Withholding Tax Reconciliation Form - City Of Loveland

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FOR TAX YEAR ENDING 2009
WITHHOLDING TAX RECONCILIATION
FEBRUARY 28. W-2’S MUST BE ATTACHED
Phone (513)583-3035 • Fax (513) 583-3037
THIS RECONCILIATION MUST BE COMPLETED & SUBMITTED BY FEBRUARY 28.
1) TOTAL NUMBER OF W-2’S ATTACHED...................................................
CITY OF LOVELAND
2) TOTAL PAYROLL FOR YEAR .................................................................... $
JANUARY
APRIL
JULY
OCTOBER
$
$
$
$
3) LESS PAYROLL NOT SUBJECT TO TAX** ............................................... $
FEBRUARY
MAY
AUGUST
NOVEMBER
4) PAYROLL SUBJECT TO TAX .................................................................... $
$
$
$
$
5) WITHHOLDING TAX LIABILITY @ 1% OF LINE 4 .................................... $
MARCH
JUNE
SEPTEMBER
DECEMBER
$
$
$
$
6) TOTAL REMITTANCES MADE................................................................... $
1ST QUARTER
2ND QUARTER
3RD QUARTER
4TH QUARTER
7) DIFFERENCE (SEE SPECIFIC FILING INFORMATION)............................ $
$
$
$
$
6. PAID FOR YEAR .......................................................................................................... $
I hereby certify that the information and statements contained herein are true and correct.
Signed
Title
Federal ID no.
Date
Phone no.
MAIL TO:
LOVELAND TAX OFFICE
120 WEST LOVELAND AVE., LOVELAND, OH 45140-2932
FORM W3
**Explanation must be attached.

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