Instructions For Form Cca-102 - Employer'S Return Of Income Tax Withheld

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CENTRAL COLLECTION AGENCY
DIVISION OF TAXATION
PO BOX 94520 • CLEVELAND, OHIO 44101-4520
EMPLOYER’S RETURN
OF INCOME TAX WITHHELD
PHONE: 216-664-2070 TOLL FREE: 1-800-223-6317
SPECIFIC INSTRUCTIONS:
Line 1 - Enter the total taxable employment wages as defined in ORC 718.03. Do not include wages from individuals under the age of 18. Exceptions: Grand
River, Medina and Painesville under the age of 16, Creston under the age of 19. Do not include wages earned in taxing communities not listed
on this return.
Line 2 - Enter the amount of employment tax withheld. See employment city for tax rate. Allocation of employment tax withheld must be detailed on the front
of this form.
Line 3- Enter the amount of residence tax withheld. Allocation of residence tax must be detailed on the reverse of this form.
Line 4 - Adjustment of income tax withheld. -Line 4 should be used for the correction of errors made in withholding of income tax from wages paid in prior
quarters. Any amount shown on Line 4 must be explained on the reverse of this form.
Line 5 - Balance Due / Paid herewith. Please make checks payable to the Central Collection Agency. The amount indicated must be paid with the return by the
due date indicated and allocated to the City of Employment unless work is performed in a non-taxing area. Tax withheld in a non-taxing area reverts
back to the City of Residence of the employee.
Signature - Sign, date and enter phone number before returning this form. A return is not considered filed until signed. Name and Address changes should be
made on the reverse of this form.
Date Due - All filings are due by the 20th day following the end of the withholding period.
ALLOCATION OF EMPLOYMENT AND RESIDENCE TAX REMITTED MUST BE COMPLETED TO AVOID PENALTY.
All employers which withhold in excess of $100.00 a month must file monthly.
ALLOCATION OF EMPLOYMENT TAXES WITHHELD
Municipality Rate Code
Tax Withheld
Municipality Rate Code
Tax Withheld
Municipality Rate Code
Tax Withheld
Municipality Rate Code
Tax Withheld
Ada
1.15%
002
Grand River
2%
357
North Perry Village
1%
555
Timberlake
1%
788
Andover
1.5%
006
Highland Hills
2.5%
371
North Randall
2.5%
560
Wadsworth
1.3%
815
2%
Barberton
2%
025
Liberty Center
1%
408
Norton
575
Warrensville Hts.
2%
830
Bradner
1%
117
Linndale
2%
420
Oakwood Village
1%
585
Willoughby
2%
870
Bratenahl
1.5%
120
Madison Village
1%
455
Orwell
1%
605
Willoughby Hills
1.5%
880
Painesville
2%
Burton
1%
176
Medina
1.25%
487
610
990
2%
Chardon
2%
185
Paulding
.5%
640
991
1%
Mentor
2%
490
Cleveland
2%
200
Mentor-on-the-Lake
2%
495
Peninsula
1%
645
992
2%
Creston
1%
238
Metamora
1%
497
Perry
1%
655
993
2%
Rock Creek
1%
Cridersville
1%
239
Middlefield
1%
510
698
994
2%
Dunkirk
1%
266
Munroe Falls
2%
533
Rocky River
1.5%
700
995
2.5%
Gates Mills
1%
330
New Franklin
1%
537
Russells Point
1%
703
996
2.5%
Geneva-on-the-Lake
1%
347
Seville
1%
Northfield Village
2%
545
722
997
2%
Grand Rapids
1%
356
South Russell
1%
North Baltimore
1%
548
772
998
1.75%
2. Total Employment
1. Total Employment Wages
Taxes
Subject to Withholding
3. Total Residence Taxes
Emp
File
(allocate on reverse)
FEDERAL ID #
Code
Code
4. Adjustments
(explain on reverse)
For the period
5. TOTAL TAXES
ALLOCATED
To
Due on or before
Make checks payable to CCA
SHOW CHANGE OF ADDRESS OR CHANGE OF
ALL EMPLOYERS WHICH WITHHOLD IN EXCESS
FILING STATUS ON THE REVERSE SIDE OF THIS FORM
OF $100.00 PER MONTH MUST REPORT MONTHLY
CENTRAL COLLECTION AGENCY • DIVISION OF TAXATION
EMPLOYER’S RETURN
Allocation of Employment
PO BOX 94520 • CLEVELAND, OHIO 44101-4520
Taxes Remitted
OF INCOME TAX WITHHELD
Municipality Rate Code
Tax Withheld
Municipality Rate Code
Tax Withheld
Municipality Rate Code
Tax Withheld
Municipality Rate Code
Tax Withheld
Ada
1.15%
002
Grand River
2%
357
North Perry Village
1%
555
Timberlake
1%
788
Andover
1.5%
006
Highland Hills
2.5%
371
North Randall
2.5%
560
Wadsworth
1.3%
815
Barberton
2%
025
Liberty Center
1%
408
Norton
2%
575
Warrensville Hts.
2%
830
Bradner
1%
117
Linndale
2%
420
Oakwood Village
1%
585
Willoughby
2%
870
Bratenahl
1.5%
120
Madison Village
1%
455
Orwell
1%
605
Willoughby Hills
1.5%
880
Painesville
2%
Burton
1%
176
Medina
1.25%
487
610
990
2%
Chardon
2%
185
Mentor
2%
490
Paulding
.5%
640
991
1%
Cleveland
2%
200
Mentor-on-the-Lake
2%
495
Peninsula
1%
645
992
2%
Perry
1%
Creston
1%
238
Metamora
1%
497
655
993
2%
Cridersville
1%
239
Rock Creek
1%
698
994
2%
Middlefield
1%
510
Dunkirk
1%
266
Munroe Falls
2%
533
Rocky River
1.5%
700
995
2.5%
Gates Mills
1%
330
New Franklin
1%
537
Russells Point
1%
703
996
2.5%
Geneva-on-the-Lake
1%
347
Seville
1%
Northfield Village
2%
545
722
997
2%
Grand Rapids
1%
356
North Baltimore
1%
548
South Russell
1%
772
998
1.75%
2. Total Employment
1. Total Employment Wages
Taxes
Subject to Withholding
Signature
Title
Co. Phone
Date
3. Total Residence Taxes
I have examined this return and to the best of my knowledge, it is correct and complete.
Emp
File
(allocate on reverse)
FEDERAL ID #
Code
Code
4. Adjustments
(explain on reverse)
For the period
5. TOTAL TAXES
ALLOCATED
To
Due on or before
Make checks payable to CCA
CCA-102

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