CITY OF WOOSTER, OHIO
                                              2022 WOOSTER INDIVIDUAL INCOME TAX 
REQUEST FOR FILING EXTENSION,  DECLARATION OF ESTIMATED TAX AND NON-FILING DECLARATION

Full Name (include spouse if filing jointly)                                                      Mail To:
                                                                                 CITY OF WOOSTER
                                                                                 INCOME TAX DEPT
Address                                                                                           PO BOX 1088
                                                                                 WOOSTER OH 44691
City, State & Zip Code

                                                                                                  QUESTIONS?
Social Security No.                          Spouse's S.S. No. (if joint)                         (330) 263-5226

                                             REQUEST FOR EXTENSION OF TIME TO FILE
         This extension does not extend the due date for tax due for 2022 or any estimated taxes for 2023.

1. I request an extension of time until_________________, 2023 to file my City of Wooster income tax return for 2022.
2. The extended date requested should be no later than October 15, 2023.
3. No late filing penalty will be charged; however, penalty and interest shall be calculated on any amount due.                                
4. Estimated balance due, if any, for 2022 Wooster income tax.                                            $

                                             DECLARATION OF 2023 WOOSTER INCOME TAX ESTIMATE
                                             Due on or before April 18, 2023
        Extension of time to file a tax return does not apply to a declaration of estimated tax or payment of quarterly installments
        The tax rate for 2023 is 1.5%. The City of Wooster allows 100% credit for taxes paid to another city up to 1.5%
5. A declaration of estimated tax should be filed, and quarterly estimates made for 2023 to avoid penalty and interest for any
taxpayer required to pay 2023 estimated taxes. A taxpayer is required to pay estimated taxes if their tax liability, less credit for
Wooster taxes withheld and/or taxes paid other cities, will equal or exceed $200.
6. Total 2023 Wooster estimated taxes. (Total tax less estimated
credit for Wooster tax withheld and taxes paid other cities.)                   $
7. 25% of line 6 due with this extension                                                                  $
8. Total amount paid with extension request.
(Add lines 4 and 7 and enter here. Make check payable to "City of Wooster")                               $

                                             2022 NON-RESIDENT INDIVIDUAL NON-FILING DECLARATION
                                             Due on or before April 18, 2023
Non-residents who received a Wooster income tax return in the mail or filed a 2021 tax return and are not required to 
file a 2022 Wooster tax return, should complete this non-filing declaration in lieu of filing a tax return.
        I/we were not residents of Wooster at any time in 2022,  any wages earned within the City of Wooster had Wooster income tax 
        withheld at a rate of 1.5% or greater, and I/we had no business or rental activity within Wooster in 2022.

        I declare that I have examined this form, and to the best of my knowledge and belief it is true, correct, and complete.
Do you authorize your preparer to contact us regarding this return? Yes  No 

Taxpayer's Signature                         Date                               Paid Preparer's Signature                      Date

Spouse's Signature (if joint return)         Date                               Firm or individual

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