Form Sd 101 Long - Employer'S Payment Of School District Income Tax Withheld - 2013
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2013 SD 101 Long
Rev. 11/12
Employer’s Payment of School
School District Income Tax
13070100
District Income Tax Withheld
P.O. Box 182388
Columbus, OH 43218-2388
Ohio withholding acct. no.
FEIN
Payment due date
For the period ending
Name
For State Use Only
Number and street
M
M
D D
Y
Y
City, state, ZIP
Go paperless! File your return through Ohio
Business Gateway: tax.ohio.gov
District
District
District
District
District Name
Number
Tax Due
District Name
Number
Tax Due
Ada EVSD
3301
Columbus Grove LSD
6901
Amanda-Clearcreek LSD
2301
Continental LSD
6902
Anna LSD
7501
Cory-Rawson LSD
3203
Ansonia LSD
1901
Covington EVSD
5503
Antwerp LSD
6301
Crestline EVSD
1704
Arcadia LSD
3201
Crestview LSD
1503
Arcanum-Butler LSD
1902
Crestview LSD
8101
Arlington LSD
3202
Dalton LSD
8502
Athens CSD
0502
Danville LSD
4202
Ayersville LSD
2001
Defi ance CSD
2003
Bellevue CSD
3901
Eastwood LSD
8702
Berkshire LSD
2801
Eaton CSD
6803
Berne-Union LSD
2302
Edgerton LSD
8602
Bethel LSD
5501
Elgin LSD
5101
Bettsville LSD
7401
Elmwood LSD
8703
Bexley CSD
2501
Evergreen LSD
2602
Big Walnut LSD
2101
Fairbanks LSD
8001
Bloom-Carroll LSD
2303
Fairborn CSD
2903
Bluffton EVSD
0203
Fairfi eld Union LSD
2304
Botkins LSD
7502
Fairlawn LSD
7503
Bowling Green CSD
8701
Fort Loramie LSD
7504
Bradford EVSD
5502
Fort Recovery LSD
5406
Bryan CSD
8601
Franklin Monroe LSD
1903
Buckeye Central LSD
1701
Fremont CSD
7202
Buckeye Valley LSD
2102
Gorham Fayette LSD
2603
Canal Winchester LSD
2502
Goshen LSD
1305
Carey EVSD
8801
Greeneview LSD
2904
Carlisle LSD
8301
Greenfi eld EVSD
3603
Cedar Cliff LSD
2902
Greenville CSD
1904
Celina CSD
5401
Hardin-Houston LSD
7505
Centerburg LSD
4201
Hardin Northern LSD
3302
Central LSD
2002
Hicksville EVSD
2004
Chippewa LSD
8501
Highland LSD
5902
Circleville CSD
6501
Hillsboro CSD
3604
Clear Fork Valley LSD
7001
Holgate LSD
3501
Clermont-Northeastern LSD
1303
Hopewell-Loudon LSD
7403
Cloverleaf LSD
5204
Jackson Center LSD
7506
Clyde-Green Springs EVSD
7201
Jefferson LSD
4901
Coldwater EVSD
5402
Jennings LSD
6903
Colonel Crawford LSD
1703
Subtotal from page 2
Columbiana EVSD
1502
Total tax due
I declare under penalties of perjury that this return, including any accompanying schedules and state-
DO NOT STAPLE OR OTHERWISE ATTACH YOUR CHECK
OR CHECK STUB TO THIS FORM. DO NOT SEND CASH.
ments, has been examined by me and, to the best of my knowledge and belief, is a true, correct and
Make check payable to SCHOOL DISTRICT INCOME TAX and
complete return and report.
mail to School District Income Tax, P.O. Box 182388, Columbus,
OH 43218-2388.
Signature
Title
Date
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