Form Fw-3 - Employer'S Annual Reconciliation Of Income Tax Withheld

2014

FW-3

CITY OF FLINT

EMPLOYER’S ANNUAL RECONCILIATION OF INCOME TAX WITHHELD

2014

1. EMPLOYER NAME AND ADDRESS

2. FEDERAL EMPLOYER IDENTIFICATION NUMBER

DUE ON OR BEFORE

2/28/2015

SUMMARY OF WITHHOLDING TAX PAID

TAX WITHHELD

MONTH/QUARTER

WITHHOLDING TAX PAID

January

February

March

FIRST QUARTER TOTAL

April

May

June

SECOND QUARTER TOTAL

July

August

September

THIRD QUARTER TOTAL

October

November

December

FOURTH QUARTER TOTAL

TOTAL WITHHOLDING TAX PAID

NUMBER OF W-2 FORMS ATTACHED

TOTAL TAX WITHHELD PER W-2(S)

BALANCE DUE

OVERPAYMENT - ATTACH EXPLANATION*

TOTAL PAYROLL

*SUBMIT A LETTER EXPLAINING THE OVERPAYMENT AND REQUESTING A REFUND.

10. NAME AND TITLE (Please Print)

11. DATE

9. SIGNATURE

INSTRUCTIONS FOR EMPLOYER’S ANNUAL RECONCILIATION OF INCOME TAX WITHHELD

• Check identification information in Box 1 and Box 2. If incorrect, make corrections and file Notice of Change or Discontinuance, Form F-6-IT.

• Enter tax withheld and tax payment information in the Summary of Withholding Tax Paid section.

• Enter the total withholding tax paid in Box 3.

• Enter the number of W-2 forms attached in Box 4.

• Enter the amount of tax withheld per the W-2 forms attached in Box 5. Attach an adding machine tape totaling the W-2 forms or include copies of the

computer generated summary W-2 forms.

• If the withholding tax paid (Box 3) is less than the tax withheld per the W-2 forms (Box 5), enter the balance due in Box 6. The balance due must be paid in

full with this FW-3 form. Make remittance payable to: FLINT CITY TREASURER

• If the withholding tax paid (Box 3) is greater than the tax withheld per the W-2 forms (Box 5), enter the overpayment in Box 7. To receive a refund of any

overpayment, submit a letter explaining the overpayment and requesting a refund.

• If the withholding tax paid (Box 3) equals the tax withheld per the W-2 forms (Box 5), enter a zero (0) in Boxes 6 and 7.

• Sign the return in box 9; Print your name and title in Box 10; and Enter the date signed in Box 11.

• Attach the required copies of the W-2 forms (or electronic media) and payment for any balance due to the completed FW-3 form and mail to:

CITY OF FLINT INCOME TAX DEPARTMENT, WITHHOLDING TAX SECTION, PO BOX 529,

EATON RAPIDS, MI 48827-0529 OR PAY ONLINE AT:

*PLEASE VISIT FOR ELECTRONIC W2 FILING SPECIFICATIONS