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City of Fairfield
Individual Tax Return
Income Tax Division Phone: 513-867-5327
2023 701 Wessel Dr Fax: 513-867-5333
Fairfield, OH 45014
Tax Return is due by
April 15, 2024 www.fairfield-city.org
E-file available at:
https://web2.civicacmi.com/FairfieldTax
Account Number: ______________________ SSN: __________________________ PLEASE ATTACH:
Phone: _______________________________ Spouse SSN: __________________________ • FEDERAL 1040 REQUIRED
Name (s): ________________________________________________________ • W-2(S)
Address: ________________________________________________________ • OTHER APPLICABLE
SCHEDULES AND
City/State/Zip ________________________________________________________ DOCUMENTATION
If part-year resident ,indicate dates of Fairfield residency: From_____________To______________
Single
Married Filing Joint Return (even if only one had income) Did you file Joint or Separate last year? Joint Separate
Married Filing Separate Return. Enter Spouse's social security number and full name here:________________________________
1. TOTAL W-2 INCOME (Box 5 of W-2) 1.
2. INCOME OTHER THAN WAGES(Attach federal schedules, forms, supporting documentation) 2.
3. TOTAL INCOME (Add box 1 and box 2) 3.
4. TAX LIABILITY Multiply box 3 by 1.50% 4.
5. CREDITS A. Fairfield tax withheld 5A.
B. Credit for other city tax withheld (limited to 1.5%) 5B.
C.202 3Estimated tax payments 5C.
D. Prior year credit carried forward 5D.
Total of credits. Add 5A through 5D and enter here. 5E.
E.
6. If box 4 is greater than box 5E, enter your BALANCE DUE (if greater than $10.00) 6.
7. If box 5E is greater than box 4, enter your OVERPAYMENT(if greater than $10.00) 7.
A. REFUND over $10.00)( $___________________ or B.CREDIT TO 2024 (over $10.00) $___________________
8. BALANCE DUE FOR 2023 Add box 6 and box 8 (if $200.00 or greater, complete estimate section below) 8.
2024 DECLARATION OF ESTIMATED TAX DUE - Complete this section if 2023 tax due is $200.00 or greater
9.
9. Total estimated for tax year 2024 (gross taxable income multiplied by 1.50%)
10. Less credits (including tax anticipated to be withheld from employers) 10.
11. Net tax owed for tax year 2024 estimated tax 11.
12. Amount paid with this declaration for 2024 FIRST QUARTER ESTIMATED TAX 12.
13. TOTAL DUE. ADD BOXES 8AND 12 FOR TOTAL BALANCE DUE.
13.
I certify that I have examined this return including accompanying Federal 1040 page one, W-2's, schedules and statements, and to the best of my knowledge and belief, it
is true,accurate, and correct. YES NO (Note: Preparer mustsign on the line appropriate line below)
Check enclosed, made payable to City of Fairfield Income Tax Division
Paying via credit card: Enter number, expiration date, CVV code,
Your signature Date and amount authorized fully and accurately.
Spouse signature (if filing joint return) Date
Card Number: ____________________________________________
Signature of preparer (if not prepared by taxpayer) CVV Code: ______________ Exp: ___________________________
May the Tax Division discuss this return with this preparer? YES NO Amount Authorized: $______________________________________
Phone Number: __________________________________________
Cardholder Signature: _____________________________________
