Primary Taxpayer
                                                        CITY OF STOW,      OHIO                                 Retired as of _____/_____/_____
                                               INCOME TAX                 RETURN                                Social Security / disability income only for all of 2022
                                               FOR THE CALENDAR YEAR                   2022                     Unemployment income for all of 2022
    TELE: (330) 689-2849                                                                                        No taxable income for 2022 - explain: __________________________ 
    FAX: (330) 689-2847                                                                                         Under 18 for all of 2022 - Date of birth: _____/_____/_____ 
     www.stowohio.org                          PRINT NAME, ADDRESS AND PHONE NUMBER
                                                                                                                Active duty military income only for all of 2022
                                                                                                                Non-resident for all of 2022
                                                                                                                Business / rental closed or sold: _____/_____/_____
                                                                                                                                                                               Joint Taxpayer
                                                                                                                Retired as of _____/_____/_____
                                                                                                                Social Security / disability income only for all of 2022
                                                                                                                Unemployment income for all of 2022
                                                                                                                No taxable income for 2022 - explain: __________________________ 
       PRIMARY SOCIAL SECURITY                                  JOINT SOCIAL SECURITY                           Under 18 for all of 2022 - Date of birth: _____/_____/_____ 
                                                                                                                Active duty military income only for all of 2022
Did you move during 2022? FROM STOW ON                                    TO                                    Non-resident for all of 2022
     YES        NO            TO STOW ON                                  FROM                                  Business / rental closed or sold: _____/_____/_____
PART YEAR RESIDENTS: You     should complete    this form using only information on income received and taxes withheld   or paid while                                    living   or working   in Stow. 
Did you work remotely any time during 2022?   ☐ YES     ☐ NO
INCOME
1. GROSS WAGES AND SALARIES (FROM WORKSHEET I COLUMN C ON BACK OF FORM.)......................................1 $
2. NON-WAGE TAXABLE INCOME (FROM WORKSHEET II LINE 5 OR WORKSHEET III, IF APPLICABLE.) ................. 2 $
3. TOTAL TAXABLE INCOME (ADD LINES 1 & 2.) ..............................................................................................................................................................3 $
TAX
4. STOW TAX DUE BEFORE CREDITS (MULTIPLY LINE 3 BY 2%.)..................................................................................................................................4 $
CREDITS
5. CREDIT FOR TAX WITHHELD ON WAGES & SALARIES (FROM WORKSHEET I COLUMN F.)...................................5 $
6. CREDIT FOR TAX PAID ON NON-WAGE INCOME ..........................................................................................................6 $
7. 20 22 ESTIMATED   TAX  PAYMENTS  MADE       TO THE   CITY  OF STOW.    ..............................................................................7            $
    INCLUDES ANY OVERPAYMENT CARRIED FROM 2021 TO 20               22.
8. TOTAL CREDITS (ADD LINES 5, 6 & 7.)............................................................................................................................8 $
9. SUBTRACT LINE 8 FROM LINE 4. ..................................................................................................................................................................................9 $
OVERPAYMENT
    NO TAXES OF $10.00 OR LESS SHALL BE REFUNDED OR CREDITED
10. ENTER THE OVERPAYMENT     AMOUNT YOU WANT             APPLIED TO  YOUR 2023 ESTIMATED   TAX.     ................................10                               $
11. ENTER THE OVERPAYMENT AMOUNT YOU WANT REFUNDED. (ALLOW 90 DAYS FOR YOUR REFUND)...............11 $
BALANCE DUE
12. IF THE AMOUNT ON LINE     9 IS GREATER THAN $10.00,     ENTER THAT    AMOUNT    HERE.  THIS   IS YOUR 202 2BALANCE DUE..............................12 $
    THIS AMOUNT MUST BE PAID       WITH THIS FORM ON OR BEFORE APRIL 15, 20         23 OR THE IRS DUE DATE.
13. PENALTY AND INTEREST (SEE INSTRUCTIONS.). ......................................................................................................................................................13 $
ESTIMATED INCOME TAX (LEAVE LINES 14-20 BLANK   IF YOU WANT THE CITY TO CALCULATE YOUR                    ESTIMATED     TAX                                           FOR 202 3BASED ON YOUR                         2022 INCOME.)
14. ESTIMATED TAXABLE     INCOME   FOR  202 3TAX    YEAR.....................................................................................................14      $
15. ESTIMATED TAX DUE (MULTIPLY LINE 14 BY 2%.) ........................................................................................................15 $
16. TAXES TO BE WITHHELD AND PAID TO STOW AND OTHER MUNICIPALITIES. ..........................................................16 $
17. ESTIMATED TAX   DUE   FOR 2023 TAX    YEAR  (SUBTRACT     LINE 16 FROM LINE 15.) ....................................................17 $
18. FIRST QUARTER OF ESTIMATED TAX PAYABLE TO CITY OF STOW (MULTIPLY LINE 17 BY 25%)............................18 $
19. 2022 OVERPAYMENT      (FROM  LINE 10) APPLIED TO 202 3ESTIMATED       TAXES.    ..........................................................19 $
20. NET AMOUNT DUE FOR FIRST QUARTER 20         2 3(SUBTRACT LINE 19 FROM LINE 18.) ..........................................................................................20 $
TOTAL AMOUNT DUE WITH FORM
21. ADD LINES 12, 13 AND  20 AND   ENTER    THE SUM     HERE. This is the total amount due with this form on or before5April231 or, 20the IRS Due Date...21 $
    Make checks payable to: CITY OF STOW INCOME TAX DIVISION. MAIL TO:  PO Box 3649   Akron, OH 44309-3649
   RETURNS WITHOUT PAYMENT – MAIL COMPLETED RETURN AND ALL REQUIRED SCHEDULES TO: CITY OF STOW, PO BOX 1668, STOW OHIO 44224

I AUTHORIZE THE INCOME TAX DIVISION TO DISCUSS MY ACCOUNT WITH THE PREPARER NAMED BELOW. CHECK HERE
UNDER PENALTIES OF PERJURY, I DECLARE THAT I HAVE EXAMINED THIS RETURN AND ACCOMPANYING SCHEDULES AND STATEMENTS, AND TO THE BEST OF
MY KNOWLEDGE AND BELIEF, THEY ARE TRUE, CORRECT AND COMPLETE.
DECLARATION OF PREPARER (OTHER THAN TAXPAYER) IS BASED ON ALL INFORMATION OF WHICH PREPARER HAS ANY KNOWLEDGE.

SIGNATURE OF PRIMARYTAXPAYER                                                                                    DATE

SIGNATURE OF JOINTTAXPAYER   (IF JOINT RETURN)                                                                  DATE

SIGNATURE OF PERSON (AND FIRM) PREPARING RETURN, ADDRESS & PHONE NO.

                         WORKSHEET I - WAGE AND SALARY
             A COPY OF EACH FORM W-2, 1099-MISC, 1099-K, W-2G, PAGE 1 OF FEDERAL FORM 1040

SPECIAL INSTRUCTIONS
I.     The amount in Column D must have been withheld or paid to your work city.  If it was not, enter zero in
       Column D.
II.   If the tax withheld was paid to the City of Stow, enter the actual amount of tax withheld for Stow in
       Column F and ignore the amounts in Columns D & E.

Column A        Column B                 Column C           Column D          Column E      Column F
Date wages      Name of municipality in  Income earned      Multiply Column C Multiply Column C  enter smaller of
were earned     which income was earned. in Column B                          by 2%.        Column D or E.
(month/day).                             municipality.      tax rate.

                         Total Column C                                       Total Column F

                         WORKSHEET II - NON-WAGE INCOME
                A COPY OF EACH FEDERAL FORM OR SCHEDULE USED MUST BE ATTACHED.

             1. NET PROFIT (LOSS) FROM SCHEDULE C.                   $
             2. RENTAL PROFIT (LOSS) FROM SCHEDULE E.                $
             3. OTHER NON-WAGE INCOME (ATTACH EXPLANATION).          $
             4. LOSS CARRY FORWARD FROM PRIOR YEAR(S).               $
             5. COLUMN TOTAL (IF LESS THAN ZERO, USE ZERO).          $

                CARRY TOTAL FROM LINE 5 TO FRONT OF RETURN LINE 2.

                         WORKSHEET III - NON-WAGE INCOME
FOR USE BY THOSE INDIVIDUALS WITH NET PROFIT/DISTRIBUTIVE SHARE INCOME SOURCED IN 
MULTIPLE MUNICIPALITIES WITH CURRENT AND/OR PRIOR YEAR LOSSES. CONTACT THE CITY OF 
                         STOW INCOME TAX OFFICE TO OBTAIN THIS SCHEDULE.