Form W-1 - Employer'S Quarterly Return Of Tax Withheld - Village Of New Lebanon, Ohio Page 2

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INSTRUCTIONS FOR FILING FORM W-1
WHO HAS TO FILE
QUALIFYING WAGES
All employers, which have one or more employees performing duties
Begin with the Medicare wage base as defined in section 3121(a) of the
within the Village of New Lebanon, are required to withhold 1.0% of
Internal Revenue Code, and make the following mandatory adjustments
qualifying wages earned in New Lebanon of all employees 16 years of age
1. To the extent otherwise included in Medicare wages, deduct amounts
or older and remit them to the Income Tax department.
attributable to IRC 125 plans.
2. To the extent otherwise excluded from Medicare wages, add amounts
that exempt from Medicare taxes soley because of the Medicare
grandfathering provision (i.e., pre-April 1, 1986 employees).
3. To the extent otherwise excluded from Medicare wages, add ordinary
income from the sale, exchange or other disposition of a stock option,
the exercise of a stock option, or the sale, exchange or other
disposition of stock purchased under a stock option.
4. To the extent otherwise excluded from Medicare wages, add employee
contributions and deferrals to IRC section 401(k) or 457 plans.
5. To the extent otherwise excluded from Medicare wages, add
supplemental unemployment compensatoin benefits described in IRC
section 3402(0)(2).

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