Form C-1 - Return Of Income Tax Withheld - Village Of Covington (Page 2 of 2) in pdf

Form C-1 - Return Of Income Tax Withheld - Village Of Covington Page 2

Village Form C-1

VILLAGE OF COVINGTON INCOME TAX

File With

RETURN OF INCOME TAX WITHHELD

ORIGINAL

Dept. of Taxation

On Salaries, Wages and Other Compensation

P.O. Box 156

For period from_________________to__________________

Covington, OH 45318

I declare that this return has been examined by me, and to the best of my knowledge and

1. Total Tax withheld during period_ _ $________________

belief is a true, correct, and complete return, made in good faith, pursuant to Village of

Covington Income Tax Ordinance and the Regulations issued under the authority thereof.

2. Adjustment to prior returns_ _ _ _ _ $________________

(Signed) ________________________________________________________________

3. Total payable herewith _ _ _ _ _ _ _ $________________

(Corporation, Business, or Trade Name)

Make check or money-order payable to Village of Covington

Tax Department. If No Tax Was Withheld Please Indicate

By_____________________________________________Date____________________

None and Return.

Penalty $__________

Interest $__________

Total $__________

Please print your business name and address as you wish to show on our records.

Form C-1 - Return Of Income Tax Withheld - Village Of Covington Page 2