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Change tax year if necessary Instructions Reset Form Print Form
INDIVIDUAL AND BUSINESS TAX RETURN
INCOME TAX DEPARTMENT
(440) 204-1002 Payments
CITY OF LORAIN 2022 FAX (440) 204-1006 from
605 WEST 4TH ST, LORAIN, OH 44052-1605 4th Quarter
THIS RETURN IS DUE BY THE IRS DUE DATE. OR www.cityoflorain.org
FISCAL PERIOD______TO______ If under 18 - Attach proof of age
FISCAL YEAR FILERS MUST FILE ON OR BEFORE THE 15TH DAY OF
THE FOURTH MONTH AFTER THE CLOSE OF THAT FISCAL YEAR. FOR INCOME TAX DEPARTMENT USE ONLY
PAID W/RETURN: CK NO.
PLEASE MAKE SURE NAME AND ADDRESS IS CURRENT INFORMATION
DUE CR TO 2023 REFUND
Enter
__________________________________________________ DECLARING EXEMPTION
Name
__________________________________________________ Exemption Certificate on Pg. 2 Must Be Completed
and
Address __________________________________________________ IF YOU MOVED DURING THE TAX YEAR, COMPLETE THIS BLOCK
Here __________________________________________________ Date moved into Lorain
Previous Address
Date moved out of Lorain
SSN or FID JOINT SSN Present Address
Do you rent or own your home? □ Rent □ Own

W-2 WORKSHEET SEE INSTRUCTIONS BEFORE COMPLETING ROUND TO NEAREST WHOLE DOLLAR
COLUMN 1 COLUMN 2 COLUMN 3 COLUMN 4 COLUMN 5
Date wages were CITY WHERE EMPLOYED GROSS WAGES–HIGHEST WAGES EARNED WHILE LORAIN OTHER CITY MAX CREDIT 2.0 %
Earned (Month/Day)
W-2 From To WAGE ON W-2 LORAINSEE INSTRUCTIONSRESIDENT TAX WITHHELD TAX WITHHELD OF TAXED WAGES
COPIES
MUST
BE
ATTACHED
TOTALS
ATTACH A COPY OF 1040, ALL APPLICABLE W-2S, FEDERAL SCHEDULES, EXPLANATIONS ETC…
INCOME 1. Total W-2 wages from column 2, W-2G and 1099 income........................................................................1 $
2. Partial year wages earned while not a resident of Lorain ........................................................................2 $
3. TAXABLE WAGES. SUBTRACT LINE 2 FROM LINE 1 ..........................................................................3 $
4. Other income. From schedule C, E and H on Pg. 2, Line 12 ..................................................................4 $
5. TOTAL LORAIN INCOME. ADD LINES 3 AND 4 ....................................................................................5 $
TAX 6. LORAIN INCOME TAX. MULTIPLY LINE 5 BY 2-1/2% (.025)..................................................................6 $
TAX 7. Lorain income tax withheld from column 4 .................................................7 $
8. Prior year credits..........................................................................................8 $
WITHHELD,
9. Estimated payments ....................................................................................9 $
PAYMENTS
10. Credit for taxes withheld to other cities from column 5 ............................10 $
AND 11. Credit for taxes paid to other cities (limit 2.0%). See instructions ...........11 $
CREDITS 12. TOTAL PAYMENTS AND CREDITS. ADD LINES 7 THROUGH 11 ............ 12 $
13. TAX BALANCE. If line 6 is more than 12, enter amount due ................................................................13 $
BALANCE 14. Late Filing Penalty. $25, if applicable ......................................................................................................14 $
DUE, 15. Late Payment Penalty. 15% of line 13 ________ Interest (see City website for rates) ________ .......15 $
REFUND 16. TOTAL DUE. Add lines 13 through 15. Carry to line 26 below (No remittance due if $10.00 or less) ...16 $
OR 17. OVERPAYMENT. If line 12 is more than the total of lines 6, 14 and 15 enter here..17 $
CREDIT 18. AMOUNT FROM LINE 17 TO BE REFUNDED (No refund if $10.00 or less) .....18 $
19. AMOUNT FROM LINE 17 TO BE CREDITED TO NEXT YEAR ..............19 $
DECLARATION OF ESTIMATED TAX FOR 2023 (MANDATORY - When tax due is $200.00 or more)
ESTIMATE 20. Total estimated income subject to tax $ Multiply by tax rate of 2-1/2% (.025) ..............20 $
FOR 21. Subtract any estimated income tax to be withheld or paid to other cities (limit 2.0 % of wages) ...........21 $
22. Balance of city income tax declared. Subtract line 21 from line 20 ........................................................22 $
NEXT
23. Tax due before credits. Enter at least 22.5% of line 22 .........................................................................23 $
YEAR 24. Less credits. Enter line 19 from above....................................................................................................24 $
25. Net estimated tax due. Subtract line 24 from line 23 ..............................................................................25 $
26. Enter total due from line 16 above (No remittance due if $10.00 or less) .............................................26 $
TAX DUE 27. TOTAL DUE. ADD LINES 25 & 26. MAKE CHECKS PAYABLE TO LORAIN INCOME TAX DEPT...........................................27 $
If this return was prepared by a tax practitioner, check here if we may NOT contact him/her directly with questions regarding the preparation of this return.
The undersigned declares that this return (and accompanying schedules) is a true, correct and complete return for the taxable period stated and that the figures used herein are the same as used for Federal Income Tax purposes.

SIGNATURE OF PREPARER, IF OTHER THAN TAXPAYER DATE SIGNATURE OF TAXPAYER DATE

NAME AND ADDRESS OF PREPARER (PLEASE PRINT) TELEPHONE NUMBER SIGNATURE OF SPOUSE (IF JOINT RETURN) TELEPHONE NUMBER

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                                                                                                                                 Instructions
                       Attach copies of all Federal forms and schedules used to compute your local income.

                                                                                                                                 ()
                                                      For Corporations and Partnerships Only 
                                                    {- See Sch. X at www.cityoflorain.org                 }

                       Lorain
  (Resident individuals should report 100% of their profit or loss)

Partnership, Sch. K-1 and other Misc. Income
DoDonotnotincludereport1099W2GororW-2G1099incomeMiscorIncomeamountshere.reported to Amherst on a separate business return.

9 & 9a.  Total Line 6, 7 and 8

10.  Total of Lines 9 and 9a                                                                                       10.

11.  Prior NOL (5 yr. limit - schedule must be attached)                                                           11.

12. Carry profit on line 12 to the front of the return, line 4

If taxes paid to other cities, documentation must be attached.  No credit will be given on profit negated by loss.

                                                                                                                          Lorain

            a) Avg. Original Cost of Real & Tangible Personal Property
                                                                                    8..............
                                      1...............................................................
            Gross Receipts from Sales...............................................
                                          d........................................................

 T
 a
 x  S
 p  p
 a  o
 y  u
 e  s                  No taxable income to be reported due to the reason(s) below:
 r  e
 ↓  ↓
       UNDER 18 for the entire year of _________.  My date of birth is ___/___/___ (Attach proof of DOB)
       RETIRED - I received only pension, Social Security and/or interest or dividend income.
       ACTIVE MEMBER OF THE U.S ARMED FORCES FOR THE ENTIRE YEAR OF ____________.
            (This exemption does not include civilians employed by the military or the National Guard)
       DOMICILED OUTSIDE THE CITY OF LORAIN FOR THE ENTIRE YEAR OF __________.                                                   
       NO EARNED INCOME FOR THE ENTIRE YEAR OF __________.
            (Public Assistance, SSI, Unemployment, etc. is not considered earned income.) 
                                                                                                                                 L1114

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                  CITY OF LORAIN INCOME TAX INSTRUCTIONS
WHO MUST FILE:
Every Resident, full or partial year, 18 years of age and older, must                 figure.  Use  the  monthly  earnings  figure  multiplied  by  the  number  of
file a tax return, whether or not taxes are due. If you have no income or             months  of  residency  to  find  your  taxable  amount.  If  you  pro-rate  your
your ONLY source of income is retirement income (ie, SSI, pensions,                   income you must also pro-rate your city tax that was withheld on the same
interest, dividends, IRA and 401K distributions), complete the exemption              income.  Attach a worksheet explaining your calculations.
certificate on page 2 of the return.
                                                                                      DECLARATION OF ESTIMATED TAX:          Taxpayers who expect to receive
Every  Business  Entity,  whether  a  resident  or  non-resident,  who                taxable income for the coming year must declare estimated tax payments
conducts a business in Lorain must file a return and pay any tax on that              (22.5% of full amount may be paid at the time of filing the annual return).
profit.  If  you  have  a  net  loss  you  are  still  required  to  file  a  return. The estimated tax payment due dates are June 15th, September 15th, and
(“Business” includes rental income.)                                                  January 15th. This declaration is mandatory when $200.00 or more is owed.
Non-Resident Individuals, earning income in Lorain not subject to
the withholding of Lorain income tax must also file a return.                         LATE FILING PENALTY:       Except in those cases where an extension was 
                                                                                      filed, a late filing penalty of $25.00 shall be due on return filed after the due 
UNDER 18: If a person is under 18, was employed in the city of Lorain                 date, even when no tax is due. 
and had Lorain taxes withheld, send in W-2(s) with a copy of driver’s 
license or birth certificate and a refund will be issued.                             LATE PAYMENT PENALTY: A penalty will be charged on unpaid tax equal
                                                                                      to fifteen percent (15%) of the amount not timely paid.    
FILING  STATUS:  Taxpayers  who  prepare  their  federal  and  state  tax
returns using the “married filing separate” status to lower their overall             INTEREST: The interest rate used shall be the Federal short-term rate
tax liability may still file a joint return for the city of Lorain. Filing a joint    (rounded to the nearest whole number percent) plus five percent (5%). The
return will neither increase nor decrease your City of Lorain tax liability.          rate shall apply for the calendar year next, following July of the year in which
Husband and wife may file joint returns, in which case both must sign the             the Federal short-term rate is determined.
return and submit their social security numbers.
                                                                                      NET  OPERATING  LOSSES:        The  net  loss  from  an  unincorporated
WHEN TO FILE: Taxpayers who end their taxable year on December 31                     business activity may not be used to offset salaries, wages, commissions
must file on or before the IRS due date. Taxpayers on a fiscal year must              or other compensation. Operating losses may be carried forward for a
file on or before the 15th day of the fourth month after the close of that            maximum period of five years, and may be used to reduce taxable income.
fiscal year or other period.                                                          Loss incurred between 2017-2022 can only be utilized at 50%. An NOL 
EXTENSIONS:   Extension requests must be postmarked by the IRS due                    schedule must accompany this return.
date or be subject to penalties and interest. Requests should be mailed to
the Lorain tax office, e-mailed to incometax@cityoflorain.org, or faxed to            AMENDED RETURNS: Amended returns are accepted by completing an
(440) 204-1006. If you have received a Federal extension it will be honored           income tax return with the words “Amended Return” printed across the
if attached to the tax return and postmarked by the extended IRS due date.            top and indicating the year being amended. The amended return is required
An extension request is not an extension of time to pay.                              within three (3) months of the final determination of any changed tax liability
                                                                                      resulting from the Federal audit, Judicial decision, or other circumstances.
PARTIAL YEAR RESIDENTS: If you only lived in Lorain during part of
the year you must file a tax return covering that time. Report the amount             TAXABLE INCOME:      Lorain income tax is levied at the rate of 2.5%.
of income you earned while you lived in Lorain. Pay statements with                   Income  taxable  to  the  city  is  listed  below.  While  this  list  is  not
year-to-date figures or a statement from your payroll department must be              comprehensive, it encompasses most of the taxable situations. In addition
used  if  available.  When  the  actual  amount  you  earned  while  living  in       to the listing, the net profits of all unincorporated businesses, professions,
Lorain cannot be determined, you may break down your earnings by the                  rentals or other activities conducted by residents and non-residents of the
number  of  months  employed  at  the  job  arriving  at  a  monthly  earnings        city of Lorain are taxable.

                                                              TAXABLE INCOME
Wages, salaries and other compensation                                                “C” Compensation - Group Term Life Insurance Premiums over $50K
Bonuses, stipends and tip income                                                      Income from guaranteed annual wage contract
Commissions, fees and other earned income                                             Director fees
Sick pay paid by employer                                                             Strike pay
Employee contributions to retirement plans and tax deferred annuity                   Uniform, automobile, moving and travel allowances
plans (including Sec. 401k, 403b, 457b, etc)                                          Employer-provided education assistance, prizes and gifts, taxable to the
Net farm income                                                                       same extent as Federal Income Tax.
Net rental income                                                                     Executor fees
Net profits of businesses, professions, sole proprietorships, etc                     Disability payments from employer
Income from partnerships, s-corporations, estates or trusts                           Supplemental Unemployment Benefits (SUB pay)
Employer contributions to cost of fringe benefits                                     Gambling, lottery, and games of chance
Vacation pay                                                                          Ordinary gains on sale of tangible property reported on IRS form 4797
Stock options                                                                         Hobby Income
                                                                                      Any other income that is not specifically excluded in the non-taxable
                                                                                      income definition of ORC 718

                                                          NON-TAXABLE INCOME
Interest or dividend income                                                           Government disability payments
Pre-tax contributions made by or on behalf of employees to cafeteria                  Poll worker income
plans (Sec 125 Plans, etc)                                                            Military pay (Including National Guard)
Welfare benefits                                                                      Earnings of persons under 18 years of age
Social Security                                                                       Capital gains
Income from qualified pension plans                                                   Patent and copyright income
State unemployment benefits                                                           Royalties derived from intangible property
Workerʼ s compensation                                                                Annuity distributions
Proceeds of life insurance                                                            Compensatory insurance proceeds derived from property damage or
Third Party Sick Pay - (short term)                                                   personal injury settlements
Alimony
                                                                                                                                                 Revised (11/23)

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LINE BY LINE INSTRUCTIONS
Make sure your correct name and address are on the form. If you moved Line 20 – Enter estimated income subject to tax, multiplied by a tax rate
during the tax year, complete the applicable area. of 2.5%.
PAGE 1 Line 21 – Enter any Lorain tax to be withheld or credit for tax
Column 1 – Enter the city where employed. If your W-2 states “various” withheld/paid to another city.
or “all cities,” please attach a copy of the itemized breakdown. In addition,
W-2G and 1099 Misc income not included on Federal Schedule C should Line 22 – Enter net tax due by subtracting Line 21 from Line 20.
be reported here.
Line 23 – Enter amount due with estimate, 22.5% of Line 22.
Column 2 – Enter the wages earned on each wage statement. In most
cases the amount shown in Box 18 of the W-2 should be used. However, Line 24 – If applicable, enter over payment from previous year (Line 19).
if Box 5 is higher, that wage must be used to calculate total wages earned. If Line 19 exceeds Line 23, credit will carry over into 2nd Quarter payment.
Column 3 – For partial year residents, enter the amount of wages Line 25 – Subtract Line 24 from Line 23.
included in gross wages that were earned while you were a Lorain
resident. Line 26 – Enter amount from Line 16.

Column 4 – Enter City of Lorain tax withheld from Box 19 on the W-2. Line 27 – Add Lines 25 and 26. Sign and date return and make check
payable to the Lorain Income Tax Department.
Column 5 – Lorain allows a tax credit for taxes withheld by another city
up to 2.0 %. Credit may not exceed 2.0% of the wages actually taxed PAGE 2
by another city on each wage statement. When income is reduced for SCHEDULE C: Net profits shall be determined on the basis of the
partial year residency, the tax credit in column 5 is also reduced. If a information used for Federal income tax purposes, adjusted to the
portion of your gross income is not taxed by another city, 2.5% tax is requirements of the ordinance. All business entities must attach copies of
owed on that portion. (For example, township wages are not withheld on; appropriate Federal Schedules.
therefore, no credit is given and the wages are taxed at the full 2.5%.)
SCHEDULE H: This schedule is used to list all other taxable income not
Line 1 – Enter total amount of the wage statements from Column 2. Attach reported elsewhere on this return. W-2G and 1099 income should be
all wage statements to the back of the return. reported on the front of the tax return, line 1.

Line 2 – Enter the amount of wages earned while not a resident of Lorain. SCHEDULE X: See ORC 718.02 for items that are taxable and deductible.
Line 3 – Subtract Line 2 from Line 1. SCHEDULE Y: To be used only when the books and records of the
taxpayer do not disclose with reasonable accuracy the net profit
Line 4 – Enter the amount of other income from Page 2, Line 12, but not attributable to Lorain. A business allocation formula consisting of the
less than -0-. Attach appropriate schedules and documentation. average property, wages paid, and gross receipts may be used by
business entities not required to pay tax on entire net profits.
Line 5 – Add Lines 3 and 4.
Line 6 – Multiply Line 5 by 2-1/2% (.025).
Line 7 – Enter tax withheld for Lorain from Column 4.
Line 8 – Enter any prior year credits.
Line 9 – Enter any estimated payments made.
Line 10 – Enter credit for taxes withheld by other cities from Column 5.
Line 11 – Enter credit for taxes paid to other cities not shown on a W-2.
Credit may not exceed 2.0 % of the income actually taxed by the city
of Lorain. No credit will be given on profit negated by loss. Attach
appropriate documentation verifying credits from other cities. (Copy of
other city tax returns will be acceptable.)
Line 12 – Add Lines 7 through 11.
Line 13 – Subtract Line 12 from Line 6. If Line 6 is more than Line 12,
enter tax due.
Line 14 – Enter Late Filing Penalty, if applicable.
Line 15 – Enter Late Paying Penalty and Interest, if applicable. Enter
the total of these amounts on Line 15.
Line 16 – Add Lines 13, 14, and 15. Enter total here.
Line 17 – If Line 12 is more than the total of Lines 6, 14 and 15, enter
overpayment here.
Lines 18 & 19 – Indicate disposition of overpayment either by refund or
credit to next year.

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