VILLAGE OF BREWSTER BUSINESS INCOME TAX RETURN
INCOME TAX DEPARTMENT
VILLAGE OF BREWSTER, OHIO
Employer’s Quarterly Income Tax Return
For Income Earned from _____________________ until ________________________
Due Date ________________________
A.
Taxable Earning Paid to all Employees subject to
$ ______________________
Village of Brewster Income Tax
B.
Actual Tax Withheld in Quarter for Village Income
$ ______________________
Tax (Tax Rate is 1.00%)
C.
Adjustment of Tax from prior Quarter
$ ______________________
(Please Attach Explanation)
D.
Interest and Late Fee (1.00% per month)
$ ______________________
E.
Total Due
$ ______________________
Checks are payable to the Village of Brewster, Ohio
“I hereby certify that the information and statements contained herein to be true and correct.”
Name ____________________________________
Title _____________________________
Signature ___________________________________ Date ____________________________
Business Federal Tax ID Number __________________________
Business Name and Address
Mail To:
________________________________________
Village of Brewster
________________________________________
Income Tax Department
302 Wabash Avenue S
________________________________________
Brewster, Ohio 44613
Phone # 330-767-4214