2022 NON-FILING DECLARATION
                     Notification for businesses not required to file 2022 Wooster Tax Return
                     Extension Request and 2023 Estimated Tax Declaration on reverse side

Mail Return to:      City of Wooster Income Tax
                     PO BOX 1088
                     Wooster, Ohio 44691-7081

     for calendar 2021 or tax year beginning ________________________, ______________ , ending _____________________, ______________

             Name                                                                   Federal Identification Number

Please print Number and Street
or type
             City, State, Zip Code

                                  Check one box only, sign form at bottom

     The above business entity is not required to file a 2022 Wooster income tax return because it has ceased all operations 
     effective  _______________________________________________

     The above business entity is not required to file a 2022 Wooster income tax return because it has not done any 
     business within the City of Wooster in 2022 or fiscal period noted above. In addition, the company did not have any 
     physical assets located within Wooster, and did not pay compensation to employees for services performed in Wooster 
     during this period. The company expects to do business within Wooster in the following fiscal period. For this reason, it 
     should be left on active filing status for following years.

     The above business entity is not required to file a 2022 Wooster income tax return because it has not done any 
     business within the City of Wooster in 2022 or fiscal period noted above. In addition, the company did not have any 
     physical assets located within Wooster, and did not pay compensation to employees for services performed in Wooster 
     during this period. The company does not expect to do business within Wooster in the future. Please de-activate this tax 
     account. If we again do business within Wooster, we will notify Wooster's income tax office.

     Other: Attach explanation

                                               PLEASE SIGN HERE
I declare that, to the best of my knowledge, the above checked statement is true and correct. I also declare that any records
that conflict with the above statements will be reconciled with the City of Wooster.
Do you authorize your preparer to contact us regarding this return? Yes  No 

Signature of Officer                                                          Date

Title

Telephone Number

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