Form W-1 - Employer'S Return Of Taxes Withheld

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Form W-1
CITY OF BLUE ASH
EMPLOYER’S RETURN OF
Income Tax Dept.
4343 COOPER ROAD
TAXES WITHHELD
(513) 745-8516
BLUE ASH, OH 45242-5699
CITY OF BLUE ASH
This form must be submitted each period even if no tax is due.
1% tax withheld from employees' wages = $____________ for period checked.
o Jan. thru March,
20___
Due
4/30
o April thru June,
FID # ________________
ACCT. NO. ________________
20___
Due
7/31
o July thru Sept.,
20___
Due
10/31
o Oct. thru Dec.,
20___
Due
1/31
o Month of ___________________________
_____________________________________
SIGNATURE
MAKE NAME OR ADDRESS CORRECTIONS
_____________________________________
PHONE NUMBER
DATE
(BLUE ASH SUGGESTS THAT YOU MAKE A PHOTOCOPY OF THIS RETURN AND RETAIN FOR YOUR RECORDS)

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