Form W1 - Employer'S Return Of Tax Withheld - City Of North Ridgeville

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CITY OF NORTH RIDGEVILLE, OHIO, EMPLOYER’S RETURN OF TAX WITHHELD
FORM W1
DOLLARS
CENTS
1. Taxable Earnings paid all Employees subject to
I hereby certify that the information and statements
City of North Ridgeville Income Tax
contained herein are true and correct.
Is this a courtesy withholding?
YES
1.
$
Signature
2. Tax Withheld in month/quarter – 1%
2.
$
3. Adjustment
Title
3.
$
Date
4. Penalty (10% per month – Minimum $25.00)
4.
$
Federal ID no.
5. Interest (1% per month)
5.
$
Phone no. (
)
6. Total
6.
$
THIS RETURN MUST BE FILED/PAID ON OR BEFORE
NAME AND ADDRESS
THE DUE DATE SHOWN BELOW TO AVOID PENALTY
MAKE CHECK OR MONEY ORDER PAYABLE TO:
FOR THE PERIOD ENDING
NORTH RIDGEVILLE TAX DEPARTMENT
MAIL TO:
DUE ON OR BEFORE
NORTH RIDGEVILLE
INCOME TAX DEPT.
7307 AVON BELDEN RD.
NORTH RIDGEVILLE, OH 44039
(440) 353-0846
Notify the Income Tax Department promptly of any change in ownership or name and address shown above.

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