City Employee Withholding Tax Form

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CITY EMPLOYEE WITHHOLDING TAX
CITY OF GLASGOW KY
P O BOX 278
THIS RETURN MUST BE FILED WHETHER YOU HAD EMPLOYEES OR NOT DURING THIS PERIOD.
GLASGOW KY 42142-0278
(270) 651-5131
For
Ended
Due On Or Before
Total Gross Salaries, Wages, Commissions and
1.
Other Compensation Paid
º
Less Compensation Paid for Services
2.
Outside Glasgow
º
Memo To Taxpayer
3.
Taxable Earnings (Line 1 Minus Line 2)
º
4.
City Tax Withheld (Line 3 x 1.5%)
º
5.
Less Credits or Prepayments
º
Net Taxes Due On or Before Due Date
6.
(Line 4 Minus Line 5)
º
7.
Interest - ½ of 1% per month
º
City Occupational Account Number
Penalty - 1% per month
8.
Penalty -
(Maximum 10%)
º
9.
TOTAL TAX, PENALTY AND INTEREST
º
Mailing Address
Number of Employees in Glasgow
10.
On Last Payroll In This Period
º
I hereby certify that this information is true and correct:
Name
Title
Date
INSTRUCTION TO TAXPAYER
1.
Payment should be made payable to: TREASURER, CITY OF GLASGOW, 126 E. Public Sq., Suite 100, P.O.
Box 278, Glasgow, KY 42142-0278. Our Telephone number is (270) 651-5131. Our office hours are 8:00 a.m.
to 4:30 p.m., Monday thru Friday.
2.
A copy of this form must accompany your payment. You should retain a copy of the completed form for your
records.
3.
If this business has changed ownership or tax entity please notify this office immediately.
4.
Please make any necessary mailing address changes to this form.
5.
This form must be returned with explanation even if you had no employees during this tax period.
6.
All Employee Withholding Taxes remaining unpaid after they become due shall bear interest at the rate of 1/2 of
one percent per month until paid. All taxes remaining unpaid shall be subject to a one percent penalty per month
not to exceed 10%.
7.
The employer must file with the City a copy of the employees’ W-2 Wage Tax Statement on or before the last day
of February of each year.

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