Form Er-1 - Employer'S Municipal Income Tax Withholding Forms - City Of Gahanna Income Tax Department Page 13
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17RETURN OF INCOME TAX WITHHELD
CITY OF GAHANNA
FOR MONTH OF OCTOBER
10
INCOME TAX DEPARTMENT FORM ER-1
(Enter Year)
P.O. BOX 640308
1st PAYMENT
CINCINNATI, OH 45264-0301
2ND PAYMENT
(614) 342-4030
1. Tax withheld on income earned in Gahanna (1-1/2%)..................................... $
IF ADDRESS ON COUPON IS INCORRECT
PLEASE MAKE CHANGES ON FORM
2. Residence tax withheld. ...................................................................................... $
3. Adjustments and/or penalties (explain in full on back of form). .................... $
4. Balance Due with this Form. Pay this amount in FULL.................................. $
Make check payable to City of Gahanna.
I HAVE EXAMINED THIS RETURN AND TO THE BEST OF MY KNOWLEDGE IT IS CORRECT
Enter Your F.E.I.N. or S.S. No. Here
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