME - Multiply Line 5 by 2% and enter that amount.
LINE 7 - ALLOWABLE CREDITS
                     A. Ashland Income Tax withheld by employer(s)
                     B. Taxes paid to other cities (Limit of 1% of W-2 Box 18 paid to cities other than Ashland)(This credit is for residents only)
                     C. Estimated taxes paid / Prior year overpayment
                     D. Total credits (Add A, B and C)
LINE 8 - TAX DUE - If Line 5 is more than Line 7D, enter the difference. This is the amount of tax due. Amounts under $10.00 are not payable.
LINE 9 - OVERPAYMENT
                     A. If Line 6 is less than 7D, enter the difference. This is the amount of the overpayment.
                     B. Enter the portion of 9A that you would like applied to next year's return.
                     C. Enter the portion of 9A that you would like refunded. Amounts under $10.00 will not be refunded.
LINE 10 - INSUFFICIENT ESTIMATED TAXES PAID PENALTY - If Line 8 is more than $200.00 and is less than 90% of the previous year's 
                     tax due, you are subject to a penalty of 15% of taxes unpaid on the Declaration of Estimated Taxes.
LINE 11 - INTEREST - Interest will be added to any unpaid tax balance after April 18th. The interest rate is .42% per month.
LINE 12 - LATE FILING PENALTY - If your return is filed after April 18th, you are subject to a penalty of $25.00 per month it is late.
                     The maximum penalty is $150.00.
LINE 13 - TOTAL INTEREST AND PENALTIES - Add Lines 10-12.
LINE 14 - AMOUNT DUE - Add Line 8 and Line 13 and this will be the amount due for 2022.
                                                    DECLARATION OF ESTIMATED TAX
                        This section must be completed if amount due for tax year 2022 is at least $200.00
LINE 15 - Enter the total amount of income estimated to be earned in 2023.
LINE 16 - Multiply the estimated income by 2% (.02).
LINE 17 - Enter the amount of taxes estimated to be withheld by your employer for Ashland.
LINE 18 - Enter the amount of taxes paid to other cities ( Limit is 1% of wages with other city withholding).
LINE 19 - Total taxes paid to Ashland & other cities ( Add Lines 17 & 18).
LINE 20 - Net estimated tax due for 2023 (Subtract Line 19 from 16).
LINE 21 - First quarter estimate ( Multiply Line 20 by 22.5%).
LINE 22 - Amount from Line 9B.
LINE 23 - Amount due for the first quarter (Subtract Line 22 from Line 21).
LINE 24 - TOTAL AMOUNT OF TAXES DUE (Add Lines 14 & 23) BY APRIL 18TH.
                                  MAKE CHECKS OR MONEY ORDERS PAYABLE TO:
                                                    CITY OF ASHLAND FINANCE DIVISION
                                                    218 LUTHER ST, ASHLAND, OH 44805
                                                    PH: (419) 289-0386       FAX: (419) 289-9225
                                                    Pay Online at: OfficialPayments.Com