Form Wt-Pr - Petition For Reassessment Income Tax Withholding
Download a blank fillable Form Wt-Pr - Petition For Reassessment Income Tax Withholding in PDF format just by clicking the "DOWNLOAD PDF" button.
Open the file in any PDF-viewing software. Adobe Reader or any alternative for Windows or MacOS are required to access and complete fillable content.
Complete Form Wt-Pr - Petition For Reassessment Income Tax Withholding with your personal data - all interactive fields are highlighted in places where you should type, access drop-down lists or select multiple-choice options.
Some fillable PDF-files have the option of saving the completed form that contains your own data for later use or sending it out straight away.
ADVERTISEMENT
1WT-PR
(Rev 02/01)
Petition for Reassessment
I
T
W
NCOME
AX
ITHHOLDING
Regarding the Income Tax Withholding Assessment Against:
Name(s) ____________________________________________
Assessment Serial No. ________________________________
Address ____________________________________________
Tax Years ___________________________________________
City _____________________ State _____ Zip ____________
Date Assessed ____________ Date Received _____________
-
Ohio Withholding Account No. ___________________________
Date Paid ___________________________________________
-
Federal Employer Identification No. _______________________
Amount Paid _________________________________________
Note: Failure to comply with the Ohio Revised Code (ORC) section 5747.13 can result in dismissal of your petition. ORC
Sections 5747.13(B) and (E) may require payment of all or a portion of the assessment within sixty days of receipt
of the assessment. See important information on back of this form.
Indicate below your objections to the assessment. Attach additional sheets, if necessary.
Check one:
c
(Please choose city from drop down box.)
I waive a hearing.
c
I request a hearing in:
Youngstown
Zanesville
I will be represented in this matter by:
I am the party assessed or the authorized agent of the
(Complete if known. Type or print.)
party assessed, and I have knowledge of the relevant
facts in this matter.
Name ______________________________________________
Signature ________________________ Date _____________
Address ____________________________________________
Name ______________________________________________
City _____________________ State _____ Zip ____________
Title _______________ Telephone No. __________________
Telephone No. _______________________________________
For State Use Only
Please complete all blanks. Please type or print in ink.
Please file this petition in duplicate with:
Ohio Department of Taxation
Billings/Assessment Division
P.O. Box 1090
Columbus, OH 43216-1090
ADVERTISEMENT
0 votes
Related Articles
Related forms
Related Categories
Parent category: Financial