PDF document
- 1 -
City of New Philadelphia 

                                                      Income Tax Department 
150 East High Ave, Suite 041 ·  New Philadelphia, OH  44663 
Hours: Mon-Fri  8:00am - 4:30pm       (330) 364-4491  

BUSINESS QUESTIONNAIRE/WITHHOLDING ACCOUNT APPLICATION 

Please complete the application & mail. Or  fax to: (330) 364-9851. Scan & email to: cloos@newphilaoh.com 
The City of New Philadelphia imposes an income tax of 1.5% (.015) on all qualifying wages, salaries, commissions, other compen-
sation and other taxable income earned or received by residents 18 years or older. Non-residents are taxed at the same amount 
for work done or services performed or rendered within the municipality. The 1.5% tax also applies to net profits of corporations, 
individuals, partnerships, and unincorporated businesses engaged in business activity within the municipality.  

Business Name___________________________________Address__________________________________ 

City/State/Zip_____________________________________________________________________________ 

Federal ID#_______________________________  Telephone_______________________________________ 

Contact Person______________________________________  Email_________________________________ 

Business Description________________________________________________________________________ 

On what date did you begin doing business in New Philadelphia?      _____/_____/________ 

IRS Accounting Period (check one)  __Calendar Yr. end Dec. 31   __Fiscal Year ending____________________ 

Number of employees____________  Do you anticipate hiring additional employees?  __yes   __no 

Do you employ sub-contractors or other workers who are subject to city income tax?   __yes   __no 

If yes, please attach a list with their names, addresses and social security numbers. 

TYPE OF BUSINESS OWNERSHIP (check one) 

__Individual Proprietorship (owner’s SS#________________________________)            __Corporation 

__Partnership     __LLC     __Non-Profit Corporation     __Association     __Other (please explain below) 

________________________________________________________________________________________ 

If the net profit New Philadelphia Income Tax Return is filed as a partnership, association or other unincor-
porated joint business venture, how will the balance due be paid? 

__Paid in Full by the Business   __Paid Separately by the Individual Members 

Please list the name(s) and addresse(s) of the owner(s) of the individual proprietorship or partnership: 

Name______________________________________  Address_____________________________________ 

City/State/Zip____________________________________________________________________________ 

Name______________________________________  Address_____________________________________ 

City/State/Zip____________________________________________________________________________ 

If additional space is required, please attach separate documents 



- 2 -
                                       City of New Philadelphia 

                                                 Income Tax Department

                               WITHHOLDING ACCOUNT APPLICATION 

How will you report employee withholding to the New Philadelphia Income Tax Department? 
   __Monthy     OR ___Quarterly        Withholding?  ____Work from Home Employee ____Courtesy

Do you anticipate working 20 days or more within New Philadelphia City Limits?  ______Yes   ______No

__ We will report   

Name of Person Reporting______________________________  Telephone___________________________ 

Address/City/State/Zip______________________________________________________________________ 

Email_____________________________  Best Time to Contact Them________________________________ 

___Through a Payroll Service

Name of Payroll Service_____________________________________________________________________ 

Contact Person_______________________________________  

Telephone____________________________ Address/City/State/

Zip______________________________________________________________________ 

Email______________________________  Best Time to Contact Them_______________________________ 

___by using the Ohio Business Gateway (OBG)

Who will prepare your annual net profit/loss return that will be filed with our office? 

__Fiscal Officer   __Accounting Firm/CPA   __Tax Preparer    __Other_________________________________ 

Please write their name___________________________  Address___________________________________ 

City/State/Zip_____________________________________________________________________________ 

Telephone___________________________________  Email_______________________________________ 

   Please attach a list of any other businesses you own or operate in New Philadelphia. 

           Thank You and Welcome to New Philadelphia! 
           Your tax dollars are used to fund fire and police protection and other vital city services. 






PDF file checksum: 78526018

(Plugin #1/9.12/13.0)