Dayton, Ohio DW3
W2 withholding and 1099 Misc. earnings report
Annual Reconciliation
Tax Year
W2 Withholding Amounts Withheld in tax year
Federal ID #
Company Name
January
April
July
October
Address
City/State/Zip
February
May
August
November
Number of W2 employees reported 1) #
Dayton Payroll 2) $
March
June
September
December
Dayton tax @ 2.25% 3) $
Additional courtesy/resident withholding 4) $
1st Quarter
2nd Quarter
3rd Quarter
4th Quarter
TOTAL Dayton tax withheld 5) $
Total W2 Withholding Paid for year 8) $
Number of 1099Misc. Issued 6) #
1099M Dayton earnings reported 7) $
DO NOT MAIL THIS FORM TO THE CINCINNATI DW1 PAYMENT PROCESSING CENTER
Mail only to
I certify that the information contained herein are true and correct
City of Dayton Ohio
Signed
PO Box 1830
Title
Dayton, Ohio 45401
Date
Phone #
Office Location:
101 W 3rd Street
First Floor Income Tax Office
E-mail address
Dayton, Ohio 45402