Form Kw-3 - Annual Reconciliation
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1F
KW-3 (
. 10/01)
ORM
REV
A
R
NNUAL
ECONCILIATION
(Y
) _______
EAR
P.O. B
293100 / K
, O
45429-9100
OX
ETTERING
HIO
N
W-2’
A
T
T
R
UMBER OF
S
TTACHED
OTAL
AX
EMITTED
SUBMIT THIS
J
.
A
J
O
.
AN
PRIL
ULY
CT
FORM
WITH W-2’s BY
T
K
T
N
E
F
.
M
A
.
N
.
OTAL
ETTERING
AX
UMBER OF
MPLOYEES AT
EB
AY
UG
OV
W
P
W-2’
C
Y
E
ITHHELD
ER
S
ALENDAR
EAR
ND
FEBRUARY 28.
M
J
S
.
D
.
ARCH
UNE
EPT
EC
D
D
IFFERENCE
UE OR
If overpaid, check one:
*
1
Q
.
2
Q
.
3
Q
.
4
Q
.
<O
>
ST
TR
ND
TR
RD
TR
TH
TR
VERPAID
o Credit o Refund
*see instructions on reverse side
If name or address is incorrect, make necessary changes.
Federal ID No. ___________________________
I hereby certify that the information and statements contained herein are true and correct.
Signed by ___________________________________________
Date ____________
R
O
ESPONSIBLE
FFICER
Print Name __________________________________________
R
O
ESPONSIBLE
FFICER
F
KW-3 (
. 10/01)
ORM
REV
A
R
NNUAL
ECONCILIATION
(Y
) _______
EAR
P.O. B
293100 / K
, O
45429-9100
OX
ETTERING
HIO
N
W-2’
A
T
T
R
UMBER OF
S
TTACHED
OTAL
AX
EMITTED
KEEP
J
.
A
J
O
.
AN
PRIL
ULY
CT
THIS
T
K
T
N
E
F
.
M
A
.
N
.
OTAL
ETTERING
AX
UMBER OF
MPLOYEES AT
EB
AY
UG
OV
W
P
W-2’
C
Y
E
ITHHELD
ER
S
ALENDAR
EAR
ND
COPY
M
J
S
.
D
.
ARCH
UNE
EPT
EC
D
D
IFFERENCE
UE OR
If overpaid, check one:
*
<O
>
1
Q
.
2
Q
.
3
Q
.
4
Q
.
VERPAID
ST
TR
ND
TR
RD
TR
TH
TR
o Credit o Refund
*see instructions on reverse side
If name or address is incorrect, make necessary changes.
Federal ID No. ___________________________
I hereby certify that the information and statements contained herein are true and correct.
Signed by ___________________________________________
Date ____________
R
O
ESPONSIBLE
FFICER
Print Name __________________________________________
R
O
ESPONSIBLE
FFICER
ANNUAL RECONCILIATION (FORM KW-3)
GENERAL INFORMATION
On or before February 28 of each year, each employer must file a withholding reconciliation on the City of Kettering Form KW-3. Copies
of all W-2 forms applicable to the reconciliation must be attached. All W-2’s must furnish the name, address, social security number, gross
wages, city tax withheld, name of city for which tax was withheld, and any other compensation allocated or set aside for or paid to the
individual. If copies of the W-2 forms are not available, each employer must provide a listing of all employees subject to Kettering tax.
The listing shall provide the same information as is required of the W-2 form.
SPECIFIC FILING INSTRUCTIONS
The front of the Form KW-3 must show a breakdown of all withholding payments made either quarterly or monthly in the boxes provided.
The total tax payments remitted to Kettering, total Kettering tax withheld, number of W-2’s attached, and number of employees at
calendar year end must be noted in the boxes provided. The amount paid and the amount withheld should be equal. If an overpayment
exists, please check the box indicating whether you would like the overpayment credited to the following year or refunded. When using a
credit on your next withholding voucher, please note the total tax due as well as the amount of credit used. If a balance is due, please
submit the payment with this form. The completed Form KW-3 and all attachments must be submitted to the City of Kettering, Tax
Division, P.O. Box 293100, Kettering, Ohio 45429-9100 on or before February 28 of each year.
Contact the Tax Division at (937) 296-2502 for assistance.
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