Form Eqr/pw3 - Employer'S Municipal Income Tax Withholding 2007 Page 7

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City of Pickerington
FORM PW3
LEGIBLE COPIES OF W-2 FORMS OR
Employer’s Reconciliation of Tax Withheld
COMPUTER PRINT-OUTS MUST
Income Tax Department
for tax year 2007
ACCOMPANY THIS FORM.
100 Lockville Road
Due on or before February 28, 2008
Pickerington, Ohio 43147
Check here if employer paying taxes in
Phone 614-837-4116
lieu of withholding – No W-2s necessary
For Period From
To
______________
______________
1. Total number of employees as represented
7.
Income Tax Withheld from compensation as shown by
by Forms W-2 submitted herewith____________________
Form EQR for the periods of either monthly or quarterly.
2. TOTAL WAGES FOR THE YEAR TAXED AT 1%
$____________
3. TAX DUE AT 1%
$____________
MONTHLY PMTS
QUARTERLY PMTS
4. TOTAL WAGES FOR THE YEAR TAXED AT
1
/
%
$____________
2
Jan.
______________
Jul.
______________
1
5. TAX DUE AT
/
%
$____________
2
st
____________
1
qtr.
Feb. ______________
Aug.
______________
6. TOTAL TAX DUE FOR THE YEAR
$____________
Mar. ______________
Sep.
______________
ACCOUNT #
____________
2
nd
qtr.
Apr. ______________
Oct.
______________
____________
3
rd
qtr.
May ______________
Nov.
______________
Jun.
______________
Dec.
______________
____________
4
th
qtr.
8.
Grand Total Remitted________________________________
Line 8 must equal line 6. Or the difference must be accounted for on line 9.
9.
If overpayment, check one of the following and indicate amount:
Refund
Amount
$__________
Carry Over
Amount
$__________
If underpayment, please indicate remittance amount:
$_______________________

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