Form W3 1088 - Employer'S Withholding Reconciliation - City Of Louisville
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1Tax Year ___________
CITY OF LOUISVILLE
215 S MILL ST
FORM W3 1088
PO Box 109
EMPLOYER'S
WITHHOLDING
LOUISVILLE OH 44641-1699
RECONCILIATION
Voice 330-875-3434 F a x 330-875-9091
FEDERAL ID NUMBER
Name
NAME OF PERSON
COMPLETING FORM
And
LOCAL PHONE NUMBER
Address
NUMBER OF EMPLOYEES LISTED
EMPLOYEE W2'S MUST ACCOMPANY THIS FORM
INSTRUCTIONS
1. Attach check payable to City of Louisville, 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.
IMPORTANT: IS THE TOTAL REVENUE FOR YOUR COMPANY OVER $500,000 ANNUALLY?
PLEASE CIRCLE
YES OR NO
ENTER PAYROLL BY QUARTERLY OR MONTHLY TOTALS
(1)
(2) Payroll Not
(3)
(4)
(5) Tax
Gross
Subject to Tax
Payroll
Tax
Paid
Subject to Tax
Due
Per Your Records
Payroll
Period
January
February
March/Qtr-1
April May
June/Qtr-2
July August
September/Qtr-3
October
November
December/Qtr-4
TOTALS
TOTAL REMITTANCE MADE
DIFFERENCE
Employer - Explain any differences:
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