Form W-1 - Employers Quarterly Return Of Tax Withheld

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PLEASE INDICATE WHICH PERIOD THIS RETURN IS FOR:
EMPLOYERS QUARTERLY RETURN OF TAX WITHHELD
CITY OF SPRINGDALE
11700 SPRINGFIELD PIKE
JAN-MAR
200_____
(DUE APR 15)
SPRINGDALE, OH 45246
APR-JUN
200_____
(DUE JUL 15)
PHONE (513) 346-5715 FAX (513) 346-5756
JULY-SEP
200_____
(DUE OCT 15)
EMPLOYER'S SPRINGDALE ACCOUNT NUMBER
OCT-DEC
200_____
(DUE JAN 15)
OR
________________________________________________________________________
EMPLOYER'S FEDERAL I.D. NUMBER
MONTH OF____________________________
________________________________________________________________________
1.
TAXABLE EARNINGS SUBJECT TO SPRINGDALE TAX
$_________________
EMPLOYER'S PHONE NUMBER
2.
SPRINGDALE TAX
(1.5% OF LINE 1)
$_________________
________________________________________________________________________
OR
EMPLOYER'S NAME AND ADDRESS
3.
EARNINGS SUBJECT TO SPRINGDALE COURTESY TAX
$_________________
4.
SPRINGDALE COURTESY TAX (RATE____%OF LINE 3)
$_________________
5.
ADJUSTMENTS
$_________________
$
6.
TOTAL TAX PAID WITH THIS RETURN
FOR OFFICE USE ONLY
________________________________________________________________________
W-1
YOU MUST FILE THIS RETURN EVEN IF THERE IS NO TAX DUE
TAXPAYER SIGNATURE (REQUIRED)
DATE
EMPLOYERS QUARTERLY RETURN OF TAX WITHHELD
PLEASE INDICATE WHICH PERIOD THIS RETURN IS FOR:
CITY OF SPRINGDALE
11700 SPRINGFIELD PIKE
SPRINGDALE, OH 45246
JAN-MAR
200_____
(DUE APR 15)
PHONE (513) 346-5715 FAX (513) 346-5756
APR-JUN
200_____
(DUE JUL 15)
JULY-SEP
200_____
(DUE OCT 15)
EMPLOYER'S SPRINGDALE ACCOUNT NUMBER
OCT-DEC
200_____
(DUE JAN 15)
OR
________________________________________________________________________
EMPLOYER'S FEDERAL I.D. NUMBER
MONTH OF____________________________
________________________________________________________________________
TAXABLE EARNINGS SUBJECT TO SPRINGDALE TAX
EMPLOYER'S PHONE NUMBER
1.
$_________________
2.
SPRINGDALE TAX
(1.5% OF LINE 1)
$_________________
________________________________________________________________________
EMPLOYER'S NAME AND ADDRESS
OR
3.
EARNINGS SUBJECT TO SPRINGDALE COURTESY TAX
$_________________
4.
SPRINGDALE COURTESY TAX (RATE____%OF LINE 3)
$_________________
5.
ADJUSTMENTS
$_________________
$
6.
TOTAL TAX PAID WITH THIS RETURN
FOR OFFICE USE ONLY
________________________________________________________________________
W-1
YOU MUST FILE THIS RETURN EVEN IF THERE IS NO TAX DUE
TAXPAYER SIGNATURE (REQUIRED)
DATE
EMPLOYERS QUARTERLY RETURN OF TAX WITHHELD
PLEASE INDICATE WHICH PERIOD THIS RETURN IS FOR:
CITY OF SPRINGDALE
11700 SPRINGFIELD PIKE
SPRINGDALE, OH 45246
JAN-MAR
200_____
(DUE APR 15)
PHONE (513) 346-5715 FAX (513) 346-5756
APR-JUN
200_____
(DUE JUL 15)
JULY-SEP
200_____
(DUE OCT 15)
EMPLOYER'S SPRINGDALE ACCOUNT NUMBER
OCT-DEC
200_____
(DUE JAN 15)
OR
________________________________________________________________________
EMPLOYER'S FEDERAL I.D. NUMBER
MONTH OF____________________________
________________________________________________________________________
1.
TAXABLE EARNINGS SUBJECT TO SPRINGDALE TAX
$_________________
EMPLOYER'S PHONE NUMBER
2.
SPRINGDALE TAX
(1.5% OF LINE 1)
$_________________
________________________________________________________________________
EMPLOYER'S NAME AND ADDRESS
OR
3.
EARNINGS SUBJECT TO SPRINGDALE COURTESY TAX
$_________________
4.
SPRINGDALE COURTESY TAX (RATE____%OF LINE 3)
$_________________
5.
ADJUSTMENTS
$_________________
$
6.
TOTAL TAX PAID WITH THIS RETURN
FOR OFFICE USE ONLY
________________________________________________________________________
W-1
YOU MUST FILE THIS RETURN EVEN IF THERE IS NO TAX DUE
TAXPAYER SIGNATURE (REQUIRED)
DATE

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