Form Fr-900q - Employer'S Withholding Tax Booklet - 2010 Page 2

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2010
FR-900Q Employer Withholding
Government of the
*109000310000*
District of Columbia
Tax – Quarterly Return
Taxpayer Identification Number
Tax Period Ending (MMYY)
Fill in
if FEIN
Fill in
if SSN
FOR OFFICIAL USE ONLY
Business name
Account Number
Fill in
if Final return
Mailing address 1
1. DC income tax withheld
$
.00
this quarter
Mailing address 2
2. Adjustment to a
$
.00
previous quarter
of this year. Fill
in if minus.
City
State
Zip Code + 4
$
.00
3. Tax Due
2010 FR-900Q P1

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