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2022 Individual Tax Return City of Blue Ash Tax Office
Phone: (513) 745-8516
OR FISCAL PERIOD _________ TO _________ Fax: (513) 745-8651
Website: www.blueash.com
 Amended Return n Final Return Email: blueashtax@blueash.com
Remit To: 4343 Cooper Road
DUE on or before April 18, 2023 – Filing required even if no tax is
THIS SPACE IS FOR OFFICIAL USE ONLY due regardless of whether a Federal or State return is filed. Blue Ash, OH 45242
Taxpayer’s SSN ______-_____-________
Taxpayer’s Name _________________________________________
Spouse’s SSN ______-_____-________
Spouse’s Name __________________________
Taxpayer’s Address _________________________________________ Phone# ______________Other#_____________
_________________________________________ If you have moved since your last filing, give date:
_________________________________________ Into Blue Ash________ Out of Blue Ash________
Inactivate account? YES
Reason: ________________________________

Part A Tax Calculation for 2022 –Attach 1 stpage of Federal 1040, Schedule 1, and other applicable Schedules TAX OFFICE
1. Total Qualifying Wages …W-2 BOX 5…(from Worksheet A on page 2) - Attach W-2 Forms……...1. $
2. Less Nontaxable Income for part year or non-residents only (provide calculations)………………….2. $
3. Taxable Qualified Wages (Line 1 minus Line 2)…………………………………………………………..3. $
Income 4. a. Other Income from Federal Schedules: 1, C, E, F, K-1,1099-MISC/NEC..(Use Worksheet B pg. 2)–
Attach all supporting Federal schedules……………………………………………………………….4a. $
b. Other Loss (Worksheet B)…(cannot reduce qualifying wages) ............... 4b. $
5. Blue Ash Taxable Income (Line 3 plus Line 4a.) ................................................................................ 5. $
Tax 6. Blue Ash Income Tax (Multiply Line 5 by 1.25% [.0125])………………………………………………...6. $
7. a. Blue Ash Tax Withheld (per W-2s or see Worksheet A) ........................... 7a. $
b. Estimates Paid (including credit from previous year) ............................... 7b. $
c. Credit for Other City Taxes Withheld (Limitations apply, Wksht A) .......... 7c. $
Credits and Pmts d. Credit for Other City Taxes Paid (Limitations apply, Wksht C) ................. 7d. $
8. Total Payments and Credits (Lines 7a + 7b + 7c + 7d)…………………………………………………..8. $
9. Tax Due (Subtract Line 8 from Line 6)…………………………………………………………....……….9. $
10. Overpayment (Line 8 greater than Line 6) .................................................... 10. $
11. Amount to be Refunded (Amounts $10 or less will not be refunded) .................... 11. $  Refund Requested
Owe, Refund, or Credit 12. Amount to be Credited to Next Year (Amounts $10 or less will not be credited) .. 12. $
Part B Declaration of Estimated Tax for 2023 – Mandatory if estimated liability is $200.00 or more
13. Total estimated income subject to tax…………………………………………………………………….13. $
14. Blue Ash Income Tax Declared (Multiply Line 13 by 1.25% [.0125])………………………………….14. $
15. Estimated Local Taxes Withheld from Wages (Not to exceed 1.25% of those wages taxed) ……..15. $
16. Net Tax Due (Line 14 minus Line 15) STOP if this amount is zero……………………………………16. $
Next Year
17. First Quarter Declaration Due (See instructions, minimum due is 22.5%)……………………………17. $
18. Less credits (from Line 12 above)…………………………………………………………………………18. $
19. Net First Quarter estimated tax due if Line 17 minus Line 18 is greater than zero*………………19. $
Due 20. TOTAL AMOUNT DUE—Line 9 plus Line 19 (Payable to Blue Ash Income Tax Office) $

TAX OFFICE USE Tax Penalty Interest Late months TOTAL DUE $
*Subsequent estimated quarterly payments are due by the 15th of June, September and the following January.
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.
 Yes, Blue Ash
Signature of Taxpayer (Required) may contact the
Preparer shown.
Signature of Spouse (Required if Joint Return) *Credit Card Payment Form on separate page following
the Individual Return
Signature of Preparer (if other than Taxpayer)
Name and Address of Preparer

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WORKSHEET A - SALARIES, WAGES, TIPS, AND OTHER COMPENSATION PER W-2(S)
Attach copies of all: W-2s (both pages if more than one), and if applicable: Refunds from other municipalities
COLUMN A COLUMN B COLUMN C COLUMN D COLUMN E COLUMN F
Total Wages Other City Tax
W-2 Box 5 Refunded from Column B Withheld
City Where Medicare Wages another Municipality minus Blue Ash Tax (Max 1.25% - see
Employer Employed (If blank use Box 18) (if applicable) Column C Withheld instructions)

Totals $ $ $ $ $
enter Pg. 1, Ln. 1 enter Pg. 1, Ln. 7a enter Pg. 1, Ln. 7c

WORKSHEET B - BUSINESS INCOME or LOSS
Attach copies of all Federal Forms and Schedules that support amounts entered below
COLUMN A COLUMN B COLUMN C
Income / (Loss) from Blue Ash Blue Ash Taxable Income
Schedules Federal Schedules Percentage (Column A x Column B)
B1. Schedule C - Business Income %
(A separate allocation schedule is required for each Schedule C).
Schedule E - Rental Income
B2. Residents enter profit/loss from all properties. Nonresidents enter only %
profit/loss from Blue Ash properties.
Schedule K-1 - Partnership Income
B3. (Residents enter profit/loss from entities that do not withhold Blue Ash %
tax on entire distributive share)
B4. Other Income – Fed. Sched. 1 (1040) Line 8 (b-e, g-l, & z), %
1099-MISC, W-2G, Fed. Schedule F, Fed. 4797, etc.
B5. TOTAL TAX YEAR BUSNESS/OTHER INCOME (LOSS)
If (Loss) STOP, enter Pg. 1, ln.4b.
Blue Ash Losses Carried Forward to Offset Current Year Total 2017-2021
Business Income (deduction limited to 50%) Losses Available
2017-2021
NOL Applied
B6. 2017(________)+ 2018(__________)+ 2019(__________)+
(Loss Deduct 50% Limit)
2020(________)+ 2021(__________) _________________ _________________

B7. TOTAL Taxable Income (B5 less B6 Column C) $
Income enter Pg. 1, Ln. 4a.
WORKSHEET C – CALCULATION OF CREDIT FOR TAXES PAID TO OTHER MUNICIPALITIES FOR NON W-2 INCOME ONLY
Attach copies of all other municipal filings
Taxable Income Credit for Taxes Paid to Another
Municipality (attach other municipal Municipality
Income Source (Not Blue Ash) return) Taxed by Blue Ash LIMITED, Max 1.25% - see instructions

Totals $ $ $
enter Pg. 1, Ln. 7d

SCHEDULE Y - BUSINESS APPORTIONMENT FORMULA a. Located b. Located in c. Percentage
For nonresidents who earn a portion of net profits in Blue Ash. Everywhere Blue Ash (b / a)
STEP 1. Average Original Cost of Real and Tangible Personal Property
Gross Annual Rent Paid Multiplied by 8
TOTAL STEP 1 $ $ %
STEP 2. Wages, Salaries, and Other Compensation Paid $ $ %
STEP 3. Gross Receipts: Sales Made and/or Services Performed $ $ %
STEP 4. Total Percentages. (Add Percentages from Steps 1-3) %
STEP 5. Apportionment Percentage (Divide Total Percentage by Number of Percentages Used) %

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                                       CITY OF BLUE ASH TAX DEPARMENT 
                                                           
               ONE TIME CREDIT CARD PAYMENT AUTHORIZATION FORM 
                                                           
 If you would like to pay your City of Blue Ash Income Taxes via Credit Card, please complete the 
 form below and return with your Tax Return.  Credit Card information from this form will not be kept 
 on file by the City of Blue Ash Tax Department, the information will be used to process one (1) 
 payment then will be promptly destroyed in a secure manner. 
  
 Please complete the form in its entirety. 
  
 Card Details: 
  
 Name on Card:                         __________________________ 
  
 Name on Account:                      __________________________ 
  
 Amount Authorized:                    _______________ 
  
 Credit Card Number:                                           
                                       
 CVV Code:                             ________ 
  
 Expiration Date:                      ________

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CITY OF BLUE ASH INCOME TAX RETURN INSTRUCTIONS – INDIVIDUAL FORM
This form is to be used by individuals who receive income reported on federal forms W-2, W-2G, 1099-MISC, 1099-NEC, and/or Schedules
1, C, E, F, or K-1. Individuals who file who file as Sole Proprietors or Single Member LLCs should also use this form. If you had no taxable
income, then you may be able to complete the “No Income” return located on our website, www.blueash.com/departments/tax_office.

Important Notes:
All residents 18 and over are required to file a Blue Ash tax return even if no tax is owed and if no Federal or State return was filed.
Do not forget to include the required forms: W-2s, 1099s, Federal 1040 and applicable schedules, especially the Federal Schedule 1
(amount on Line 9). Your filing is not complete and will not be processed without the required forms.
If you have losses from individual business income, see the instructions for Line 4/Worksheet B. State law changes limit the amount of
loss carryforwards from tax years 2017-2021 which may be used in tax years 2018-2022.

GENERAL INFORMATION
Extension Requests: Federal extensions will extend to the Blue Ash return (6 months). If no federal extension is granted, a
taxpayer may request a Blue Ash extension by the filing due date. An extension to file is not an extension to pay. Penalty and
interest will apply to all payments received after the return due date.
Estimated Payments: First quarter due with return, quarters 2, 3, and 4 due by June 15th, September 15th, and January 15 .th
Qualifying Wages: Generally include amounts reported in the Medicare wage base (W-2 Box 5) plus employer provided
supplemental unemployment compensation benefits described in Section 3402(o)(2) of the Internal Revenue Code and
compensation of pre-1986 employees exempt from Medicare that is not included in the Medicare wage base solely because of the
Medicare grandfathering provision.
Supporting Documents: All supporting documents must be included:
 Federal 1040, Page 1 (no exceptions) and Federal Schedule 1 Federal Schedules C,E,F (if applicable)
 All pages of W-2s, W-2Gs (no exceptions)  1099-NEC/MISC  4797 Any other supporting documents
Part A – Tax Calculation
LINE 1: Enter the total qualifying wages, usually the amount shown on the W-2 in Box 5 Medicare Wages. For multiple W-2s
complete Worksheet A on page 2 of the return.
LINE 2: Part year or non-residents only: For partial year residents deduct the amount of gross wages included on Part A, LINE 1
that was earned outside of Blue Ash during the period when you were not a resident. If accurate records are not available, you
may prorate your taxable income by dividing the number of months lived in Blue Ash by the total months in the year. For non-
residents, include a schedule of calculations and an itinerary of days worked outside of Blue Ash, listing the dates and location of
the worksite.
LINE 3: LINE 1 minus LINE 2.
LINE 4: Other Income and Business Income or Loss. Complete Worksheet B on page 2 of return.
B1. Schedule C – Business Income: Residents are subject to Blue Ash tax on all business income no matter where earned. Non-
Residents of Blue Ash must multiply the net profit or loss from each Schedule C by the apportionment percentage derived on
Schedule Y to determine the Blue Ash Taxable Income (Loss). Combine the profits and losses from all businesses reported on
Schedule C.
B2. Schedule E – Rental Income: Blue Ash residents report all profits or losses from rental property no matter where the property is
located. Non-Residents of Blue Ash report profits or losses only from properties located within Blue Ash.
B3. Flow-through Profits and Losses: The tax is levied on the partners, members or other owners of a flow-through entity excluding
S-Corporations. Businesses operating in Blue Ash are required to report the portion of the net profit earned in Blue Ash and to
remit the tax on behalf of all their partners. Residents of Blue Ash are to report their distributive shares of income or loss.
B4. Other Income: Please provide documentation such as copies of federal schedules of Forms 1099-NEC/MISC not already
reported on Schedule C. Also taxable are all prizes, awards and income derived from gambling, wagering, lotteries, or games
of chance by residents, regardless of where derived or by non-residents from sources in the municipality and as reported on IRS
Forms W-2G, 5754, 4797 or any other form required by the IRS to report such prizes, awards, and income. (1099s reporting
interest, dividends, & retirement income are NOT taxable).
B5. Sum lines B1 to B4. If the total is negative you have a loss. STOP. Enter the current year loss on page 1 LINE 4b.
B6. NOL Carryforward from tax years 2017-2021: State law changes limit the deduction allowed for operating losses carried forward
from tax years 2017-2021. 50% of the losses available in these tax years (B6 Column C) may be used to reduce taxable income
on Worksheet B, LINE B5.
B7. Total Income: B5 less B6 Column C. Enter TOTAL Taxable Income on Part A, LINE 4a.
LINE 5: LINE 3 plus LINE 4a. (A net loss reported on LINE 4b may not be used to offset W-2 income from LINE 1).

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LINE 6: Multiply LINE 5 by 1.25% [0.0125].
LINE 7a: Enter the amount of Blue Ash Tax withheld by employers. Worksheet A, Column E.
LINE 7b: Enter the total amount of paid estimated tax payments, any amount paid with an extension and any prior year over-
payments. Estimated payments may be subject to the underpayment of estimated tax penalty.
LINE 7c: From Worksheet A, Column F on page 2 of return. Enter the amount of taxes withheld for, or paid to, another municipality
subject to the following limitations.
Residents of the City of Blue Ash may claim a credit for taxes paid to another municipality up to 1.25% of those wages actually
taxed) (Worksheet A, Column F) on the W-2. Credit is limited to the other local tax rate used (no more than 1.25%) multiplied by
the wages actually taxed per each individual W-2. Credit is not allowed for the portion of taxes withheld exceeding 1.25% paid to
municipalities with higher tax rates (example: City of Norwood tax rate is 2%. The difference of .75% excess may not be used as
credit to offset other W-2 income.
Part-year residents may claim taxes paid to other cities for the part of the year they were a Blue Ash resident. Provide
documentation in the form of W-2s or tax returns submitted to other municipalities. Partners claiming credit for taxes withheld or
otherwise paid to another municipality by a partnership must provide documentation to support this credit. Non-residents may not
claim taxes paid to another municipality.
Please note: If any other wage base is used besides total Qualifying Wages (usually W-2 Box 5) and/or if it is not fully withheld at
that municipality’s tax rate, adjustments could be made to your tax return. Also, refunds received from your work municipality may
affect taxes due to your resident municipality.
LINE 7d: Complete Worksheet C on page 2 of return and provide copies of other municipal filings for which you are claiming credit.
Enter the amount of taxes paid to another municipality, subject to the following limitations:
Residents of the City of Blue Ash may claim a credit for taxes paid to another municipality up to 1.25% of the non W-2 income
actually taxed per the other municipality’s return. Credit is limited to the local tax rate used (no more than 1.25%) multiplied by the
income actually taxed per each individual return.
Non-residents my not claim taxes paid to another municipality.
LINE 8: Add LINES 7a, 7b, 7c, and 7d.
LINE 9: Subtract LINE 8 from LINE 6 to find the Tax Due. Payment is not required if the amount is $10 or less.
LINE 10: If LINE 8 is greater than LINE 6, this is your overpayment. Amounts $10 or less will note be refunded or credited.
LINE 11: Enter the amount from LINE 10 to be refunded. Amounts $10 or less will not be refunded.
LINE 12: Enter the amount from LINE 10 to be credited to next year’s estimated tax liability. Amounts $10 or less will not be
credited. If an amount is listed on LINE 10, the sum of LINE 11 and LINE 12 must equal LINE 10.
Part B – Declaration of Estimated Tax for Next Year – Mandatory if estimated liability is $200 or greater.
LINE 13: Enter amount of estimated taxable income for 2023.
LINE 14: Multiply LINE 13 by 1.25% [0.0125] to determine the total estimated tax for 2023.
LINE 15: Enter the estimated amount of Blue Ash and other allowable municipal taxes to be withheld from wages.
LINE 16: LINE 14 minus LINE 15.
LINE 17: Option 1 – Divide LINE 16 by 4 to pay 25% [.25], to be on track to pay 100% of estimated tax liability by January.
Option 2 – Multiply LINE 16 by 22.5% [.225], to be on track to pay 90% of the tax liability by January.
LINE 18: Enter the amount of credits from LINE 12.
LINE 19: Enter and remit the net estimated tax due if LINE 17 minus LINE 18 is greater than zero.
This is the first of four quarterly estimated tax payments. The second payment is due on June 15 th and is equal to the amount on
LINE 19 less any overpayment still available from prior years. The third payment is due September 15 th and the final estimated
payment due January 15th. The total amount paid by January 15 thmust equal the minimum of 90% of the tax liability. Failure to
remit timely estimated payments may result in charges of penalties and interest.
LINE 20: Total amount due with return – Combine LINE 9 and LINE 19.

Make Checks Payable to: Blue Ash Income Tax Office
Mail to: 4343 Cooper Road, Blue Ash, OH 45242

PDF file checksum: 3977522103

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