Form Dw1 - Employer'S Return Of Employee Income Tax Withheld - City Of Dayton - State Of Ohio
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1DW1 Dayton Ohio
I certify that the information and statements contained herien are true
Employer’s return of employee income tax withheld
and correct. (Declaration signature is required)
1. Dayton Payroll this period
$__________
2. Dayton Tax (@ 2.25%)
$__________
(Signed)
______________________________________
3. Dayton resident withholding
$__________
(various %)
Is this an amended return?
4. Total Dayton tax withheld
$__________
(Official title)
__________________________________
o yes
5. Prior period adjustment
$__________
o no
Date
Phone #
(If adjusted, please provide explanation on back of this form)
__________
_____________________
Is this a Final return?
6. Amount remitted
$__________
o yes
Federal tax ID #
_______________________________
o no
Number of employee’s
__________
Returns are due 15 days after the end of the withholding period.
For the tax period ending
Name
Make Check or money order payable to
_____________________
CITY OF DAYTON
Address
o
Filing MONTHLY
Mail to
o
Filing QUARTERLY *
CITY OF DAYTON
City
P.O. BOX 2806
* Q
uarterly can not exceed $450.00
DAYTON, OH 45401-2806
State, Zip
,
DW1 Dayton Ohio
I certify that the information and statements contained herien are true
and correct. (Declaration signature is required)
Employer’s return of employee income tax withheld
1. Dayton Payroll this period
$__________
2. Dayton Tax (@ 2.25%)
$__________
(Signed)
______________________________________
3. Dayton resident withholding
$__________
(various %)
Is this an amended return?
4. Total Dayton tax withheld
$__________
(Official title)
__________________________________
o yes
5. Prior period adjustment
$__________
o no
Date
Phone #
__________
_____________________
(If adjusted, please provide explanation on back of this form)
Is this a Final return?
6. Amount remitted
$__________
o yes
Federal tax ID #
_______________________________
o no
Returns are due 15 days after the end of the withholding period.
Name
For the tax period ending
Make Check or money order payable to
_____________________
Address
CITY OF DAYTON
Mail to
o
Filing MONTHLY
CITY OF DAYTON
City
o
Filing QUARTERLY *
P.O. BOX 2806
* Q
uarterly can not exceed $450.00
DAYTON, OH 45401-2806
State, Zip
,
DW1 Dayton Ohio
I certify that the information and statements contained herien are true
Employer’s return of employee income tax withheld
and correct. (Declaration signature is required)
1. Dayton Payroll this period
$__________
2. Dayton Tax (@ 2.25%)
$__________
(Signed)
______________________________________
3. Dayton resident withholding
$__________
(various %)
Is this an amended return?
4. Total Dayton tax withheld
$__________
(Official title)
__________________________________
o yes
5. Prior period adjustment
$__________
o no
Date
Phone #
(If adjusted, please provide explanation on back of this form)
__________
_____________________
Is this a Final return?
6. Amount remitted
$__________
o yes
Federal tax ID #
_______________________________
o no
Returns are due 15 days after the end of the withholding period.
Name
For the tax period ending
Make Check or money order payable to
_____________________
Address
CITY OF DAYTON
Mail to
o
Filing MONTHLY
CITY OF DAYTON
o
City
Filing QUARTERLY *
P.O. BOX 2806
* Q
uarterly can not exceed $450.00
DAYTON, OH 45401-2806
State, Zip
.
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