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    CCA Notice - December 2022

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    Wews WebStaff
    The letter says it is from the CCA Division of Taxation says records show they're missing a municipal income tax return or exemption certificate for you. News 5 investigated and confirmed the agency and letter are legitimate.

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    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd

    CCA Notice - December 2022

    Uploaded by

    Wews WebStaff
    9K views1 page
    The letter says it is from the CCA Division of Taxation says records show they're missing a municipal income tax return or exemption certificate for you. News 5 investigated and confirmed the agency and letter are legitimate.

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    © © All Rights Reserved

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    The letter says it is from the CCA Division of Taxation says records show they're missing a municipal income tax return or exemption certificate for you. News 5 investigated and confirmed the agency and letter are legitimate.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    9K views1 page

    CCA Notice - December 2022

    Uploaded by

    Wews WebStaff
    The letter says it is from the CCA Division of Taxation says records show they're missing a municipal income tax return or exemption certificate for you. News 5 investigated and confirmed the agency and letter are legitimate.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    You are on page 1of 1

    DIVISION OF TAXATION

    Serving Member Communities throughout the State of Ohio since 1967

    October 2022 SL
    name
    address
    city state zip
    DELINQUENT Years: 2020 / 2021

    Municipality: city

    Our records indicate that a municipal income tax return or exemption certificate has not been received for the tax years listed.
    If you are retired, had no taxable income, or did not live in a CCA member community, complete the exemption certificate information
    below and return it to this office within 10 days. All persons with taxable income are required to return this notice with wage and
    tax statements (W-2’s, Federal Schedules C, E and/or F), in the enclosed envelope within 10 days.

    If you need additional information contact CCA at 216.664.2070 or visit our office Monday through Friday, 7:30 a.m. to 4:30 p.m..

    ___A. RETIRED with no taxable income for municipal income tax purposes - DATE RETIRED: ____ /_____/_____

    Pension, interest and dividend income are exempt.

    ___B. UNDER AGE 18 for the entire year - DATE OF BIRTH: ______/______/_____

    Montpelier, Munroe Falls, New Paris, Oakwood, Obetz, Phillipsburg, and Riverside have no minimum wage. Geneva on
    the Lake uses 15 as the minimum age. Grand River, Rushsylvania, and West Milton use 16 as the minimum age. New
    Carlisle individuals 16 and 17 years old who earn $2,500.00 or more are subject to the tax.

    ___C. NO EARNED INCOME for the entire year - Public Assistance, Unemployment, SSI, etc.

    ___D. ALREADY FILED THE CITY RETURN - Provide a copy of the return with this notice.

    ___E. FILED JOINT RETURN - Spouse’s social security shown on return: _____________________________

    ___F. DECEASED - DATE OF DEATH: ______/______/______

    ___G. MOVED – I did not live in a CCA municipality for the entire year. Provide move information:

    CURRENT ADDRESS   PRIOR ADDRESS  

    Move in date:  _____/_____/_____ 
    Move in date:  _____/_____/_____   
     

    Move out date:  _____/_____/_____ 
    ___________________________________________   
     
    street no. / name  __________________________________________ 
    ___________________________________________  
    street no. / name 
    city state zip  __________________________________________  
     

    city state zip 

    ___H. OTHER_______________________________________________________________________

    The undersigned declares that this statement is true and correct.

    Signature_______________________________________________ Date _______________________

    Telephone # ______________________________ Social Security # _____________________________


     

    205 W Saint Clair Ave Phone: 216.664.2070


    Cleveland, Ohio 44113-1503 Fax: 216.420.8299
    www.ccatax.ci.cleveland.oh.us Toll Free: 800.223.6317

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