Form Fr-900q - Employer/payor Withholding Tax - Quarterly Return - 2013
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1This is a FILL-IN format. Please do not handwrite any data on this form other than your signature.
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Print
2013
FR-900Q Employer/Payor
Government of the
*139000710002*
District of Columbia
Withholding Tax – Quarterly Return
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Clear
Account Number
Taxpayer Identification Number
Fill in
if FEIN
Fill in
if SSN
Tax Period Ending (MMYY)
OFFICIAL USE ONLY
Vendor ID#0002
Business name
Fill in
if final return
0313
Fill in
if non-wage
Due Date:
Business mailing address 1
04202013
.
1. DC income tax withheld
$
.
this quarter per W2’s/1099’s
Business mailing address 2
2. Adjustment to a previous
.
$
.
quarter of this year. Fill
City
State
Zip Code + 4
in circle if a minus.
.
$
.
3. Tax Due
Telephone number of person to contact
Under penalties of law, I declare that, to the best of my knowledge, this return is correct.
Preparer’s PTIN
Declaration of paid preparer is based on the information available to the preparer.
Taxpayer’s signature
Title
Date
Paid Preparer’s Signature
Date
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2013 FR-900Q
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Parent category: Financial