Geneva, OH · Ashtabula County
Individual Refund Form
The Individual Refund Form lets a nonresident taxpayer claim a municipal income tax refund for a year when an employer withheld tax despite the taxpayer performing no services within the municipality.
- licensed online notary
- ~15 min average
- Notarized PDF emailed
What you’ll need
- Government-issued photo ID
- Webcam-enabled device (laptop or phone)
- This form, ready to upload as a PDF
What this form is
Use this form to request a refund of municipal income tax withheld by an employer for a period when you performed no services within the municipality’s corporate limits. The form is for nonresidents and requires a separate claim for each calendar year. Complete the taxpayer section, attach a W-2 and supporting information, have the employer complete its certification, and submit the claim to the municipality’s Income Tax Department.
Who needs it
A nonresident taxpayer may use this form to claim a refund when an employer withheld municipal income tax for a period in which the taxpayer performed no work within the municipality.
How to get this notarized
- 1
Download the Form
Download the Individual Refund Form and read the instructions on the back before completing it.
- 2
Fill In the Claim
Complete the taxpayer section for one calendar year, explain the refund grounds, and attach a W-2 and supporting information.
- 3
Book an Online Notary
Arrange an online notarization with a commissioned online notary for the form's sworn taxpayer claim.
- 4
Sign on Video
Sign the claim during the video session when instructed; the notary completes the jurat.
- 5
Submit to the City
Have the employer complete its certification, then submit the form and supporting records to the municipality's Income Tax Department.
Preview the form
The blank PDF straight from Geneva. Look it over, then upload your filled copy to start the notary session.
You’ll need ID and a webcam.
A licensed online notary will join you on video, verify your government-issued ID, witness your signature, and apply their seal. You’ll receive the notarized PDF by email when the session ends.
Frequently asked questions
- How do I get the Individual Refund Form notarized online?
- Complete the taxpayer section, then meet with a commissioned online notary by video. Sign the claim when instructed, and make sure the employer completes its certification before you submit the form and supporting records.
- Do I need to notarize this refund claim?
- Yes. The instructions say to notarize the claim, which must state each ground for the request under oath. The taxpayer claiming the refund signs before an officer administering an oath.
- Can I use this form for more than one tax year?
- No. The instructions require a separate claim form for each calendar year. Include the requested tax year, attach a W-2 and supporting information, and have the employer complete the certification.
- Does Ohio allow online notarization for this form?
- Ohio authorizes online notarization by a commissioned online notary under R.C. §§147.60–147.66. Confirm with the city or village if unsure whether it will accept your completed online-notarized claim.