Rita Form 37B – Fill Out and Use This PDF

	Form	37B	Regional Income Tax Agency		2011
			RITA Individual Income Tax Return
			For use by taxpayers who did not move, have only
			W-2 Income, and live in full credit municipalities
	Your social security number			Spouse’s social security number
	Your irst name and middle initial			Last name
	If a joint return, spouse’s irst name and middle initial			Last name
	Current home address (number and street)					Apt #
	City, state, and ZIP code
	Daytime phone number			Municipality you lived in for the tax year

Contact us toll free:

Cleveland 800.860.7482

Columbus 866.721.7482

Youngstown 866.750.7482

TDD 440.526.5332

Filing Status:

Single or Married Filing Separately 3

Joint 2

1

If you have overpaid, indicate your choice:

Refund 3

Credit 2

1

If this is an amended return, check here:

If you are exempt from iling, check this box and complete the back of this form:

RITA’s e-File

Easy, Fast, Free & Secure

www.ritaohio.com

Under penalties of perjury, I declare that I have examined this return, and to the best of my knowledge and belief, it is true, correct, and accurately lists all amounts and sources of municipal taxable income I received during the tax year.

Your Signature	Date	Preparer’s Signature	Date
Spouse’s Signature if a joint return	Date	Preparer’s Address	Id Number

Mail with payment and W2s to: Regional Income Tax Agency PO Box 94652 Cleveland, OH 44101-4652

Mail with W2s & without payment to: Regional Income Tax Agency

PO Box 94653

Cleveland, OH 44101-4653

May RITA discuss this return with the preparer shown above?

Yes

No Preparer Phone #:

Name of taxpayer(s) shown on page 1

Your social security number

Spouse’s SSN if iling joint exemption Year

3.	I was under 18 years of age for the entire year (or the appropriate age for my resident
	municipality as indicated below in the Special Notes). Attach a copy of your birth
	certiicate or driver’s license.
4.	I am a retired individual and received only pension, social security, interest and/or
	dividend income for the year indicated above. Attach a copy of page 1 of your federal
	Form 1040, 1040A or 1040EZ. If you did not ile a federal return, attach a copy of your
	1099-R or statement of Social Security Earnings.
5.	Prior to the irst day of the year indicated above, I moved out of a RITA municipality, and I had no
	rental or self-employment income earned in a RITA municipality during the year indicated above.
		Current Home Address (number and street)	City		State	Zip
		Prior Home Address (number and street)	City		State	Zip
6.
	The taxpayer indicated above is deceased. Indicate the date of death to the right.
7.	I am not exempt from tax. However, I iled and reported my taxable income to RITA on
	a joint return iled with my spouse.
		Spouse’s name		Spouse’s social security number

Date of Birth	Mo	Day	Year
Retirement Date	Mo	Day	Year
Date of Move	Mo	Day	Year
Date of Death	Mo	Day	Year

Address of legal domicile (number and street)

City

State Zip

Special Notes

The under 18 years of age exemption does not apply to residents of the following municipalities:

•	Addyston	•	Ripley
•	Belpre	•	Riverside
•	Campbell	•	Rossford
•	Fremont	•	Saint Paris
•	Girard	•	Tontogany
•	Harrison	•	Williamsburg
•	Lockland	•	Wintersville
•	Middleport	•	Youngstown

•Oxford

•Powhatan Point

The following municipalities use an under 16 years of age exemption instead of an under 18 years of age exemption:

•	Avon Lake	•	Jackson Center
•	Cedarville	•	Jewett
•	Fairborn	•	Yellow Springs

For the under 18 years of age exemption to apply, the resident must be a full-time elementary, junior high or high school student if a resident of:

• Cardington

The following municipalities have additional special rules:

Bellevue

•State unemployment compensation is taxable Garield Hts.

•Residents of Garield Hts. who are 62 years of age and older are entitled to a wage exemption. Grove City

•Developmentally disabled employees earning less than the minimum hourly wage while employed at government-sponsored shall be exempt from the levy of tax.

Lockland

•Any Lockland taxpayer who is 65 yrs. of age or older on December 21 of the taxable year and has gross taxable income of $1200.00 or less is exempt. An exemption certiicate must be iled.

Loveland

•Loveland does not give credit for Kentucky county taxes withheld. Mogadore

•Taxpayer’s who are full time, post secondary education program students for at least 5 calendar months of the year may be eligible for a tax credit not to exceed $75.00.

Oakwood Village

•Personal earnings of any person who is a full-time high school or undergraduate college student working within the State of Ohio during the taxable year for which period they are residents of Oakwood Village may be exempt from paying residence tax.

Ottawa

•Students 18 years of age or under and earning less than $600.00/yr are exempt from paying municipal income tax.

Reynoldsburg & Worthington

•Income of the mentally retarded or developmentally disabled while working in a government funded workshop for less than minimum wage is exempt.

Sherwood

•The irst $10,000.00 of any salaries, wages, commissions and other compensation earned by any natural person sixty-ive (65) years of age and over is exempt.

Yellow Springs

•Individuals under 18 years of age who are newspaper carriers are exempt from paying municipal income tax.