Form W-1 - Employer'S Return Of Tax Withheld
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1VILLAGE OF ARCHBOLD, OHIO – EMPLOYER’S RETURN OF TAX WITHHELD
FORM W-1
___________________________________________________________________________________________________
Dollars
Cents
I hereby certify that the information and state-
1.
Taxable Earnings paid all employees subject to
ments contained herein are true and correct.
Archbold, Ohio, Village Income Tax
$
(Signed) ________________________________
$
Actual Tax Withheld (Archbold Rate – 1.5%)
2.
$
(Official Title) ___________________________
3.
Adjustment of Tax for Prior Period (see instructions)
Date
$
4.
Interest & Penalties
$
TOTAL
THIS RETURN MUST BE FILED ON OR
BEFORE THE DUE DATE SHOWN BELOW.
MAKE CHECK OR MONEY ORDER PAYABLE TO:
Acct #_______________________________________________
ARCHBOLD, OHIO – INCOME TAX
Name _______________________________________________
FOR PERIOD_______________________
Addr________________________________________________
DUE ON OR BEFORE__________________________
Addr________________________________________________
MAIL TO: VILLAGE OF ARCHBOLD
Income Tax Department
City, State, Zip________________________________________
300 N. DEFIANCE STREET
P.O. BOX 406
Notify
Income Tax Department promptly of any change in ownership or name and address shown above.
ARCHBOLD, OHIO 43502-0406
INSTRUCTIONS FOR PREPARING AND FILING FORM W-1
HOW TO PREPARE THIS FORM:
Line 1 – Enter total compensation PAID all taxable employees
during period for which return is made. If no compensation
was paid during the period, so indicate and return Form W-1.
Line 2 – Enter total ACTUAL tax withheld from taxable
employees during the period for VILLAGE OF ARCHBOLD,
OHIO – INCOME TAX.
Line 3 – To adjust current payment of actual tax withheld for
underpayment or overpayment in previous period.
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