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City of Lakewood - Division of Municipal Income Tax
FORM L-1 City Income Tax Return for Individuals 2022 Due By: April 18 2023,
DATE OF MOVE DURING 2022 : Refund
Into Lakewood ______________ Prior Address: _________________________________________________
Extension
Out of Lakewood ______________ Current Address: _______________________________________________ Amended - Year ___________
Contact Information: Taxpayer's Social Security Number Make checks payable and mail to:
City of Lakewood - Division of Tax
Spouse's Social Security Number (if joint) PO Box 77047
Cleveland, OH 44194
Filing Status - CHECK ONLY ONE Phone: (216) 529-6620
Telephone: (_______________) _______________-____________________________________ Single Fax: (216) 529-6099
DO NOT FORGET TO ATTACH THE FOLLOWING DOCUMENTS (AS APPLICABLE): Married - Filing Joint
Married - Filing Separately Email: taxdept@lakewoodoh.net
If you want Lakewood to calculate your tax - STOP, check the box, sign and date the return. Submit with W-2s before March 15, 2023.
TABLE A-1: WAGES AND COMPENSATION
SECTION 1: Part-Year Resident Calculation
This section should only be used for moves within the State of Ohio. If you lived 1. Number of Months Lived in Lakewood:
in Lakewood for the entire year, or if you moved directly into Lakewood from a 2. Divide Section 1, Line 1 by 12:
residency out of state, calculate Columns 1 and 3 by 100%. 3. Multiply Section 1, Line 2 by 100: %
SECTION 2: W-2 Income Calculation
Dates wages LOCATION WHERE EARNED Column 1 Column 2 Column 3 Column 4 Column 5 Column 6
were earned List each W2 separately Total Wages Withheld for Withheld for Tax Credit Limit Smaller of Tax Credit
MM DD MM DD or Compensation Lakewood other localities (Column 1 x .01) Column 3 or 4 (Column 5 x .50)
Enter Section 1, Line 3 in Column 1 and
Column 3, and multiply each listing in Columns 1 __________% __________%
& 3 by percentage before entering on form. 100%
Lakewood (Calculate at 100%)
Lakewood (Calculate at 100%)
[ATTACH ALL CITY COPY W-2 & 1099 FORMS HERE] Total from TABLE A-2:
Overall Total: Total
(to Line 1) (to Line 6) (to Line 7)
INCOME
1. Wages and compensation (from Table A-1, Section 2, Column 1) 1.
2. 2.
3. Total Taxable Non-Schedule Income (add Lines 1 and 2) 3.
4. Schedule Income (From Table B, Column 6, Line 9) - DO NOT enter amount less than zero 4.
TAX AND CREDITS
5. Total Non-Schedule Lakewood tax due before credits (multiply Line 3 by 1.5% or .015) 5.
6. Taxes withheld and paid to Lakewood (from Table A, Section 2, Column 2) 6.
7. Wage income tax credit (from Table A, Section 2, Column 6) 7.
8. Total Non-Schedule Credits (add Lines 6 and 7) 8.
9. Total Non-Schedule tax due before estimated payments (subtract Line 8 from Line 5) 9.
10. Total Schedule tax due before estimated payments (from Table B, Column 6, Line 16) 10.
11. Total tax due before estimated payments (add Lines 9 and 10) 11.
12. 2022 estimated tax payment(s) and unused prior year credits - up-to-date amounts available at 12.
13. Total net tax - Subtract Line 12 from Line 11 and proceed to Line 16. If less than $10.00, enter zero and proceed to Line 14 13.
OVERPAYMENT
14. Overpayment - If Line 12 is greater than Line 11, and not less than $10.00, subtract Line 11 from Line 12 14.
15. From Line 14 - Amount to be credited to 2023 - $_______________ Amount to be refunded - $_______________ (Proceed to Line 17)
BALANCE DUE
16. Balance Due - If Line 11 is greater than Line 12, and not less than $10.00, subtract Line 12 from Line 11 16.
ESTIMATED INCOME TAX FOR 2023
17. Estimated income tax for 2023 (from Line 11) 17.
18. First quarter payment (multiply Line 17 by 25% or .25) 18.
19. 2022 credit applied to first quarter 2023 estimate (from Line 15) 19.
20. Total amount due by April 18, 2023 (add Line 16, 18, and subtract Line 19) 20.
The undersigned declares this to be a true, correct, and complete return of Lakewood Income Tax for the period stated.
_______________________________________________________________________________________________
Taxpayer's Signature Date Acct. Number _________________________________
_______________________________________________________________________________________________ Exp. Date ____________ Security Code ___________
Spouse's Signature Date Amount Paid $________________________________
_______________________________________________________________________________________________ ______________________________________________
[ATTACH CHECK OR MONEY ORDER HERE] Tax Preparer's Signature (if other than taxpayer) Phone # Date Signature
I authorize the City of Lakewood - Division of Municipal Income Tax to discuss my account and enclosures with my preparer (above)
