Occupational Tax Refund Form

  • AFFIDAVIT REGARDING PETITION FOR REFUND OF IRONDALE OCCUPATIONAL TAX

  • I, the undersigned, do hereby certify under oath that I am entitled to a refund of City of Irondale Occupational Tax for the period(s) and for the amount(s) indicated below, determined based upon a percentage of time spent working outside of the corporate limits of the City of Irondale, as follows.
  • Date Format: MM slash DD slash YYYY
  • Employee Worksheet

  • Please enter the percentage in percent format without the percent sign (ie. 100% would be written 100.00)
  • Accepted file types: jpg, jpeg, png, tif, pdf, doc, docx.
  • Accepted file types: jpg, jpeg, png, tif, pdf, doc, docx.
  • I further certify that the information contained herein, to the best of my knowledge, is true and correct.
  • Date Format: MM slash DD slash YYYY
  • Statement of Employer

  • I do hereby certify that I have examined the information above relating to the employee’s job title, job duties, wages, and tax withheld and have determined that this information, to the best of my knowledge, is true and correct. I have also examined the exclusion percentage claimed by the employee and find that it is reasonable, and can be substantiated by the company's books and records.
  • Date Format: MM slash DD slash YYYY