Form Eqr - Employer'S Quarterly Return Of Tax Withheld

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EMPLOYER'S QUARTERLY RETURN OF TAX WITHHELD
W
City of Bowling Green, Ohio
Form EQR
Dollars
Cents
I hereby certify that the information and statements
contained herein are true and correct.
1. Bowling Green Taxable Earnings RATE = 1.92%
%
(Signed)
2. Taxable earnings paid BG residents at
(reduced credit rate)
3. Actual Tax Withheld in quarter for B.G. Income Tax
(Official Title)
4. Adjustment of Tax for prior quarter (explain on back)
Owner, Partner, Member, President, Treasurer, Agent, Date
THIS RETURN MUST BE FILED
(1 1/2% per month or portion thereof)
5. Interest
ON OR BEFORE THE DUE DATE AS SHOWN BELOW
(3% [Minimum $10 per month)
6. Penalty
MAKE CHECK OR MONEY ORDER PAYABLE TO:
-
INCOME TAX
7. Total (include interest and penalty if due)
City of Bowling Green, Ohio
MARCH 31
FOR QUARTER ENDING
Name: ____________________________________________
APRIL 30
DUE ON OR BEFORE
Address: _______________________________________
_
MAIL TO: City of Bowling Green, Income Tax Div.
________________________________________________
PO Box 189 Bowling Green, OH 43402
(419) 354-6213 Fax (419) 354-5122
Notify Income Tax Department promptly of any change
in ownership or name and address shown above.

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