Employer'S Reconciliation Of Tax Withheld Form

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CITY OF IRONTON
EMPLOYER'S RECONCILIATION OF TAX WITHHELD
WHR
5. Actual Tax Withheld
1. Total Number of Taxable Employees
6. Interest
2. Total Salaries, Wages, Commissions and
other compensation paid all employees
7. Penalty (see ordinance)
3. Less Non-Taxable Items (Compensation Paid
8. Total Amount Due
Non-Residents for service outside Ironton)
9. Total Amount Paid City
10. Items 8 and 9 should be identical. Show
4. Total Taxable Earnings
amount and any discrepancy on reverse
side.
COPIES OF W-2 FORMS MUST BE SUBMITTED WITH FORM.
Notify Income Tax Department promptly of any change in name or address as shown above.
20___
Mail To:
For The Year:
City of Ironton
BIG BUSINESS USA
Income Tax Dept.
Due On Or Before:
_____ 15, 20____
1234 MAINT STREET
P.O. Box 704
PO BOX 12345
___-___-___-______________
Ironton, OH 45638
ANYWHERE,
OH XXXXX-0000
(740) 532-9241
Codified ordinances - Chapter 14, See 14-20(d)

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