Form O-W-1 - Return Of Tax Withheld

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VILLAGE OF PANDORA
Employer’s Return of Tax Withheld-Form O-W-1 Office of Taxation under
Ordinance No. 439-00 enacted Nov.28,2000.
1. Number of Taxable Employees
I hereby certify that the
2. Total salaries,wages,commissions and
information and statements
other
$__________
contained herein and in any
Compensation paid all
$__________
schedules or exhibits attached
Employees
are true and correct.
3. Taxable income of employees$_________
________________________________
4. Actual tax withheld
Signature
Date
In Quarter at 1.5%
$________
Credit: Tax paid to city or
Village of________
$________
________________________________
Official title
Balance of Tax Due
$________
(include interest/penalty)
Make check or money order
payable to Commissioner of
Taxation, Village of Pandora
(If no wages paid this
quarter, mark “None” and
return this form with
explanation.
Name and Address
For ______________________
Due on or before
__________________________
Mail to Village of Pandora, Commissioner of Taxation, P.O. Box 193,
Pandora, Ohio 45877
Notify Commissioner property of any change in name and address.

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