Form 322 - Annual Reconciliation Of Compensation Tax Withheld From Wages
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1FORM 322 ANNUAL RECONCILIATION OF COMPENSATION TAX WITHHELD FROM WAGES FOR TAX YEAR
EMPLOYER NAME AND ADDRESS:
QUARTERLY PAYMENTS BREAKDOWN
Total Compensation Tax Remitted Jan. 1 - Dec.
31 as Reported on Line 1 of Form 319
1.
3.
BUREAU ACCOUNT NO.
QTR. ENDED 3/31
QTR. ENDED 9/30
$
0.00
$
0.00
2.
QTR. ENDED 6/30
4.
QTR. ENDED 12/31
$
0.00
$
0.00
FEDERAL EIN
5.
A. NUMBER OF W-2 RECORDS REPORTING LOCAL
TOTAL TAX REMITTED
0.00
$
(should equal box 6)
COMPENSATION TAX WITHHELD IS:
6.
TOTAL TAX WITHHELD
$
B.
ENCLOSE VERIFICATION OF THE TOTAL COMPENSATION
as reported on W-2's
TAX WITHHELD AS REPORTED ON THE W-2 RECORDS
YORK ADAMS TAX BUREAU
SUBMITTED TO YATB. EXAMPLE: CALCULATOR TAPE OR
COMPUTER REPORT.
PO BOX 15627, YORK PA 17405
(717) 812-0759
C. IF OVERPAID, CHECK ONE:
REFUND
APPLY TO NEXT YEAR
D. IMPORTANT! ENCLOSE COPIES OF ALL W-2 INFORMATION REPORTED ON THIS FORM 322.
CONTACT PERSON'S NAME (PRINT) ____________________________________
PHONE NO.: ___________________________
AUTHORIZED OFFICER'S NAME (PRINT) _________________________________
FAX NO.: ______________________________
_____________________________
_________________
________
I DECLARE UNDER PENALTIES PROVIDED BY LAW THAT THIS RETURN HAS BEEN EXAMINED
AUTHORIZED SIGNATURE REQUIRED
TITLE
DATE
BY ME AND TO THE BEST OF MY KNOWLEDGE IS A TRUE, CORRECT AND COMPLETE RETURN.
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