Centerville, OH · Gallia County
Income Tax Refund Request Form
Centerville residents use this form to claim a refund of Centerville income tax and provide the tax, employment, and supporting information for the claim.
What this form is
This form lets a claimant request a refund of Centerville income tax for a specified tax year. It asks for income, tax withheld, employment details, the reason for the claim, and a calculation of the claimed overpayment. Claimants must attach a copy of their W-2 and provide supporting facts; proof of age is required if the claimant is under 18. The employer certification is not required for claimants under 18.
Who needs it
A person claiming a Centerville income tax refund should complete this form and provide the supporting information requested for the claim.
How to submit it
File the completed form with the City of Centerville Income Tax Department at 100 W. Spring Valley Rd., Centerville, OH 45458. The form also lists fax number (937) 433-0310.
About notarization
This form is signed and dated without a notary; the claimant and employer certifications require signatures, and no sworn or notarized attachment is stated.
How to submit this form
- 1
Download The Form
Download the Centerville Income Tax Refund Request Form PDF.
- 2
Complete The Claimant Section
Enter the tax year, claimant and employment information, refund reason, income and withholding figures, and overpayment calculation.
- 3
Gather Supporting Documents
Attach a copy of your W-2 and the supporting facts requested. Furnish proof of age if the claimant is under 18.
- 4
Sign And Submit
Sign and date the claimant certification, obtain the employer certification when required, and file the form with the Income Tax Department.
Frequently asked questions
- What is the Centerville Income Tax Refund Request Form for?
- It is used to request a refund of Centerville income tax for a tax year. The form collects income and withholding figures, employment details, the reason for the claim, and a calculation of the overpayment.
- What should I attach to the refund request?
- The form asks claimants to attach a copy of their W-2 and provide the facts supporting the claim. It also says to furnish proof of age if the claimant is under 18.
- Do I need a notary for the Centerville refund request?
- No. This form is signed and dated without a notary. The claimant and employer certifications require signatures, and no sworn or notarized attachment is stated.
- How do I submit the Centerville refund request?
- File it with the City of Centerville Income Tax Department at 100 W. Spring Valley Rd., Centerville, OH 45458. The form also lists fax number (937) 433-0310.