Kettering, OH · Montgomery County
Declaration of Exemption Return
Kettering residents who meet the listed income or retirement criteria use this form to request an exemption from the city income tax filing requirement.
What this form is
This form lets eligible Kettering residents request an exemption from the city income tax return filing requirement. It asks for taxpayer and spouse contact and Social Security information, the reason for exemption, and signatures and dates. Permanently retired or disabled applicants must provide the supporting documentation specified on the form; the city says qualified persons need to file this return one time only.
Who needs it
Kettering residents who meet the form’s permanent retirement or disability criteria and have only the specified nontaxable income may use it to request an exemption.
How to submit it
Submit the completed form and supporting documentation to the Tax Division at P.O. Box 293100, Kettering OH 45429, using the address shown on the form.
About notarization
This document is signed without a notary; the signer declares the information true, correct, and complete and signs and dates the form.
How to submit this form
- 1
Download The Form
Download the Declaration of Exemption Return.
- 2
Complete The Form
Enter the requested taxpayer and spouse information, select the applicable exemption reason, and sign and date the form.
- 3
Gather Supporting Documents
Attach page 1 of your federal Form 1040 when applicable, or proof of permanent disability for a disability exemption.
- 4
Submit To The Tax Division
Send the completed form and supporting documents to the Tax Division at the address printed on the form.
Frequently asked questions
- Who can use the Declaration of Exemption Return?
- The form describes exemptions for qualifying residents who were permanently retired or permanently disabled for the entire year and received only specified nontaxable income.
- What supporting documents does the form require?
- Retired applicants must attach page 1 of their federal Form 1040 when applicable. Disabled applicants must attach proof of permanent disability.
- Do I need a notary for the Declaration of Exemption Return?
- No. The form calls for the signer’s signature and date, and it has no notary block. It asks for supporting tax return or disability documentation where applicable.
- How do I submit the Declaration of Exemption Return?
- Send the completed form and supporting documentation to the Tax Division at P.O. Box 293100, Kettering OH 45429, using the address shown on the form.