City Income Tax Deduction Form by lht10255

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									Logan Hocking Local School District City Income Tax Deduction Form
Please Note: Employees who either work or live within the Logan City limits are subject to Logan City Income tax.

************************************************************************************************************************ LOGAN CITY TAX FORM Please be advised that I either live or work within the Logan City limits and Logan City Income tax should be deducted from my pay. _________________________________________________ Signature _________________________ SSN (optional) Please be advised that Logan City Income tax should not be deducted from my pay check. I do not work within the Logan City limits and do not live within the Logan City limits. I realize that if I do become subject to Logan City Income tax, it is my responsibility to notify the Treasurer’s Office of the change in status. _________________________________________________ Signature _________________________ SSN (optional) ************************************************************************************************************************ OPTIONAL CITY INCOME TAX FORM NOTE: We also have optional city tax deductions for the following: • • City of Athens (Either the full 1.65%, or the courtesy .65% for those who are subject to both Logan & Athens tax) City of Lancaster (either the full 1.75%, or the courtesy .75% for those who are subject to both Logan & Lancaster tax) City of Pickerington (either the full 1%, or the courtesy .5% for those who are subject to both Logan & Pickerington tax) ___________________ Date ___________________ Date

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If you are subject to any of these taxes and wish to have them deducted from your pay, please complete the form below and return it to the Treasurer’s office. Please deduct income tax for: _______________________________________________ City Name –(for Athens, Pickerington, or Lancaster please indicate tax %) I realize that if there is a change in my tax liability for the above named city Income tax, it is my responsibility to notify the Treasurer’s Office of the change in status. _________________________________________________ Signature _________________________ SSN (optional) ___________________ Date

Rev.8/2009


								
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