Form Pk-3 - Employer'S Registration Report For Newark Payroll Tax - 2007

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EMPLOYER COPY
CITY OF NEWARK
Division of Tax Abatement and Special Taxes
Newark, New Jersey 07102
EMPLOYER'S REGISTRATION REPORT FOR NEWARK PAYROLL TAX
This registration report is to be filed by all employers subject to the Newark Payroll Tax. Read the instructions begin-
ning on page 2 before completing this form. Please print or type all information required, indicating "N/A" if item
does not apply to you. This registration report should be filed with your first payment.
__________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
1.
Employers Name
2. Employers Federal ID No.
…………………………………………………………………………………
…………………………………………………….
3. Principal Location Of Employer within City Of Newark
5. New Jersey Unemployment No.
Street
Zip Code
……………………………………………………… Newark, NJ …………………….
…………………………………………………….
6. Area Code and Telephone Number
Block No…………………………………… Lot No………………………………...
4. Mailing Address ( if different from 3)
…………………………………………………….
Street or P.O. Box
7. Number Of Employees
…………………………………………………………………………………
City, State and Zip Code
…………………………………………………….
…………………………………………………………………………………
8. Type of Organization (check one)
Individual
Partnership
Corporation
Industrial
Financial & Insurance
Transportation
Services
Other ……………………………………………………………………………………………...
9. Principal Product or Service
………………………………………………………………………………………………………………………………………….
Certification: I certify that all information given on this report is correct.
Signature ………………………………………… Title (print)……………………………………….. Date ………………………
ALL OF THE ABOVE ITEMS MUST BE ANSWERED
CITY OF NEWARK PAYROLL TAX RETURN
1 . Gross Payroll this Quarter
1/2007
2. Gross Payroll Excluded
For First Quarter ended March 31, 2007 (payment due April 30, 2007)
(from Schedule A. reverse)
3. Taxable Payroll
(line 1 less line 2)
Employer's Federal ID No.
4. Payroll Tax - 1 % (If Line 3 is
$2.500.00 or less, enter 0)
Employer's Name, Mailing Address and Telephone Number
Employer
5. Interest (if any)
___________________________________________________
Street or P.O. Box
6. Penalty (if any)
___________________________________________________
City, State and Zip Code
7. Credit (Overpayments in prior
Make checks payable to:
_______________________
years.)
"City of Newark-Payroll Tax"
Area Code– Telephone Number
Mail to: P.O. Box 15118
_______________________
8. Amount of this Payment (sum
Newark, New Jersey 07192
Block No.
Lot No.
of lines 4, 5 and 6) less line 7.
2007
I certify that
this is a
Date
correct return:
Form PK-3
Signature
Preparer’s Signature (Other than Taxpayer)

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