Form 11 - Employer'S Municipal Tax Withholding Statement

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EMPLOYER’S MUNICIPAL TAX WITHHOLDING STATEMENT
FORM
REMIT TO:
RITA - PO BOX 94736 - CLEVELAND, OH 44101-4736
11
FOR THE PERIOD
DUE ON OR BEFORE
S
TO
E
C
T
DISTRIBUTE THE AMOUNTS FROM SECTION A LINE 1 NEXT TO THE NAME OF THE
I
MUNICIPALITY(IES) WHERE THE TAXES ARE DUE IN SECTION B BELOW.
O
RETURN BOTH SECTIONS A AND B WITH YOUR REMITTANCE.
N
A
ADDRESS
CORRECTIONS
MAKE
CHECK PAYABLE
1. DUE and PAID $ ______________
TO RITA
FED. ID# __________________________________
X SIGNATURE
I
HAVE
EXAMINED
THIS
RETURN TO THE BEST OF MY
TITLE
KNOWLEDGE. IT IS CORRECT.
NAME ____________________________________
DATE
/
PHONE
ADDRESS _________________________________
__________________________________________
SECTION B
RATE
AMOUNT WITHHELD
RATE
AMOUNT WITHHELD
RATE
AMOUNT WITHHELD
RATE
AMOUNT WITHHELD
Ashville
.50
Garfield Hts.
2.00
Mount Sterling
1.00
Seven Hills
2.00
Aurora
1.00
Glenwillow
2.00
New Albany
1.00
Shaker Hts.
1.75
Avon
1.00
Grandview Hts.
2.00
Newburgh Hts.
2.00
Shawnee Hills
2.00
Avon Lake
1.50
Highland Hts.
1.50
Newtown
1.00
Sheffield Village
1.00
Bay Village
1.50
Hudson
1.00
North Lewisburg
1.00
Silver Lake
2.00
Beachwood
1.50
Hunting Valley
.75
North Olmsted
2.00
South Euclid
1.50
*
Beachwood
East JEDD
1.50
Independence
2.00
North Royalton
1.00
South Solon
1.00
*
Beachwood
West JEDD
1.50
Kirtland
1.00
Oakwood Village
2.00
Steubenville
2.00
Bedford Hts.
2.00
LaGrange
1.50
Olmsted Falls
1.50
Streetsboro
1.00
Bentleyville
1.00
Lakemore
2.00
Orange
2.00
Strongsville
2.00
*
Orange-Chagrin
Berea
2.00
Lakewood
1.50
Highlands JEDD
2.00
Sunbury
1.00
Bexley
2.00
Lockland
2.10
Ottawa
1.00
Toronto
1.50
Boston Hts.
1.50
Lyndhurst
1.50
Pepper Pike
1.00
University Hts.
1.50
Brady Lake
1.00
Maple Hts.
2.00
Plain City
1.00
Upper Arlington
2.00
Brecksville
2.00
Mayfield Hts.
1.00
Powell
.75
Valley View
2.00
Broadview Hts.
2.00
Mayfield Village
1.50
Reminderville
1.50
Vermilion
1.00
Brooklyn Hts.
2.00
Middleburg Hts.
1.75
Reynoldsburg
1.50
Wakeman
1.00
Chagrin Falls
1.50
Milan
.50
Richmond Hts.
2.00
Walton Hills
1.00
Cuyahoga Hts.
1.50
Milford Center
1.00
Richwood
.50
Westlake
1.50
East Cleveland
2.00
Mogadore
2.00
Riverside
1.50
Willowick
2.00
Elyria
1.75
Moreland Hills
1.00
Saint Paris
1.00
Wintersville
1.00
Fairview Park
1.50
Mount Gilead
1.00
Salineville
1.00
Woodmere
2.00
Galena
1.00

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