Form W-1 - Employer'S Return Of Tax Withheld - City Of Hubbard

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EMPLOYER’S RETURN OF TAX WITHHELD
CITY OF HUBBARD
Instructions on Reverse Side
DOLLARS
CENTS
I hereby certify that the information and statements contained
herein are true and correct.
1.
Taxable Earnings paid all Employees subject to
$
Hubbard, Ohio City Income Tax . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
(Signed)
$
2.
Actual Tax Withheld in period for City Income Tax . . . . . . . . . . . . . .
TAX RATE OF ONE PERCENT (1%)
(Official Title)
3.
Adjustment of Tax for prior period (see instructions). . . . . . . . . . . . .
Date
THIS RETURN MUST BE FILED
. . . . . . . . . . . . . . . . . . .
ON OR BEFORE THE DUE DATE SHOWN BELOW
4.
Interest:
MAKE CHECK PAYABLE TO:
INCOME TAX DEPT.
5.
Penalty:
. . . . . . . . . . . . . . . . . . .
$
MAIL TO:
CITY OF HUBBARD
6.
TOTAL . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
INCOME TAX DEPT.
P.O. BOX 307
HUBBARD, OHIO 44425-0307
FOR MONTH(S) OF
FINAL RETURN - CHECK HERE AND INDICATE REASON:
DUE ON OR BEFORE
W-1
Please notify the Income Tax Department of any changes in name and/or address shown above.
If receipt is desired, return Taxpayer’s Copy of this form and enclose self-addressed, stamped envelope.

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