Form W-1 - Employer'S Return Of Tax Withheld For 2014 Page 6

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Form W-1 - Employer·s Return of Tax Withheld for
Fairfield Income Tax Division 513.867.5327
M-
_________________
1. Number of Employees
________
Federal ID #:
Due:
NOV 15, 201
2. Payroll subject to Tax
$ _______________
Month/Quarter:
OCT 201
3. Tax Liability @ 1.5% (.015)
$ _______________
Amount Remitted $____________ Check #: ____________
4. Tax Withheld from Wages
$ _______________
Make checks payable to: Fairfield Income Tax
__________________________________
Signature
Date
Remit to:
__________________________________
FAIRFIELD INCOME TAX DIVISION
Phone Number
PO BOX 73852
CLEVELAND OH 44193-0002
Change of Address:
__________________________________
__________________________________
Form W-1 - Employer·s Return of Tax Withheld for
Fairfield Income Tax Division 513.867.5327
_________________
1. Number of Employees
________
Federal ID #:
Due:
DEC 1 , 201
2. Payroll subject to Tax
$ _______________
Month/Quarter:
NOV 201
3. Tax Liability @ 1.5% (.015)
$ _______________
Amount Remitted $____________ Check #: ____________
4. Tax Withheld from Wages
$ _______________
Make checks payable to: Fairfield Income Tax
__________________________________
Signature
Date
Remit to:
__________________________________
FAIRFIELD INCOME TAX DIVISION
Phone Number
PO BOX 73852
CLEVELAND OH 44193-0002
Change of Address:
__________________________________
__________________________________
Form W-1 - Employer·s Return of Tax Withheld for
Fairfield Income Tax Division 513.867.5327
_________________
1. Number of Employees
________
Federal ID #:
Due:
JAN 15, 201
2. Payroll subject to Tax
$ _______________
Month/Quarter:
DEC 201
3. Tax Liability @ 1.5% (.015)
$ _______________
Amount Remitted $____________ Check #: ____________
4. Tax Withheld from Wages
$ _______________
Make checks payable to: Fairfield Income Tax
__________________________________
Signature
Date
Remit to:
__________________________________
FAIRFIELD INCOME TAX DIVISION
Phone Number
PO BOX 73852
CLEVELAND OH 44193-0002
Change of Address:
__________________________________
__________________________________

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