Payroll Withholding Tax Form - City Of Auburn (Page 2 of 2) in pdf

Payroll Withholding Tax Form - City Of Auburn Page 2

EMPLOYER’S QUARTERLY RETURN OF PAYROLL TAX WITHHELD

Number of Taxable Employees _______

1. Total salaries, wages, commissions &

I hereby certify that the information and statements contained herein and

other compensation paid (*)

any schedule or exhibits attached are true and correct.

2. Less compensation paid for services

(Signed)___________________________________________________

outside of Auburn

3. Taxable Earnings (line 1 minus line 2)

(Official Title) _______________________________(Date)___________

4. Actual Tax Due at 1.5%

5. Penalty- 5% per month/ $25 minimum

For Period Ending

Month

Day

Year

6. Total (include penalty if due)

December

20__

*If no wages were paid this quarter, mark “NONE”, sign and return form

Return Due on or Before

Business Name:

Month

Day

Year

Address:

January

20__

City, State Zip:

Make checks payable to: City of Auburn

NOTIFY FINANCE DIRECTOR, CITY OF AUBURN, OF ANY CHANGE IN OWNERSHIP, NAME,

Mail payment and form to: PO Box 465, Auburn, KY 42206

OR ADDRESS SHOWN ABOVE

Make checks payable to: City of Auburn

NOTIFY FINANCE DIRECTOR, CITY OF AUBURN, OF ANY CHANGE IN OWNERSHIP, NAME,

Mail payment and form to: PO Box 465, Auburn, KY 42206

OR ADDRESS SHOWN ABOVE

Payroll Withholding Tax Form - City Of Auburn Page 2