Form W-3 - Withholding Tax Reconciliation
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1CITY OF BLUE ASH - WITHHOLDING TAX RECONCILIATION
th
Due on or before February 28
(513) 745-8516
FORM W-3
Mail to
:
Fax: (513) 745-8651
BLUE ASH TAX OFFICE
4343 COOPER ROAD
BLUE ASH, OHIO 45242-5699
INSTRUCTIONS
- Copies of W-2’s of taxable employees MUST accompany the filing of this form W-3. Include tape showing total gross wages.
- If non-employee compensation of $600.00 or more per individual was paid for work performed in Blue Ash, copies of
1099’s MUST also accompany this return.
- All blanks must be completed.
EMPLOYER’S NAME, ADDRESS AND ACCOUNT NO.
ALL BLANKS MUST BE COMPLETED
Fed. ID# of Company: ________________________________
Submitted by (please print):____________________________
Official Title:________________________________________
Signature:__________________________________________
Date:______________________________________________
Phone:_____________________________________________
Email: _____________________________________________
7.
First quarter ending March 31
$______________
Total Blue Ash Income Tax Remitted for Tax Year ____________
8.
Second quarter ending June 30
$______________
9.
Third quarter ending September 30
$______________
1.
Total number of W-2 forms submitted
____________
10.
Fourth quarter ending December 31
$______________
2.
Total number of current Blue Ash employees
____________
3.
Total Blue Ash payroll for the year
$_______________
11.
Credits from prior year
$______________
4.
Less payroll not subject to tax
12.
Total remitted for the year
$______________
(*Must include explanation below)
$____________
13.
Overpayment credited to next year
(Refunds not issued to active accounts)
$______________
5.
Payroll subject to tax
$_______________
14.
Additional tax due
$______________
6.
Withholding tax liability @ 1.25% of Line 5 $_______________
No taxes or credits of less than $1.00 shall be collected or refunded
EXPLANATION OF PAYROLL NOT SUBJECT TO TAX / W-2s NOT FULLY SUBJECT TO BLUE ASH TAX
*(If no explanation is provided, 1.25% of total gross payroll is due and payable.)
FOR OFFICE USE ONLY
)
(BLUE ASH SUGGESTS THAT YOU MAKE A PHOTOCOPY OF THIS RETURN AND RETAIN FOR YOUR RECORDS
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