New Madison, OH · Darke County
Taxpayer Assistance Form
Taxpayers can use this form to ask CCA’s Division of Taxation to prepare their municipal income tax return and provide the required supporting documents.
What this form is
This form asks CCA’s Division of Taxation to prepare a taxpayer’s 2023 municipal income tax return. It requests supporting tax documents, taxpayer and spouse signatures when filing jointly, and contact information for anyone authorized to discuss the return with CCA. The form says to include the listed documents and states that the return assistance request must be received by April 1, 2024, to avoid potential penalty and interest.
Who needs it
Taxpayers who want CCA’s Division of Taxation to prepare their municipal income tax return should complete this form and include the listed supporting documents.
How to submit it
The form says to drop off or mail it to the listed CCA addresses: Cleveland Office Mail-In, Cleveland Office Drop-Box, or the City of Clayton Drop-Box. It lists addresses in Cleveland and Clayton, Ohio.
About notarization
This document is signed and dated without a notary; it lists no notarized or sworn attachment, so the taxpayer and, if filing jointly, spouse just sign and date it.
How to submit this form
- 1
Download The Form
Download the Taxpayer Assistance Form for CCA to prepare your municipal income tax return.
- 2
Complete The Form
Fill in the form, authorize anyone who may discuss the return with CCA, and sign and date it.
- 3
Gather Supporting Documents
Attach copies of the tax documents listed on the form; the document says they will not be returned.
- 4
Submit To CCA
Drop off or mail the form and attachments to one of the CCA addresses listed on the document.
Frequently asked questions
- Do I need a notary for the Taxpayer Assistance Form?
- No. The document has taxpayer and spouse signature lines but no notary block. The taxpayer and, if filing jointly, spouse sign and date it.
- How do I submit the Taxpayer Assistance Form?
- The form says to drop off or mail it to one of the listed CCA locations: the Cleveland Office Mail-In address, the Cleveland Office Drop-Box, or the City of Clayton Drop-Box.
- What documents should I attach?
- The form lists W-2 or 1099 copies showing municipal tax withheld, applicable business or rental income schedules, other-income details if applicable, and the first two pages of the federal Form 1040 and Schedule 1.