Form Ww-1 - Return Of Income Tax Withheld - City Of Westerville

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CITY OF WESTERVILLE, OHIO – RETURN OF INCOME TAX WITHHELD
(see Page 1 For Instructions) WW-1
1.
Tax withheld on income earned in Westerville, (2.0% rate) ...... $
2.
Residence tax withheld.............................................................. $
3.
Adjustments to Prior Returns .................................................... $
4.
Balance Due with this Form. Pay this amount in FULL ............ $
5.
Late Payment Penalty Charge (10%)......................................... $
6.
Late Interest Charge at 1% per month...................................... $
FOR CITY USE ONLY
7.
TOTAL DUE (Make check payable to City of Westerville) ........ $
Federal I.D. No.
File With: City of Westerville
I declare that this has been examined by me, and to
Income Tax Division
the best of my knowledge and belief it is a true, correct
P.O. Box 130
and complete return, made in good faith, pursuant to
Westerville, Ohio 43086-0130
City of Westerville Income Tax Ordinance and
(614) 901-6420
regulations.
FAX (614) 901-6820
(Signed)
FOR THE PERIOD ENDING
(Title)
Date
JANUARY 31, 2013
DUE ON OR BEFORE
FEBRUARY 15, 2013
If you did not have any Employees or withheld income
Please make corrections if necessary
tax for this period, please indicate and return this form.

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