Form Wh-1 - Withholding Tax
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1
2Withholding Tax Payments − Line Instructions for Completing Form
1. Enter the total amount of Indiana State Tax withheld.
2. Enter the total amount of County Tax withheld. You must complete the county tax breakdown portion of the return on the reverse side.
3. State and county tax due − Add Lines 1 and 2. If no tax is due, enter .00 on Line 3.
4. A payment made after the due date is subject to penalty and interest calculated using the amount entered on Line 3. The penalty is
10 percent of the total on Line 3 or $5, whichever is greater. To calculate interest, multiply the amount due on Line 3 by the annual
interest rate and divide the result by 365. Multiply that result by the number of days the payment is late. EFT filers: If your EFT
payment is late, do not enter penalty and interest on Line 4. Do not remit penalty and interest with your return. An assessment notice
for late payment penalty and interest will be issued automatically.
5. Enter EFT payments made for the tax period.
6. Total amount due with the return is Line 3 plus Line 4 minus Line 5. Do not send cash. Make the check payable (in U.S funds)
to the Indiana Department of Revenue.
W
WH−1
0811
Check if Amended
Taxpayer ID Number
KROGER STORE 909
For Tax Period
KROGER LIMITED PARTNERSHIP I
0007202873 001
0
AUG 2011
Filing Status
Due on or Before
EARLY FILER
SEP 20 2011
,
,
.
1.
Total State Tax Withheld
,
,
.
2.
Total County Tax Withheld
(Carry over total from reverse side)
,
,
.
3.
Line 1 plus Line 2. If no tax is due, enter (.00) on Line 3
If late, penalty is greater of $5 or 10% of Line 3, plus interest.
,
,
.
EFT taxpayers Do Not Use. You will be billed separately
4.
2011
9
The
annual interest rate is
%
,
,
.
5.
EFT Credits
,
,
.
Total Amount Due − Line 3 plus Line 4 minus Line 5
6.
I have completed the breakdown of county tax withheld for each county on the reverse page.
X
Authorized Signature
Date
Phone
____________________________
____________________________________________
I declare under penalties of perjury that this is a true, correct and complete return.
Due Date:
SEP 20 2011
(0526311(
INDIANA DEPARTMENT OF REVENUE
P.O. BOX 7221
INDIANAPOLIS, IN 46207-7221
(462077221216(
080007202873001050050000015940831201105
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