Form Q-1 - Employer Quarterly Return Of Withholding Tax - 2003 Page 2

Q-4

EMPLOYER QUARTERLY RETURN OF WITHHOLDING TAX

CINCINNATI INCOME TAX BUREAU

P O BOX 640770

2003

CINCINNATI OH 45264-0770

FOR OFFICIAL USE ONLY

ACCOUNT #:

FED ID#:

SSN#:

TAX RATE: 2.1%

QUARTER ENDING: DEC. 31, 2003

DUE DATE: JANUARY 31, 2004

AMOUNT DUE: $____________________

DATE

PHONE (

)_________________SIGNATURE______________________TITLE____________

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Section 311-31 of the Cincinnati Municipal Code states

Monthly payment of taxes withheld shall be made by an employer if the taxes deducted in the prior calendar year were

more than three thousand six hundred dollars ($3,600), or if such deductions otherwise normally exceed three hundred

dollars ($300) per month. Such payments shall be made to the city within fifteen days after the close of each calendar

month.

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Parent category: Financial