Employers Withholding Reconciliation - Village Of Golf Manor - 2016

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VILLAGE OF GOLF MANOR WITHHOLDING TAX
RECONCILIATION
6450 Wiehe Road
Golf Manor, Ohio 45237-4216
Office 531-5155
Fax 531-4404
TAX YEAR 2016
DUE 02/28/17
FEDERAL ID NUMBER ___________________________________
NAME OF EMPLOYER ___________________________________
NAME OF PREPARER ____________________________________
ADDRESS ______________________________________________
_______________________________________________________
LOCAL PHONE NO. ______________________________________
NUMBER OF EMPLOYEES ________________________________
EMPLOYEE W-2’S MUST ACCOMPANY THIS FORM
1. Attach check payable to the Village of Golf Manor for difference if withholding exceeds
remittance.
2. If remittance exceeds amount withheld, give explanation and request refund below.
3. Attach explanation if column 2 is used
4. If non-employee compensation was paid in excess of $600.00 per individual copies of
1099’s must accompany the return.
ENTER PAYROLL BY QUARTERLY OR MONTHLY TOTALS
Period
(1)
(2)
(3)
(4)
(5)
Gross Payroll
Payroll Not
Payroll
Tax Due
Tax Paid Per Your
Subject to
Subject to
Records
Tax
Tax
January
February
March/Qtr 1
April
May
June/Qtr 2
July
August
September/Qtr 3
October
November
December/Qtr 4
TOTALS
TOTAL REMITTANCE MADE
___________

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