Form H-501 - Hamtramck Income Tax Withheld
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1
2EMPLOYER’S MONTHLY DEPOSIT
H-501
HAMTRAMCK INCOME TAX WITHHELD
DO NOT WRITE
IN THIS SPACE
IDENTIFICATION NO.
MONTH
PAY TO:
1
2
CITY OF HAMTRAMCK
MAIL TO:
DUE ON OR BEFORE
CITY OF HAMTRAMCK
3
INCOME TAX DEPARTMENT
NAME AND ADDRESS
P.O. BOX 209
EATON RAPIDS, MI 48827
Monthly filing not required unless Highland Park
withholding tax exceeds $100.00
4
Amount
$
Deposited
IMPORTANT: If deposit is for a period other than
Box 2 enter the correct period
MONTH
YEAR
HERE
SIGNATURE
TITLE
DATE
CUT HERE BEFORE FILING
EMPLOYER’S MONTHLY DEPOSIT
H-501
HAMTRAMCK INCOME TAX WITHHELD
DO NOT WRITE
IN THIS SPACE
IDENTIFICATION NO.
MONTH
PAY TO:
1
2
CITY OF HAMTRAMCK
MAIL TO:
DUE ON OR BEFORE
CITY OF HAMTRAMCK
3
INCOME TAX DEPARTMENT
NAME AND ADDRESS
P.O. BOX 209
EATON RAPIDS, MI 48827
Monthly filing not required unless Highland Park
withholding tax exceeds $100.00
4
Amount
$
Deposited
IMPORTANT: If deposit is for a period other than
Box 2 enter the correct period
MONTH
YEAR
HERE
SIGNATURE
TITLE
DATE
CUT HERE BEFORE FILING
CITY OF HAMTRAMCK
INCOME TAX
MAKE CHECK
& MAIL TO
P.O. BOX 209
H-501
EATON RAPIDS, MI 48827
DO NOT WRITE
IN THIS SPACE
AMOUNT WITHHELD
HAMTRAMCK INCOME
1
TAX WITHHELD
ST. MONTH THIS QTR.
1
AMOUNT WITHHELD
HP-941/501
2
nd. MONTH THIS QTR.
2
AMOUNT WITHHELD
3
INCOME TAX
rd. MONTH THIS QTR.
3
TOTAL TAX WITHHELD
*
THIS QUARTTR.
4
*
5
ADJUSTMENT
PERIOD
DUE ON
IDENTIFICATION
ADJUSTED TAX
6
WITHHELD
IF FINAL RETURN CHECK HERE AND
LESS MONTHLY
COMPLETE QUESTIONS ON THE REVEERSE SIDE.
PAYMENTS
THIS QUARTER
AMOUNT
*
DUE
SIGNATURE
TITLE
DATE
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