Form Dw-3 - Reconciliation Of Withholding Returns - City Of Dayton

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FORM DW-3
Reconciliation of Withholding Returns • City of Dayton
File with: City of Dayton Income Tax • P.O. Box #2806 • Dayton, OH 45401-2806
(RECONCILIATION ONLY) Due February 28
th
Only submit Wage and Tax Statements with this form. Do not send paymen ts. If you need to send
any payments, please mail under a separate envelope with an explanation to the above address.
Attach copies of all 1099 misc. issued
Tax Year (City Income Tax Withheld):
1. List Total Number of Wage Statements Represented:
Company Name:
Federal I.D. #
Date
Address :
City:
State:
Zip:
Preparer:
Contact Phone No:
2. Total Tax Withheld From Employees (City of Dayton):
3. Total Authorized Employment as of December 31:
4. List Total Income Tax Withheld during this year as shown on Form DW-1:
Monthly Filers
Quarterly Filers
January:
February:
March:
1
Quarter =
st
April:
May:
June:
2
Quarter =
nd
July
August
September:
3
Quarter =
rd
October:
November:
December:
4
Quarter =
th
5. Total Tax Withheld for the year: $
6. # of 1099 misc. attached:
The City of Dayton no longer collects tax for other Municipalities.

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