Granville, OH · Licking County
Refund Claim Form
Granville residents and employers use this form to request a refund of village income tax withheld or paid in error.
What this form is
Use this form to request a refund of Granville village income tax withheld from an employee or remitted by an employer in error. The form asks for claimant, employment, residence, tax period, refund amount, and reason details, along with employer certification. Employee claims must include a W-2, a schedule of dates and locations worked outside the village, and a telework agreement or employer policy; incomplete claims will not be processed.
Who needs it
Nonresidents whose employer withheld Granville village income tax for work partly outside the village, and employers that remitted employee tax in error, may file this claim.
How to submit it
Mail the completed form to the Granville Income Tax Department, 141 E Broadway, PO Box 514, Granville, OH 43023; email it to [email protected] or fax it to 740-587-0128.
About notarization
This form is signed and dated without a notary; the instructions require supporting documents, but none is identified as sworn or notarized.
How to submit this form
- 1
Download The Form
Download the Granville Refund Claim Form PDF.
- 2
Complete The Claim
Fill in the claimant, employment, residence, tax period, refund amount, and reason details; sign and date the form.
- 3
Gather Required Documents
For an employee claim, attach the W-2, a schedule of dates and locations worked outside the village, and the employer’s telework agreement or policy.
- 4
Submit The Claim
Mail, email, or fax the completed form and documentation using the contact details printed on the form.
Frequently asked questions
- Who can file the Granville Refund Claim Form?
- A nonresident may file if village income tax was withheld and they performed less than all services within the village limits. Employers may also file if they remitted employee income tax to the village in error.
- What documents must accompany an employee claim?
- The instructions require the claimant’s W-2, a schedule of dates and locations worked outside the village, and a copy of the employer’s telework agreement or telework policy. Claims without complete documentation will not be processed.
- Do I need a notary for the Refund Claim Form?
- No. The form is signed and dated without a notary. The instructions require supporting documents, but none is identified as sworn or notarized.
- How do I submit the Granville refund claim?
- Mail it to the Granville Income Tax Department at 141 E Broadway, PO Box 514, Granville, OH 43023; email it to [email protected]; or fax it to 740-587-0128.