Form Cc-102 Draft - Cal State L.a. University Auxiliary Services - 2017
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2CCA – DIVISION OF TAXATION
EMPLOYER’S RETURN
205 W SAINT CLAIR AVE
OF INCOME TAX WITHHELD
CLEVELAND OH 44113-1503
216.664.2070
800.223.6317
C of C 120-102 12/2017
INSTRUCTIONS
Line 1 - Enter the total taxable employment wages as defined in ORC 718. Do not include wages from individuals under the age of 18. Exceptions: Carey, Dresden, Frazeysburg, Hamilton,
Montpelier, Munroe Falls, New Paris, Oakwood, Phillipsburg and West Alexandria have no age limit; Grand River, Rushsylvania, West Liberty and West Milton under the age of 16;
Geneva-On-The-Lake under the age of 15. New Carlisle indviduals 16 and 17 years old who earn $2500.00 or more are subject to the tax.
Line 2 - Enter the amount of employment tax withheld. See employment municipality for tax rate. Allocation of employment tax withheld must be detailed on the front of this form.
Line 3 - Enter the amount of residence tax withheld. Allocation of residence tax must be detailed on the reverse of this form.
Line 4 - Adjustment of income tax withheld. –Line 4 should be used for the correction of errors made in withholding of income tax from wages paid in prior quarters. Any amount shown on
Line 4 must be explained on the reverse of this form.
Line 5 - Balance Due / Paid herewith. Make checks payable to the CCA – Division of Taxation. The amount indicated must be paid with the return by the due date indicated and
allocated to the City of Employment unless work is performed in a non-taxing area. Tax withheld in a non-taxing area reverts back to the City of Residence of the employee.
Signature - Sign, date and enter phone number before returning this form. A return is not considered filed until signed. Name and Address changes should be made on the reverse of this form.
Date Due - Monthly filings are due by the 15th day of the month following the end of the withholding period. Semimonthly filings are due by the 3rd banking day after the 15th day of the
withholding period and the 3rd banking day after the last day of the withholding period. Quarterly filings are due on or before the last day of the month following the last day of each
calendar quarter.
ALLOCATION OF EMPLOYMENT AND RESIDENCE TAX REMITTED
MUST BE COMPLETED TO AVOID PENALTY
Clear Form
Employers which withhold more than $200.00 per month must file monthly.
Employers always withholding $200.00 or less per month can file quarterly.
Click here to go to residence calculation
1. Total Employment Wages
2. Total Employment Taxes
$0.00
Subject to Withholding
►
(allocate below)
Emp Code
FEDERAL ID #
File Code
Name
3. Total Residence Taxes
$0.00
►
(allocate on reverse)
For the period
4. Adjustments
Current Address
►
(explain on Reverse)
To
Due on or before:
5. TOTAL TAXES
$0.00
City
State
Zip
►
ALLOCATED
Make checks payable to CCA.
ALLOCATION OF EMPLOYMENT TAX WITHHELD
Rate% Code
Rate% Code
Rate% Code
Rate% Code
Municipality
Tax Withheld
Municipality
Tax Withheld
Municipality
Tax Withheld
Municipality
Tax Withheld
Ada
1.65 002
Hamilton
2 365
Orwell
1 605
Revenue Sharing/JEDD/JEDZ (complete below)
Alger
1 004
Highland Hills
2.5 371
Paulding
1 640
Butler Co Annex
2 951
Barberton
2.25 025
Huntsville
1 382
Phillipsburg
1.5 659
Clayton/Clay
1.5 984
Bratenahl
1.5 120
Liberty Center
1 408
Rock Creek
1
698
Emerald Park
2.5 993
Burton
1 176
Linndale
2 420
Rushsylvania
1 702
Gateway
2.5 990
Mentor-on-the-Lake
Carey
1.5 181
2 495
Russells Point
1 703
Cleve/High Hills
2.5 995
Clayton
1.5 199
Montpelier
1.6
517
Seville
1 722
Hamilton - Fairfield I
2 952
Cleveland
2.5 200
Munroe Falls
2 533
Shreve
1 755
Hamilton - Fairfield II
2 953
Dresden
1 260
New Carlisle
1.5 534
South Russell
1.25 772
Hamilton - Fairfield III
2 954
Elida
.75 276
New Miami
1.75 539
Timberlake
1 788
High Hills/Cleve
2.5 996
Frazeysburg
1 307
New Paris
1 541
Union
1 797
IX Center
2.5 992
Vlg of Liberty Ctr/Twp
Gates Mills
1 330
North Baltimore
1 548
Warrensville Hts.
2.6 830
1 986
Geneva-on-the-Lake
1.5 347
North Perry Village
1 555
Waynesfield
1 833
Shaker Sq
2.5 994
Germantown
1.25 348
North Randall
2.75 560
West Alexandria
1 834
Warr Hts/Cleve
2.6 997
Grand Rapids
1 356
Norton
2 575
West Liberty
1 837
Grand River
2 357
Village of Oakwood
1 585
West Milton
1.5 835
SHOW CHANGE OF ADDRESS OR CHANGE OF
Employers which withhold more than $200.00 per month must file monthly.
Employers always withholding $200.00 or less per month can file quarterly.
FILING STATUS ON THE REVERSE SIDE OF THIS FORM
CCA – DIVISION OF TAXATION
EMPLOYER’S RETURN OF INCOME TAX WITHHELD
Make checks payable to CCA.
205 W SAINT CLAIR AVE
CLEVELAND OH 44113-1503
2. Total Employment Taxes
1. Total Employment Wages
$0.00
►
(allocate below)
Subject to Withholding
Emp Code
FEDERAL ID #
File Code
3. Total Residence Taxes
Name
$0.00
►
(allocate on reverse)
Current Address
4. Adjustments
For the period
►
(explain on Reverse)
Zip
To
5. TOTAL TAXES
Signature
Title
Co. Phone
Date
Due on or before:
$0.00
►
ALLOCATED
I have examined this return and to the best of my knowledge, it is correct and complete
ALLOCATION OF EMPLOYMENT TAX WITHHELD
Ada
1.65 002
Hamilton
2 365
Orwell
1 605
Revenue Sharing/JEDD/JEDZ (complete below)
Alger
1 004
Highland Hills
2.5 371
Paulding
1 640
Butler Co Annex
2 951
Barberton
2.25 025
Huntsville
1 382
Phillipsburg
1.5 659
Clayton/Clay
1.5 984
Bratenahl
1.5 120
Liberty Center
1 408
Rock Creek
1 698
Emerald Park
2.5 993
Burton
1 176
Linndale
2 420
Rushsylvania
1 702
Gateway
2.5 990
Mentor-on-the-Lake
Carey
1.5 181
2 495
Russells Point
1 703
Cleve/High Hills
2.5 995
Clayton
1.5 199
Montpelier
1.6 517
Seville
1 722
Hamilton - Fairfield I
2 952
Cleveland
2.5 200
Munroe Falls
2 533
Shreve
1 755
Hamilton - Fairfield II
2 953
Dresden
1 260
New Carlisle
1.5 534
South Russell
1.25 772
Hamilton - Fairfield III
2 954
Elida
.75 276
New Miami
1.75 539
Timberlake
1 788
High Hills/Cleve
2.5 996
Frazeysburg
1 307
New Paris
1 541
Union
1 797
IX Center
2.5 992
Vlg of Liberty Ctr/Twp
Gates Mills
1 330
North Baltimore
1 548
Warrensville Hts.
2.6 830
1 986
Geneva-on-the-Lake
1.5 347
North Perry Village
1 555
Waynesfield
1 833
Shaker Sq
2.5 994
Germantown
1.25 348
North Randall
2.75 560
West Alexandria
1 834
Warr Hts/Cleve
2.6 997
Grand Rapids
1 356
Norton
2 575
West Liberty
1 837
Grand River
2 357
Village of Oakwood
1 585
West Milton
1.5 835
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