PDF document
- 1 -
                                              Change tax year if necessary                                                                                                      Reset Form                                      Print Form
CITY TAX DEPT.                                              2022
50 TOWN SQUARE, P.O. BOX 155                                              LIMA INCOME TAX RETURN                                                  IF YOU MOVED DURING TAX YEAR
LIMA, OHIO 45802                                      FOR USE BY ALL TAXPAYERS ON A CALENDAR YEAR BASIS                                           STATE DATE 
                                                    OR OTHER TAXABLE PERIOD BEGINNING                                                             INTO LIMA                        OUT OF LIMA 
PHONE: (419) 221-5245                                           AN E   D N                                     N I D G               2   0       ,
FAX: (419) 998-5527                                         CALENDAR YEAR TAXPAYERS FILE ON OR BEFORE                                                                           ATTACH VERIFICATION 
                                                    APRIL 15, 2023  FISCAL AND PARTIAL YEARS, File on or before                                   LOCAL PHONE 
                                                      the 15th day of the 4th month following close of the tax year.                              SSAN 
                                                                                                                                                  JOINT SSAN 

1.   ENTER GROSS WAGES, SALARIES, BONUSES, COMMISSIONS AND OTHER COMPENSATION                                                                     LIMA TAX                      WAGES
     RECEIVED BEFORE ANY PAYROLL DEDUCTIONS. Attach copies of W-2 Forms ON BACK                                                                   WITHHELD                      ETC.
                                                                                                                                            $                                 $ 
                                                                                                                                            $                                 $ 
                                                                                                                                            $                                 $ 
     a. TOTAL: IF NO OTHER TAXABLE INCOME ENTER TOTAL WAGES HERE AND ON LINE 6... $                                                                                             XXXXXXXXXXXX $ 
2.   OTHER INCOME - FROM PAGE 2 (Attach Federal Schedules) (schedule losses cannot offset qualifying wages) .........
3.   TOTAL INCOME (total lines 1 and 2) ......................................................................................................................................
4a.  ITEMS NOT DEDUCTIBLE (from line m Schedule X below) ................................................................................................. $ 
     b. ITEMS NOT TAXABLE (from line z Schedule X below) .................................................................................................
     c. ADD EXCESS OF 4a OVER 4b TO LINE 3. DEDUCT EXCESS OF 4b OVER 4a FROM LINE 3 ...............................                                                             XXXXXXXXXXXX
5a.  ADJUSTED NET INCOME (line 3 plus or minus line 4c)........................................................................................................
     b. AMOUNT ALLOCABLE TO LIMA IF SCHEDULE Y PAGE 2 IS USED                                                                          % OF LINE 5a..................
     c. LESS ALLOCABLE NET LOSS PER PREVIOUS LIMA INCOME TAX RETURN.........................................................
6.   AMOUNT SUBJECT TO LIMA INCOME TAX (line 5a or 5b less line 5c) .............................................................................
7.   LIMA INCOME TAX (1.5% or .015 of amount shown on line 6) ...........................................................................................
8.   CREDITS:(a) LIMA tax withheld by employer(s).................................................................................................................... $ 
                   (b)   Payments and credits on Declaration of Estimated Tax............................................................................
                   (c)   Earned income, taxes paid City of                                                                 (By Individuals Only)......................
                   (x)   TOTAL CREDITS ALLOWABLE...................................................................................................................
9.   BALANCE OF TAX DUE (line 7 less line 8x) PAYMENTS MUST ACCOMPANY THIS FORM (No payment is due for amount under $10.00)                                                             ............ $
10.  OVERPAYMENT CLAIMED (If line 8x exceeds line 7 enter difference here (No overpayment is to be claimed on amount under $10.00) $                                            INTEREST
     Enter amount of line 10 you want: CREDITED to your........ Estimated Tax $                                                       REFUNDED $                                PENALTY ............ $
                                                                                                                                                                                TOTAL ............ $
        SCHEDULE X – RECONCILIATION WITH FEDERAL INCOME TAX RETURN AS REQUIRED BY ORC SECTION 718 (For Business Use Only)
ITEMS NOT DEDUCTIBLE                                                                                                   ADD ITEMS NOT TAXABLE                                                                                    DEDUCT
a.  Federally deductible losses from IRC 1221 or 1231                                                                      n.  Capital gains (IRC 1221 or 1231 property dispositions
   property dispositions  ........................................................................... $                    except to the extent the income and gains apply to
b.  Five percent of intangible income reported in letter O,                                                                those described in IRC 1245 or 1250) ................................................. $ 
   except that from IRC 1221 property dispositions ...............................                                         o.  Federally reported intangible income such as, but not limited
c.  Taxes based on income (State)  ...........................................................                             to interest, dividends, and patent and copyright income  ....................
d.  Taxes based on income (City)  .............................................................                            p.  Amount of Federal Tax Credit to the extent they have
e.  Guaranteed payments or accruals to or for current                                                                      reduced corresponding operating expenses  .......................................
   or former partners or members  ...........................................................                              q.  Not previously deducted IRC Section 179 Expense ............................
f.  Federally deducted dividends, distributions, or amounts set                                                            r.  Partnership, S corp, LLC charitable contributions ...............................
   aside for, credited to, or distributed to REIT or RIC investors  ...............                                        s.  Other 
g.  Federally deducted amounts paid or accrued to or for
   qualified self-employed retirement plans, health 
   insurance plans, and life insurance plans for owners or 
   owner-employees of non-C corp entities ............................................
h.  Rental activities by partnership, S corp or LLC, Trusts  ......................
i.  Other  ....................................................................................................
m. Total (enter as line 4a above)  ............................................................... $                       z.  Total (enter as line 4b above) ............................................................... $ 

The undersigned declares that this return (and accompanying schedules) is a                                                IF YOU OWE MORE THAN $200 QUARTERLY ESTIMATE PAYMENTS ARE REQUIRED
true, correct and complete return for the taxable period stated, and that the figures                                      and you may be subject to penalties and interest due to lack of estimated payments. Further, you 
used are the same as used for federal income tax purposes and understands that                                             may need to make estimate payments for 2024 if you expect to owe the same or greater amount 
this information may be released to the tax administration of the city of residence                                        next year.
and the I.R.S.
Sign               Your
Here               Signature                                Date                                                           Paid        Your
                                                                                                                           Preparer’s  Signature                                        Date
If a joint return, Spouse
both must sign     Signature                                Date                                                           Use Only
                                                                                                                                       Print
   CHECK BOX IF CITY MAY DISCUSS YOUR RETURN WITH TAX PREPARER.                                                                        Name                                             PTIN



- 2 -
SCHEDULE C – PROFIT (OR LOSS) FROM BUSINESS OR PROFESSION - ATTACH FEDERAL SCHEDULES                                                                                                              PAGE 2
1.  TOTAL RECEIPTS, LESS ALLOWANCES, REBATES AND RETURNS  ........... $ 
2.  LESS, (a) Cost of Goods Sold, or (b) Cost of Operations, whichever is 
    applicable               (indicate labor charges included)  ............. $ 
3.  GROSS PROFIT FROM SALES, ETC. (line 1 less line 2)                          $
4.  DIVIDENDS $    , INTEREST $                            , ROYALTIES  ...... $ 
5.  RENTS RECEIVED, IF CONNECTED WITH TRADE OR BUSINESS  .............. $ 
6.  OTHER BUSINESS INCOME (Specify)  ............................................................ $ 
7.  TOTAL BUSINESS INCOME BEFORE DEDUCTIONS ................................................................................     $ 

BUSINESS DEDUCTIONS
8.  COMPENSATION OF OFFICERS............. $                                 14. UTILITIES............................... $ 
9.  SALARIES and WAGES not deducted elsewhere $                             15. INSURANCE.......................... $
10. PAYMENTS TO PARTNERS..................... $                             16. DEPRECIATION, Amortization, Depletion            $ 
11. RENTS (paid to           ) $                                            17. REPAIRS................................ $ 
12. INTEREST ON BUSINESS INDEBTEDNESS         $                             18. ADVERTISING AND PROMOTION                        $ 
13. BUSINESS TAXES (Income)..................... $                          19. AUTO, TRUCK AND TRAVEL .. $ 
    (Other business taxes) ............................. $                  20. OTHER (Attach Statement).... $ 
21. TOTAL BUSINESS DEDUCTIONS (total of lines 8 to 20)............................................................................. $ 
22. NET PROFIT (or loss) FROM BUSINESS OR PROFESSION (line 7 less line 21).................................................................................... $ 

SCHEDULE G – INCOME FROM RENTS (IF NOT INCLUDED IN SCHEDULE C.) - ATTACH FEDERAL SCHEDULES
Kind and Location of Property          Amount of Rent          Depreciation     Repairs              Other Expenses                   Net Income (or loss)

TOTAL INCOME (or loss) SCHEDULE G  ....................................................................................................................................................... $ 

SCHEDULE H – OTHER INCOME NOT INCLUDED IN SCHEDULE C OR G -                     ATTACH FEDERAL SCHEDULES
INCOME FROM PARTNERSHIPS, ESTATES AND TRUSTS, FEES, etc
               RECEIVED FROM                                                FOR (DESCRIBE)                                            AMOUNT

TOTAL INCOME SCHEDULE H  ..................................................................................................................................................................... $ 
TOTAL SCHEDULES C, G AND H. ENTER AS LINE 2, PAGE 1 ................................................................................................................... $ 

SCHEDULE Y – BUSINESS ALLOCATION FORMULA                                                          
                                                                                                                      A. LOCATED B. LOCATED                              C. (B ÷ A)
                                                                                                                      EVERYWHERE      IN LIMA                            PERCENTAGE
STEP 1. Average Value of Real and Tangible Personal Property..................................
        Gross Annual Rentals Multiplied by 8.............................................................
        TOTAL STEP 1.................................................................................................                                                                            %
STEP 2. Wages, Salaries, Etc., Paid .............................................................................                                                                                %
STEP 3. Gross Receipts from Sales made and/or Work or Services Performed .........                                                                                                               %
STEP 4. TOTAL PERCENTAGES ..............................................................................................................................................                         %
STEP 5. Average PERCENTAGE (Divide Total Percentages by Number of Percentages Used – Carry to Line 5b - Page 1)                                                                                  %






PDF file checksum: 948264978

(Plugin #1/9.12/13.0)