Quarterly Payroll Tax Statement Form - City Of Newark - 2010

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Quarter 2010 FORM
DELINQUENT AFTER April 30, 2010
NEWARK PAYROLL TAX STATEMENT
USE BLACK INK AND STAY INSIDE THE LINE
BUSINESS TAX ID NUMBER
BUSINESS START DATE
BUSINESS NAME
ADDRESS
CITY
STATE
ZIP CODE
TELEPHONE NUMBER
EMAIL ADDRESS
NO. OF EMPLOYEES
BUSINESS CLOSED ____________
SOLD DATE ____________
For First Quarter ended March 31, 2010 (payment due April 30, 2010)
1.
Total wages, tips and other compensation
2.
Apportionment ( If Applicable)
(See the apportionment section of the instructions)
a.
______________
b.
______________
c.
______________
d.
______________
Total Apportionment
3.
Total Taxable Payroll (enter line 1 if no apportionment; otherwise, subtract
apportionment- line 2, from line 1 and enter the remainder on line 3)
4.
Payroll Tax Calculated (Multiply line 3 by the Payroll Tax rate of 1% or (.01)
5.
If paid after April 30, 2010, enter INTEREST (see instruction)
If paid after April 30, 2010, enter PENALTY (see instruction)
6.
7.
TOTAL DUE. (Add Lines 4, 5, & 6)
Make check payable to: City of Newark-Payroll Tax
Under the laws of the State of New Jersey, I declare under penalty of perjury that I have read the foregoing and that it is true, correct, and complete to best of my
knowledge and belief
X
SIGN HERE
DATE
THIS STATEMENT MUST BE FILED BY APRIL 30, 2010 OR YOU WILL BE SUBJECT TO INTEREST AND PENALTIES
1/2010
PLEASE DO NOT TEAR APART HERE
CITY OF NEWARK- PAYROLL TAX
P.O. BOX 15118
NEWARK, NEW JERSEY 07192
PAYROLL TAX
TAXPAYER ASSISSTANCE: PHONE: (973) 733-3770 IN –PERSON: 920 BROAD STREET RM B-26
STATEMENT
BUSINESS TAX ID NUMBER
CONTACT NAME
PAYMENT ENCLOSED
NOTE: Payment enclosed must equal the amount due on Line 7
(
)
Please write your Business Tax ID on your check

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