CITY OF MANSFIELD                                         FORM FR  –B                                           
P.O. BOX 577 
INCOME TAX DIVISION                                   INCOME TAX RETURN                                          BUSINESS 
MANSFIELD, OHIO 44901-0577                                YEAR 2023 
Telephone (419) 755-9711                                        OR                                               
          Fax (419) 755-9751 
                                                                                                                  
 Make Checks and Money       Fiscal Period__________________to____________________                               Tax Return for 
 Orders Payable to:          CALENDAR YEAR TAXPAYERS FILE ON OR BEFORE APRIL 15, 2024                            ___Corporation 
 City of Mansfield           FISCAL and PARTIAL YEARS FILE WITHIN 105 DAYS AFTER THE CLOSE OF THE FISCAL YEAR.   ___Partnerships 
                                                                                                                 ___Fiduciary 
 DID YOU FILE A CITY         Is this a Final Return    Yes        No?                                            ___Estates 
 RETURN LAST YEAR?                                                                                               ___Trusts 
    YES         NO                                                                                               CHECK ONE 
                                                                                                                 
Name: __________________________________________                                       
                                                                                       
Address: ________________________________________                                      
                                                                                       Federal Employer Identification Number 
                                                                                                                                       
City: _______________ State: _______________  Zip Code: ______                                                    
                                                                                      Has a return been previously filed with                  
                                                                                      Mansfield Using this number?                                                                                                                                                     
Is this an address change    _____  Yes  _____  No                                        YES                     NO 
 
1.    Taxable Income from Federal Return (attach Copy of Federal Return) ………………………………………………………………                           $ 
                                                                                                                             
2.    Adjustments (from line O, Schedule X) on following page.………………………………….……………………………………………                               $ 
                                                                                                                             
3.    Loss carry forward (Tax year 2017 is the first loss carry forward year allowed).…………………………..……………….                   $ 
                                                                                                                             
4.    Taxable Income before allocation (Line 1 plus/minus line 2 less line 3) ………………………………………………………….                       $ 
                                                                                                                             
5.    Apportionment Percentage (From Schedule Y) _____________%                                                              
                                                                                                                            $ 
6.    Mansfield Taxable Income (Multiply line 4 by line 5) …………………………………………………………………………………………. 
                                                                                                                             
7.    Mansfield Income Tax (Multiply line 5 by 2%)…………………………………………………………………………………………………….                                   $ 
                                                                                                                             
8.    Credits applied from 20___ to this year’s liability…………………………………………………………………            $ 
                                                                                                                             
9.    Estimates paid on this year’s liability…………………………………………………………………………………….                $ 
                                                                                                                             
10.   Total Credits………………………………………………………………………………………………………………………………………………………….                                              $ 
                                                                                                                             
11.   Tax Due (Subtract line 10 from line 7) ……………………………………………………………………………………………………………….                                    $ 
                                                                                                                             
12.    LATE FILING PENALTY - PLUS LATE PAYMENT PENALTY (see instructions) …………………………………………………….                             $ 
                                                                                                                             
13.   Interest (10% per annum if paid after due date)…………………………………………………………………………………………………                                  $ 
                                                                                              Pay This Amount                
14.    Total Due (If less than $10.00-do not remit)……………………………………………………………………..                                             $ 
                                                                                                                             
15.    Overpayment (Line 10 greater than line 7) (must be more than $10.00)………………………..        $ 
                                                                                                                             
         A.  Amount from line 14 to be refunded……………………………………………………………………………..                $ 
                                                                                                                             
         B.  Amount from line 14 to be credited to next year………………………………………………………….           $ 
  If this return was prepared by a tax practitioner, check here if we may 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 PERSON PREPARING, IF OTHER THAN TAXPAYER     DATE                SIGNATURE OF TAXPAYER OR AGENT                  DATE 
 
ADDRESS OF FIRM OR EMPLOYER                               PHONE #             TITLE                                           PHONE # 

                 SCHEDULE X  –RECONCILIATION WITH FEDERAL INCOME TAX RETURN 
            ITEMS NOT DEDUCTIBLE              ADD                       ITEMS NOT TAXABLE                             DEDUCT 
A  Capital Losses (Excluding Ordinary Loss)…. $                  I  Capital Gains (Excluding Ordinary Gain)           $ 
B  Income Taxes Paid……………………………………..          $                 J  Interest Earned or Accrued………………….                 $ 
C  5% of Amount Deducted as                                                                                            
                 Intangible Income……………………….  $                 K  Dividends……………………………………………..                       $ 
                                                                 L  Income From Royalties,                             
D  Guaranteed Payments to Partners……………       $                     Patents and Copyrights………………………                   $ 
E  Amounts for Qualified Self-Employed                                                                                 
    Retirement, Health & Life Insurance Plans                                                                          
    For owners of non-C Corporation Entities                                                                           
    or self-employment tax……………………………         $                 M  Other (Explain)___________________  $ 
F  Other………………………………………………………..               $                       _______________________________   
G  TOTAL ADDITIONS…………………………………..             $                       _______________________________   
                                                                      _______________________________   
                                                                 N  TOTAL DEDUCTIONS                                  $ 
                                                                                                                         
                                                 Combine lines G and N and enter net on front page Line 2  $ 
 
                 SCHEDULE Y  –BUSINESS APPORTIONMENT FORMULA 
                                                                    A  Located         B  Located in                 C  Percentage 
                                                                    Everywhere       Mansfield                         (B / A)              
Step 1  Average Original Cost of real and tangible personal property  $                $                              
           Gross annual rentals paid multiplied by 8…………………………….    $                  $                              
           Total Step 1…………………………………………………………….……………..              $                  $                                               % 
Step 2  Gross receipts from sales made and/or work or services                                                        
            Performed……………………………………………………………….……………..  $                             $                                               % 
Step 3  Wages, Salaries, Etc. Paid……………………………………………………..            $                  $                                               % 
Step 4  Total Percentages……………………………………………………………………                                                                                    % 
Step 5  Average percentage (Divide total percentages by number of percentages used   – carry to line 4 on front)……  
 
                 SCHEDULE Z   – PARTNER’S DISTRIBUTIVE SHARE OF NET INCOME 
 
                                                                2  Social Security   3  Amount                     4  EIN of Payer 
1  Name and address of each partner                                 Number 
 
(a)                                                                                                                       
 
(b)                                                                                                                       
 
(c)                                                                                                                       
 
(d) 
 
Carry forward to line 1 on front                                        TOTAL                                       
 
                                    ATTACH FEDERAL SCHEDULES