City Form Sw-1 - Return Of Income Tax Withheld - City Of Sidney Income Tax

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City Form SW-1
City of Sidney Income Tax
File With
RETURN OF INCOME TAX WITHHELD
ORIGINAL
Dept. of Taxation
on salaries, wages, and other compensation
201 West Poplar Street
Sidney, 0hio 45365-2720
For period from_________________to_____________________________________________________
I declare that this return has been examined by me, and to the best of my
1. Total Tax
$ -------------------
knowledge and belief is a true, correct and complete return, made in good faith,
withheld during period
pursuant to City of Sidney Income Tax Ordinance and the Regulations issued
2. Adjustment to
$ -------------------
under the authority thereof.
prior returns
$ -------------------
(Signed)_________________________________________________________
3. Total payable herewith
(Corporation, Business or Trade Name)
Make check or money-order payable to City of Sidney, Ohio
By_______________________________________ Date__________________
If No Tax Was Withheld Please lndicate None And Return
-
$________
Penalty
$________
Interest
$ -------------
Total

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