Reconciliation Of Louisville Tax Withheld Form printable pdf download

Reconciliation Of Louisville Tax Withheld Form

CITY OF LOUISVILLE, OHIO

215 South Mill Street

Louisville, OH 44641 (330) 875-3434

RECONCILIATION OF LOUISVILLE TAX WITHHELD

COMPANY NAME: _____________________________________ FIN# ________________________

ADDRESS: _____________________________________

_____________________________________

1. Total Number of employees as represented by

Forms W-2 submitted herewith……………….

______________

2. Total LOUISVILLE Income Tax withheld from wages

During

as shown by employee’s statement

(Form W-2) ……………………………………$ ___________

3. Total LOUISVILLE Income Tax Withheld during

Quarter ended March 31,

$ ________________

Quarter ended June 30,

$ ________________

Quarter ended Sept. 30,

$ ________________

Quarter ended Dec. 31,

$ ________________

4. TOTAL

$ ________________

5. Difference between Lines 2 & 4

$ ________________

•

If Line 5 indicates a balance due, the amount thereof should accompany this return; If Line 5 indicates an overpayment,

a refund request signed by the employer should be made.

W-3

______________________________________________________________________________________________

Reconciliation Of Louisville Tax Withheld Form