Form W-1 - Employer'S Return Of Tax Withheld Page 4
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4RECONCILIATION OF WEST CARROLLTON
FORM W-3
INCOME TAX WITHHELD
MAIL TO: CITY OF WEST CARROLLTON
West Carrollton Income Tax paid during
DIVISION OF TAXATION
January ............... $
July...................... $
300 E. CENTRAL AVE.
February.................
August....................
WEST CARROLLTON, OHIO 45449-1810
March*....................
September* ............
April........................
October ..................
1. Total number of employees per W-2’s ..............
May ........................
November ..............
2. West Carrollton total wages per W-2’s .............
June* ......................
December* .............
3. West Carrollton tax withheld per W-2’s ............
4. West Carrollton tax paid....................................
TOTAL ................ $
5. Difference – balance due/(refund) ....................
Payment/refund not required if less than $2.00
I hereby certify that the information and statements contained herein are true,
correct, and complete.
Signed
Title
Date
*The monthly breakdown is not required for taxpayer’s filing quarterly.
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