Form Eqr - Employer'S Quarterly Return Of Tax Withheld - Village Of Mantua

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VILLAGE OF MANTUA, O.
Form EQR
EMPLOYER'S QUARTERLY RETURN OF TAX WITHHELD
Employer's Name:______________________________________
Federal I.D. number:___________________________________
Address:_____________________________________________
City/State/Zip:_________________________________________
I hereby certify that the information and
.
1. Number of Taxable Employees: ___________
Dollars
Cents
statements contained herein and in any
Total Salaries, Wages, Commissions and other
$
2.
___________ .___________
schedules or exhibits attached are true and
Compensation Paid all employees (*)
correct.
Less: Non-taxable Items (Compensation paid
$
3.
___________ .___________
non-residents for Services outside Mantua)
$
4. Taxable Earnings (Item 2 minus Item 3)
___________ .___________
(Signed) .....................................................
Actual Tax Withheld in Quarter for City Income
$
5.
___________ .___________
Tax
(Official Title) .............................................
Adjustment of Tax for Prior Quarter (see
Owner, Partner, Member, President, Treasurer, Agent
$
5a.
___________ .___________
instructions)
$
6. Interest (1/2% per month or fraction thereof)
___________ .___________
Date........................................................
$
7. Penalty (3% per month or fraction thereof)
___________ .___________
.
.
$
8. TOTAL (Include interest and penalty, if due
___________ .___________
MAKE CHECK OR MONEY ORDER PAYABLE TO:
* If no wages paid this quarter, mark "None" and return this form with
VILLAGE OF MANTUA, O. - INCOME TAX
explanation.
TAX RATE:
FOR MONTHS OF __________________________
ONE AND ONE-HALF PERCENT (1 1/2%)
DUE ON OR BEFORE _______________________
Mail to: INCOME TAX DEPT.
P.O. Box 775
Notify Income Tax Dept. promptly of any change in ownership or
MANTUA, OH 44255
name and address shown above.
Fourth Quarter 2013 taxes must be postmarked by Jan. 31, 2014
First Quarter 2014 taxes must be postmarked by March 31, 2014
Second Quarter taxes must be postmarked by June 30, 2014
Third Quarter taxes must be postmarked by October 31, 2014
Fourth Quarter taxes must be postmarked by Jan. 31, 2015

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