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Form BR            File With                                                              BUSINESS                                                                        ACCOUNT
CITY OF MIDDLETOWN                                                   2023 - CITY OF MIDDLETOWN - 2023
INCOME TAX DIVISION                     TAXABLE PERIOD BEGINNING ____________________ AND ENDING _________________
      P.O. BOX 428739
MIDDLETOWN, OHIO 45042                                        CALENDAR YEAR TAXPAYERS FILE ON OR BEFORE APRIL 15, 2024                                                    FEDERAL ID
       (513) 425-7862                                        FISCAL YEAR DUE ON 15        TH DAY OF THE 4TH MONTH AFTER YEAR END 
www.cityofmiddletown.org                                     EXTENSION REQUESTS MUST BE ATTACHED TO YOUR RETURN.

TAXPAYERS NAME AND ADDRESS (MAKE ADDRESS CORRECTIONS)
                                                                                                                   CONSOLIDATED RETURN                AMENDED RETURN
                                                                                                                   SHOULD YOUR ACCOUNT BE INACTIVATED?      YES             NO
                                                                                                                   IF YES, PLEASE EXPLAIN:  __________________________________________
                                                                                                                   FILING STATUS (CHECK ONE)
                                                                                                                               CORPORATION                                S-CORPORATION
                                                                                                                               PARTNERSHIP                               LLC
                                                                                                                               FIDUCIARY (TRUSTS AND ESTATES)
                                                                                                                   BUSINESS TELEPHONE:      __________________________________________
                                                                                                                   EMAIL: ___________________________________________________________
                                                                                                                                                                       OFFICE USE ONLY
1. Adjusted Federal Taxable Income (attach copy of Federal return) .                         . . . . . . . . . . . . . . . . . . . .      1 $______________            1 ______________
2. Adjustmen ts (from Line M, Schedule X) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .    2        $______________                2 ______________
3. Taxable income before apportionment (Line 1 plus/minus Line 2) .                          . . . . . . . . . . . . . . . . . . . .    3 $______________              3 ______________
4. Net loss carryforward (limited to 5 years) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .         4 $______________                4 ______________
5. Taxable income after NOLs (Line 3 minus Line 4) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .                  5 $______________                5 ______________
6. Apportionment percentage _______% (from Line 5, Schedule Y) . . . . . . . . . . . . . . . . . . . . .                              6 $______________                6 ______________
7.. Income subject to Middletown Income tax (Line 5 multiplied by Line 6) . . . . . . . . . . . . . . . . .   7 $______________                                        7 ______________
8. Middletown tax is 2.0% (0.02) of Line 7 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .      8 $       ______________             8 ______________
9. Tax Credits:
          A.  Estimated Payments . . . . . . . . . . . . . . . . . . . . . . . . . 9 A $_______________                                                                9A _____________
          B.  Prior Year Overpayments . . . . . . . . . . . . . . . . . . . . . 9 B $_______________                                                                   9B _____________
          C.  Total tax credits (Lines 9A and 9B) . . . . . . . . . . . . .  9 C $_______________                                                                      9C _____________
10.0. Balance due (if Line 8 is greater than Line 9C) Line 8 minus Line 9C . . . . . . . . . . . . . . . . . . .10 $____________                                       10 _____________

11.1.Overpayment (i f Line 8 is less than Line 9C) Line 9C minus Line 8 . . . . . . . . . . . . . . . . . . . . 11 $____________                                       11 ______________
       A.  Refund Amount . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11A $_______________                                                                  11A _____________
       B.  Credit Amount . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11B $_______________                                                                11B _____________

                                                      DECLARATION OF ESTIMATED TAX FOR 2024

12. Total estimated income subject to tax (to avoid penalty, no less than Line 7) . . . . . . . . . . . . 12 $_______________                                        12 _______________
13. Estimated tax due (multiply Line 12 by 2.0% {0.02}). If less than $200, estimated
      payments are not required. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  13 $_______________            13 _______________
14. First quarter tax due before credits (at least 25% of Line 13) . . . . . . . . . . . . . . . . . . . . . . . .  14 $_______________                              14 _______________
15. Prior year tax credit from Line 11B above . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  15 $_______________                     15 _______________
16. Net estimated first quarter tax due with this return (Line 14 minus Line 15). ( finegative,
      enter zero) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  16 $_______________ 16 _______________
17. TOTAL TAX DUE (Lines 10 and 16). Make Check payable to Middletown Income Tax Divison . .   17 $_______________                                                   17 _______________

*First quarter estimatedth          tax paymentsth    th shouldth be paid with this return.  Subsequent estimated payments
are due by the 15  day of the 6 , 9  and 12 months after the beginning of the taxable year.

The undersigned declares that this return (and accompanying schedule) is a true, correct and complete return                            FOR OFFICIAL USE ONLY - PENALTY & INTEREST
of the taxable period stated and that the figures used herein are the same as used for Federal Tax purposes.               FAILURE TO PAY ESTIMATE BY DEC 15           $ _______________________
Signature of Taxpayer or Agent ______________________________________________________________                              FAILURE TO PAY ESTIMATE BY JAN 31             $ ___________________
                                                                                                                                   FAILURE TO FILE BY APRIL 15         $ _______________________
Title ____________________________________________________                Date __________________________                                                                  ___________________
                                                                                                                           FAILURE TO PAY TAX DUE BY APRIL 15 
________________________________________________________________________________________                                                              INTEREST   $ __________________________________________
                                    Name & address of person or firm preparing this return
Telephone number of the preparer _______________________________________________________________________________                                      PENALTY    $ _______________________
May we discuss this return with the taxpreparer?      Yes    No                                                                       TOTAL PENALTY & INTEREST         $ _______________________$ ___________________
                                                                                                                                            GRAND TOTAL   $ _______________________



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A.   Capital Losses (Sec 1221 or 1231 included) . . . . . .      $ _______________          J. I.   Capital gains (except 1245/1250 property dispositions)   $ _______________
B.   Taxes on or measured by net income  . . . . . . . . . . .                              J.  K.Intangible income . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ _______________
     Taxes on or measured by net income . . . . . . . . . . . . . . . . .  $ _______________
                                                                                                  (interest, dividend, payments, copyrights)
C.   Expenses attributable to non-taxable income (5% of Line J) $ _______________           K.  L.Other income exempt (Explain)

D.   Federally deducted dividends, distributions, or amounts K)                                   . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ _______________
     set aside for, credited to, or distributed to  
     REIT or RIC investors                                       $ _______________
                                                                                                  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ _______________
E.   Federally deducted amounts paid or accrued to or for 
     plans, pension plans and life insurance plans for owners or                                  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ _______________
     owner-employees of non-C corp entities . . . . . . . .      $ _______________
                                                                                             M.   . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ _______________
F.   Charitable contributions in excess of the 10% federal limit . . $ _______________      L.   Total Deductions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ _______________
I. G.   Other (Explain) . . . . . . . .                          $ _______________          N.    Deduct Line MIfrom LineM,     I (and enter on Line 2) . . .
H.   Total additions . . . . . . . . .                           $ _______________          M.   Deduct Line L from Line H (and enter on Line 2) . . . . . . . . .  $ _______________

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