Form It-15 - Employer'S Semi-Monthly Or Monthly Deposit Of City Income Tax Withheld - Columbus Income Tax Division

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Columbus
1
Groveport
9
Columbus
Groveport
9
EMPLOYER’S SEMI-MONTHLY OR
MONTHLY DEPOSIT OF
$
$
$
$
CITY INCOME TAX WITHHELD
Obetz
Obetz
10
Canal Winchester
11
10
Canal Winchester
11
Columbus Income Tax Division
$
$
$
$
DATES WAGES PAID =
Tax Year
Qtr.
Year and quarter to which this
Marble Cliff
14
Marble Cliff
14
13
Brice
13
Brice
payment is to be applied
$
$
$
$
Make checks payable and mail to:
COLUMBUS CITY TREASURER
Lithopolis
15
Harrisburg
16
Lithopolis
15
Harrisburg
16
EMPLOYER WITHHOLDING TAX
PO BOX 182489
$
$
$
$
COLUMBUS, OH 43218-2489
TOTAL - ALL CITIES
TOTAL - ALL CITIES
Employer’s Identification No./FID No.
$
$
OFFICE USE ONLY
USE LABELS ENCLOSED WHEN
MAKING DEPOSITS
KEEP THIS COUPON FOR YOUR RECORDS
FORM IT-15 (W-5)/Rev. 07/04
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
Columbus
1
Groveport
9
Columbus
Groveport
9
EMPLOYER’S SEMI-MONTHLY OR
MONTHLY DEPOSIT OF
$
$
$
$
CITY INCOME TAX WITHHELD
Obetz
10
Canal Winchester
11
Obetz
10
Canal Winchester
11
Columbus Income Tax Division
$
$
$
$
DATES WAGES PAID =
Tax Year
Qtr.
Year and quarter to which this
Marble Cliff
14
Marble Cliff
14
13
Brice
13
Brice
payment is to be applied
$
$
$
$
Make checks payable and mail to:
COLUMBUS CITY TREASURER
Lithopolis
15
Harrisburg
16
Lithopolis
15
Harrisburg
16
EMPLOYER WITHHOLDING TAX
PO BOX 182489
$
$
$
$
COLUMBUS, OH 43218-2489
TOTAL - ALL CITIES
TOTAL - ALL CITIES
Employer’s Identification No./FID No.
$
$
OFFICE USE ONLY
USE LABELS ENCLOSED WHEN
MAKING DEPOSITS
KEEP THIS COUPON FOR YOUR RECORDS
FORM IT-15 (W-5)/Rev. 07/04
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
Columbus
1
9
Columbus
9
Groveport
Groveport
EMPLOYER’S SEMI-MONTHLY OR
MONTHLY DEPOSIT OF
$
$
$
$
CITY INCOME TAX WITHHELD
Obetz
Canal Winchester
Obetz
Canal Winchester
10
11
10
11
Columbus Income Tax Division
$
$
$
$
DATES WAGES PAID =
Tax Year
Qtr.
Year and quarter to which this
Marble Cliff
13
Brice
14
Marble Cliff
13
Brice
14
payment is to be applied
$
$
$
$
Make checks payable and mail to:
COLUMBUS CITY TREASURER
Lithopolis
15
Harrisburg
16
Lithopolis
15
Harrisburg
16
EMPLOYER WITHHOLDING TAX
PO BOX 182489
$
$
$
$
COLUMBUS, OH 43218-2489
TOTAL - ALL CITIES
TOTAL - ALL CITIES
Employer’s Identification No./FID No.
$
$
OFFICE USE ONLY
USE LABELS ENCLOSED WHEN
MAKING DEPOSITS
KEEP THIS COUPON FOR YOUR RECORDS
FORM IT-15 (W-5)/Rev. 07/04
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -

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