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

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CITY OF IRONTON
EMPLOYER'S RETURN OF TAX WITHHELD
W-1
I
hereby certify that the information and statements contained herein in any schedules
or exhibits attached are true and correct.
1. Total Number of Taxable Employees
2. Total Salaries, Wages, Commissions and
other compensation paid all employees
(Signed) __________________________________________________
3. Taxable Earnings
(Official Title) _____________________________________________
4. Actual Tax Withheld At I%
5. Adjustments for Tax for Prior Period
THIS RETURN MUST BE FILED ON
OR BEFORE THE DATE AS SHOWN BELOW
6. Interest (1 1/2 per month)
7. Penalty (1 1/2 per month)
Make Check or Money Order Payable To:
CITY OF IRONTON - INCOME TAX
8. Total (include Interest and Penalty if Due)
P.O. Box 704
X-X-XX-XXXXXX
IRONTON, OHIO 45638
____/_____/ 20____
For Period Of:
ONE BIG BUSINESS
1234 MAIN STREET
____/_____/20_____
Due On Or Before:
P.O. BOX 12345
ANYWHERE, USA 00000-0000
Notify Income tax Department promptly of any change in name or address as shown above.

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