Do I need a notary for the Income Tax Exemption Form?

No. The form has signature and date fields but no notary block. Include the front page of your federal 1040 as instructed.

Who can apply for this income tax exception?

The form says residents at least 60 years old who receive only nontaxable income may apply. It lists examples of nontaxable and taxable income.

How do I submit the Income Tax Exemption Form?

Complete and sign the form, include the front page of your federal 1040, and return it to the Tax Administrator’s office.

What information does the form ask for?

It requests contact information, dates of birth, Social Security numbers, income sources, and information about farm or rental property ownership.

Anna, OH · Shelby County

No notary required

Income Tax Exemption Form

Anna residents who are at least 60 and receive only nontaxable income use this form to apply for an exception from filing an annual city tax return.

What this form is

The form lets Anna residents who are at least 60 years old and receive only nontaxable income apply for an exception from filing an annual city tax return. It asks for the resident’s and spouse’s contact and income details, including Social Security numbers, income sources, and whether they own a farm or rental property. The form says to include the front page of the federal 1040.

Who needs it

Anna residents at least 60 years old with only nontaxable income can use this form to apply for the city tax return exception.

How to submit it

Return the completed form to the Tax Administrator’s office with the front page of your federal 1040, as directed on the form.

About notarization

This form is signed and dated without a notary; it asks for the front page of the federal 1040, and the signer just signs and dates the form.

How to submit this form

1
Download the Form
Download the Income Tax Exemption Form for Anna.
2
Complete the Form
Provide the requested personal, spouse, property, and income information.
3
Gather the Attachment
Include a copy of the front page of your federal 1040, as directed on the form.
4
Sign and Submit
Sign and date the form, then return it with the attachment to the Tax Administrator’s office.

Frequently asked questions

Do I need a notary for the Income Tax Exemption Form?: No. The form has signature and date fields but no notary block. Include the front page of your federal 1040 as instructed.
Who can apply for this income tax exception?: The form says residents at least 60 years old who receive only nontaxable income may apply. It lists examples of nontaxable and taxable income.
How do I submit the Income Tax Exemption Form?: Complete and sign the form, include the front page of your federal 1040, and return it to the Tax Administrator’s office.
What information does the form ask for?: It requests contact information, dates of birth, Social Security numbers, income sources, and information about farm or rental property ownership.

Need something notarized?

This Income Tax Exemption Form doesn’t need a notary — but if you have another Anna form that does, a commissioned online notary can help.