Form P.r.-1 - Employers Return Of Occupational Tax Withheld

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EMPLOYERS RETURN OF OCCUPATIONAL TAX WITHHELD
Form P.R.−1
CITY OF BIRMINGHAM, ALABAMA
ORDINANCE NO. 97−184
(INSTRUCTIONS ON NEXT PAGE)
* 1. NUMBER OF TAXABLE EMPLOYEES____MONTH OF_____
I hereby certify that the information and statements contained
herein and any schedules or exhibits attached are true and
** 2. TOTAL SALARIES, WAGES, COMMISSION, AND OTHER
$
correct, for the month ending
COMPENSATION PAID ALL TAXABLE EMPLOYEES . . . . . . . .
3. LESS NON−TAXABLE ITEMS (COMPENSATION, PAID FOR
SERVICES OUTSIDE OF BIRMINGHAM) . . . . . . . . . . . . . . . .
MONTH
YEAR
(Please Attach Letter of Explanation)
4. TAXABLE EARNINGS (ITEM 2 MINUS ITEM 3) . . . . . . . . . . . .
5. ACTUAL WITHHELD IN MONTH AT 1% . . . . . . . . . . . . . . . . $
SIGNATURE
6.
Add PENALTY for failure to timely file 10%
(minimum $50.00) . $ _____
Add PENALTY for failure to timely pay 10%
(minimum $3.00)
. $ _____
OFFICIAL TITLE
DATE
Add INTEREST of 1% per month
. . . . . . . . . . . . . . . . $ _____
TOTAL AMOUNT OF PENALTIES AND INTEREST − Total of Item 6 . . . . . .
A monthly return must be filed on or before the twentieth day
$
of the next month.
7. TOTAL AMOUNT FOR WHICH REMITTANCE IS ATTACHED . . . .
Make check or money order payable to:
CITY OF BIRMINGHAM
Mail To:
City of Birmingham
P O Box 830638
Birmingham, Alabama 35283−0638
If NAME or ADDRESS has changed, please complete "CHANGE OF TAXPAYER INFORMATION" form.
* Number of employees MUST be shown.
** If no wages were paid this month, mark "0" and return this form with explanation.
EMPLOYERS RETURN OF OCCUPATIONAL TAX WITHHELD
Form P.R.−1
CITY OF BIRMINGHAM, ALABAMA
ORDINANCE NO. 97−184
(INSTRUCTIONS ON NEXT PAGE)
* 1. NUMBER OF TAXABLE EMPLOYEES____MONTH OF_____
I hereby certify that the information and statements contained
herein and any schedules or exhibits attached are true and
** 2. TOTAL SALARIES, WAGES, COMMISSION, AND OTHER
$
correct, for the month ending
COMPENSATION PAID ALL TAXABLE EMPLOYEES . . . . . . . .
3. LESS NON−TAXABLE ITEMS (COMPENSATION, PAID FOR
SERVICES OUTSIDE OF BIRMINGHAM) . . . . . . . . . . . . . . . .
MONTH
YEAR
(Please Attach Letter of Explanation)
4. TAXABLE EARNINGS (ITEM 2 MINUS ITEM 3) . . . . . . . . . . . .
5. ACTUAL WITHHELD IN MONTH AT 1% . . . . . . . . . . . . . . . . $
SIGNATURE
6.
Add PENALTY for failure to timely file 10%
(minimum $50.00) . $ _____
Add PENALTY for failure to timely pay 10%
(minimum $3.00)
. $ _____
OFFICIAL TITLE
DATE
Add INTEREST of 1% per month
. . . . . . . . . . . . . . . . $ _____
TOTAL AMOUNT OF PENALTIES AND INTEREST − Total of Item 6 . . . . . .
A monthly return must be filed on or before the twentieth day
of the next month.
$
7. TOTAL AMOUNT FOR WHICH REMITTANCE IS ATTACHED . . . .
Make check or money order payable to:
CITY OF BIRMINGHAM
Mail To:
City of Birmingham
P O Box 830638
Birmingham, Alabama 35283−0638
If NAME or ADDRESS has changed, please complete "CHANGE OF TAXPAYER INFORMATION" form.
* Number of employees MUST be shown.
** If no wages were paid this month, mark "0" and return this form with explanation.
EMPLOYERS RETURN OF OCCUPATIONAL TAX WITHHELD
Form P.R.−1
CITY OF BIRMINGHAM, ALABAMA
ORDINANCE NO. 97−184
(INSTRUCTIONS ON NEXT PAGE)
* 1. NUMBER OF TAXABLE EMPLOYEES____MONTH OF_____
I hereby certify that the information and statements contained
herein and any schedules or exhibits attached are true and
** 2. TOTAL SALARIES, WAGES, COMMISSION, AND OTHER
correct, for the month ending
$
COMPENSATION PAID ALL TAXABLE EMPLOYEES . . . . . . . .
3. LESS NON−TAXABLE ITEMS (COMPENSATION, PAID FOR
SERVICES OUTSIDE OF BIRMINGHAM) . . . . . . . . . . . . . . . .
MONTH
YEAR
(Please Attach Letter of Explanation)
4. TAXABLE EARNINGS (ITEM 2 MINUS ITEM 3) . . . . . . . . . . . .
5. ACTUAL WITHHELD IN MONTH AT 1% . . . . . . . . . . . . . . . . $
SIGNATURE
6.
Add PENALTY for failure to timely file 10%
(minimum $50.00) . $ _____
Add PENALTY for failure to timely pay 10%
(minimum $3.00)
. $ _____
OFFICIAL TITLE
DATE
Add INTEREST of 1% per month
. . . . . . . . . . . . . . . . $ _____
TOTAL AMOUNT OF PENALTIES AND INTEREST − Total of Item 6 . . . . . .
A monthly return must be filed on or before the twentieth day
$
of the next month.
7. TOTAL AMOUNT FOR WHICH REMITTANCE IS ATTACHED . . . .
Make check or money order payable to:
CITY OF BIRMINGHAM
Mail To:
City of Birmingham
P O Box 830638
Birmingham, Alabama 35283−0638
If NAME or ADDRESS has changed, please complete "CHANGE OF TAXPAYER INFORMATION" form.
* Number of employees MUST be shown.
** If no wages were paid this month, mark "0" and return this form with explanation.

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