0301 2024

                             This form may be electronically filed and paid at crisp.columbus.gov
2024
                    City of Columbus, Income Tax Division 
    Form
        IT-11 Employer's Quarterly Return of City Tax Withheld
ACCOUNT INFORMATION
                                                                                                      TAX YEAR                                                                          QUARTER
Account ID    WTH-                                                                                                                         2024

                                                           Check this box if AMENDED
FEIN                                                       Should this account be inactivated?                                                                                           YES   NO
                                                           IF YES,  
                                                           please explain
Employer name

                                                           Effective date
Address

City                         State         Zip code

WITHHOLDING DUE
                                   QUALIFIED  
              CITY                                         TAX RATE                                                                                                                     TAX DUE
                                           WAGES

01  Columbus                                                                                          2.5%

88  Alternate Columbus*
                       *For additional tax due from residents working in cities with a lower tax rate.
1. TOTAL TAX DUE ...................................................................................................................................................................... 1

2.      LESS PRIOR PAYMENT.................................................................................................................    2

3.  TOTAL NET AMOUNT DUE (PLEASE DO NOT REMIT AMOUNTS OF $10.00 OR LESS)...................................................                                                             3

Make checks payable to:     CITY TREASURER 
Mail to:                     Employer Withholding Tax 
                             PO Box 182489 
                             Columbus, OH 43218-2489

             ■  It is the employer's responsibility to determine the required frequency of depositing 
              withholding based on the withholding amounts. See IT-11 Instructions for details. 
             ■  This return must be filed even if no wages were paid during the quarter. 
             ■  This form MUST accompany your tax payment. 

 SIGNATURE

OFFICER NAME (Please print)                                OFFICER SIGNATURE

OFFICER TITLE                                              DATE

                                           Print Form      Reset Form                                                                                                                          IT-11 1

0302 2024

Employer name:                                             FEIN

PAYROLL SCHEDULE

This Payroll Schedule must be completed and filed with     DATE WAGES PAID COLUMBUS TAX WITHHELD
your Form IT-11 for the quarter.  The Payroll Schedule 
does not substitute for the quarterly IT-11 return. 

DATE WAGES PAID COLUMN:  List every date on which 
compensation was paid to your employees during the 
quarter of this return. Attach additional pages if needed. 

COLUMBUS TAX WITHHELD COLUMN:  For each payroll 
date, enter the total of Columbus tax required to be 
withheld on employees' Qualifying Wages, plus any 
withheld as a courtesy based on residency. 

Total withholding from the Payroll Schedule MUST match 
the total tax due on Page 1 of the IT-11 quarterly return.

                                                                      TOTAL

                              Print Form                   Reset Form      IT-11 2