Form M-1 - Employer Monthly Return Of Withholding Tax - Cincinnati Income Tax Bureau - 2005 Page 4

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M-10
EMPLOYER MONTHLY RETURN OF WITHHOLDING TAX
CINCINNATI INCOME TAX BUREAU
2005
P O BOX 634580
CINCINNATI OH 45263-4580
FOR OFFICIAL USE ONLY
ACCOUNT #:
FED ID#:
SSN#:
TAX RATE: 2.1%
MONTH ENDING: OCTOBER 31, 2005
DUE DATE: NOVEMBER 15, 2005
AMOUNT DUE: $____________________
DATE
PHONE (
)_________________SIGNATURE______________________TITLE____________
------------------------------------------------------------------------------------------------------------------------------------------------
M-11
EMPLOYER MONTHLY RETURN OF WITHHOLDING TAX
CINCINNATI INCOME TAX BUREAU
2005
P O BOX 634580
CINCINNATI OH 45263-4580
FOR OFFICIAL USE ONLY
ACCOUNT #:
FED ID#:
SSN#:
TAX RATE: 2.1%
MONTH ENDING: NOVEMBER 30, 2005
DUE DATE: DECEMBER 15, 2005
AMOUNT DUE: $____________________
DATE
PHONE (
)_________________SIGNATURE______________________TITLE____________
------------------------------------------------------------------------------------------------------------------------------------------------
M-12
EMPLOYER MONTHLY RETURN OF WITHHOLDING TAX
CINCINNATI INCOME TAX BUREAU
2005
P O BOX 634580
CINCINNATI OH 45263-4580
FOR OFFICIAL USE ONLY
ACCOUNT #:
FED ID#:
SSN#:
TAX RATE: 2.1%
MONTH ENDING: DECEMBER 31, 2005
DUE DATE: JANUARY 15, 2006
AMOUNT DUE: $____________________
DATE
PHONE (
)_________________SIGNATURE______________________TITLE____________

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