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                   CITY OF SPRINGFIELD                                                                                                               FORM W-1 
                   INCOME TAX DIVISION 
                   76 E.HIGH STREET                                                                                                                  FORM W-3     
                   SPRINGFIELD OH 45502
                   (937) 324-7357

                                        EMPLOYER CITY TAX WITHHOLDING BOOKLET 

                                                 FOR TAX YEARS 2018 AND FORWARD 
                                             Questions or Concerns?  Email: TaxFilingHelp@springfieldohio.gov          

                                                                   NOTE TO EMPLOYERS 
These forms are to be used for the filing of withholding payments The.  W-1 forms can be used for either monthly or quarterly periods The W-3.    is for the 
year end reconciliation Also. included is a summary worksheet for your records If you.  have any questions, you may   contact our office at (937) 324-7357. 
Additional forms and information are available on the City of Springfield website at www springfieldohio. gov.If required. to make Federal withholding tax 
payments electronically,you are also required to pay Springfield withholding taxes by electronic funds transfer You. may file and pay electronically using 3 
different options: 
1. Tax Connect on the city website (or go directly to: https://web1.civicacmi.com/SpringfieldTax/)
2. Ohio Business Gateway
3. ACH Credit - using your own template and software Contact.      the City of Springfield Income Tax Division for 
   details.  
                                                                 GENERAL INFORMATION 
Each employer located within or doing business within the City of Springfield who employs one or more persons, is required to withhold the City of 
Springfield income tax at the rate of 2 4%. from all compensation allocated or set aside for or paid, to the,employee(s ) Each.employer is required to file 
the Employer’s Return of City Tax Withheld (Form W-1) along with the monthly, semi-monthly or quarterly withholding payments on or before the due 
dates as shown below The.   failure of any employer to receive or procure Form W-1 shall not excuse him/her from making this return or from remitting the 
tax withheld.Per ORC 718, for tax years 2017 and  forward      : 
THRESHOLD     
1. Monthly remittance is required if the total Springfield withholding during the preceding calendar year exceeded $2,399 00; or.  any month of the
   preceding quarter exceeded  $200 00.     . 
2. Semi-monthly remittance may be required if the total Springfield withholding during the preceding calendar year exceeded $11,999 00; or.    any month
   of the preceding calendar year exceeded $1 000,    00.    . 
3. Quarterly remittance is allowed when monthly or semi-monthly remittance is not required. 
DUE DATES
1. Monthly - due by the 15th day of the next month       . 
2. Quarterly - due by the last day of the month following the end of the quarter. 
3. Semi-monthly     - taxes withheld during the first 15 days of a month are due by the 3rd banking day after the 15th of the month Taxes.   withheld after
   the 15th of the month to the end of the month are due by the 3rd banking day after the last day of the month. 

                                                           FORM W-1 FILING INSTRUCTIONS 
LINE 1       Enter the total compensation allocated, set aside, or paid to all taxable employees during the filing period If no.compensation was 
             allocated,set aside or,  paid during this period record, a zero (0) on lines 1-7 and return Form W-1 to the City of Springfield Income, Tax 
             Division. 
LINE 2       Compute tax due (2.    4%. times payroll).    
LINE 3       Enter any adjustments to the tax withheld on line 2; e g.additional.,  tax withheld at employee request, other city payments, etc All   . 
             adjustments must be explained. 
LINE 4       Amount of tax due must be paid with this  return. 
LINES 5 &6   Penalty and Interest on late payments will be calculated by the City of Springfield Income     Tax Division   . 
LINE 7       Tax due plus penalty and interest, if applicable. 
             The Name,Address, Federal        Identification Number and Responsible Officer's information must be provided for the return to be complete       . 

                                                                 PENALTY AND INTEREST 
Payment and Form W-1 not received on or before the due date shall be considered delinquent and shall be subject to penalty and interest charges as 
provided for in the City of Springfield Tax Ordinance. Contact the City of Springfield, Income Tax Division (937), 324-7357 for the applicable charges       . 
TAX YEARS 2017 AND FORWARD 
Late Payment Penalty:       up to 50% of tax due  
Interest: For the applicable tax year, the federal short-term rate rounded to the nearest whole number percent, plus five percent 
Late Filing Penalty:  $25.00 per late month

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FORM W-1 EMPLOYER'S RETURN OF CITY TAX WITHHELD CITY OF SPRINGFIELD
INCOME TAX DIVISION
PERIOD ENDING DUE ON OR BEFORE ACCOUNT NO. PO BOX 5200 SPRINGFIELD
OH 45501-5200
(937) 324-7357
www.springfieldohio gov.
I hereby certify that the information and statements
1. COMPENSATION SUBJECT TO CITY OF SPRINGFIELD TAX .... $_________ contained herein are true and correct to best of
my knowledge.
2. TAX DUE (2.4%) ................ ........ .................

3. ADJUSTMENTS (Explain fully below) .... ................. Signed By: _
(Responsible Officer)
4. BALANCE DUE ..... ........................ ......... Date: ----------------

5. PENALTY {To be calculated by Income Tax Division) ...... ................. ........... . Print Name: _

6. INTEREST {To be calculated by Income Tax Division) Telephone: _

7. TOTAL (Make checks payable to the City of Springfield) .............$___________________ Email Address: _

NAME AND ADDRESS : Federal I.D. Number ,

IS THIS A COURTESY WITHHOLDING? () YES () NO OFFICE
USE
Notify the City of Springfield Income Tax Division promptly ONLY P/M Date:
of any change in ownership or name and address shown above.

If line 3,ADJUSTMENTS,was completed,provide explanation here :

If this is an AMENDED RETURN,provide explanation here :

If this is a FINAL RETURN, provide additional information:

OUT OF BUSINESS ? () MERGED □______ OTHER □______
Effective Date Effective Date Provide Explanation

NEW OWNER'S NAME AND ADDRESS

NEW OWNER'S FEDERAL IDENTIFICATION NUMBER

If out of business you, are still required to reconcile tax withholdings by February 28 of the following year .

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CITY OF SPRINGFIELD WITHHOLDING TAX RECONCILIATION FOR TAX YEAR                                                                                                                                                                                   _ 
SUBMIT BY FEBRUARY 28.                                                                                                                                                      Account #:                                                             __ 
W-2s MUST BE ATTACHED OR FILED ELECTRONICALLY                                                                                                                               Federal ID#                                                            _ 
NAME AND ADDRESS: 

                                                                                                                                                                             P/M Date:                                                             _ 

1) TOTAL NUMBER OF W-2’S ATTACHED ................................................................................................................................ 
2) TOTAL PAYROLL FOR YEAR: ........................................................................                           ...................... .... ........... .... ....... .... ........... . ... ......$                                  _    
3)  LESS PAYROLL NOT SUBJECT TO TAX (PROVIDE EXPLANATION):  .........                                                        ........... .... ....... .... ........... .... ....... .... ........... .... ......$                                  _ 
4)  PAYROLL SUBJECT TO TAX: .........................................  . .....               ... ...... . . ..... .....  .. ... ... ....... . ..... ..... .... ..... ..... ..... ....... ... .. ... ... ... .. ...$ ......                         _    
5) WITHHOLDING TAX LIABILITY@ 2.4% OF LINE 4                                : ...........     ........... ........... .... ...........             ........... . ... ...........   ................ ........... . ... ......$                      _ 
6) TAX WITHHELD.................................................... .  ........... .... ...........         ........... .    ... ...........      ........... .  ... ........... . ... ....... . ... ........... . ... ......$                     _ 
7) MANDATORY Enter larger of line 5 or line 6                   ........... ..... .... ..... ..... ..... ........ ..... .... ..... ..... ..... ........ ..... .. ... ... ... .. ... ... .. ... ... ... .. ... ......$                              _ 
   COURTESY:Enter line 6 ……………………………………………………………………………………………………………$______________________ 
8) TOTAL PAID:  ......................................... ..... ........... ........... . ... ...........    ........... .   ... ...........       ........... . ... ........... . ..... ...... ...............    ...$......                      _ 
9)  DIFFERENCE (line 7 minus line: 8)........ .....       ... ...... . ..... .... .. ....................................................... . . ..... ..... .... ..... .....            .. ... ... ... .. ... ...... $                            _ 
   IF OVERPAYMENT:  REFUND                                                                    _CREDIT TO NEXT YEAR                                                                                                 _ 

              JANUARY                                                   APRIL                                                                                 JULY                                                              OCTOBER 
$                                               $                                                                            $                                                                        $ 
              FEBRUARY                                                      MAY                                                                            AUGUST                                                               NOVEMBER 
$                                               $                                                                            $                                                                        $ 
               MARCH                                                        JUNE                                                                         SEPTEMBER                                                              DECEMBER 
$                                               $                                                                            $                                                                        $ 
             1STQUARTER                                         2NDQUARTER                                                                           3RDQUARTER                                                                 4TH QUARTER 
$                                               $                                                                            $                                                                        $ 

Total Paid For Year ......................................................................................................................................................................... $                                                    _ 

I hereby certify that the information and statements contained                               herein are true and correct. 
Signed_______________ Date                                                                                                                                                                                                                         _ 
Print Name:                                                                                                                                                Telephone 
Email Address:- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -                       
MAIL TO:         CITY OF SPRINGFIELD 
                 INCOME TAX DIVISION 
                 PO BOX 5200         
                 SPRINGFIELD OH 45501 5200-                                                                                                                                                                                                   Form W-3 

                                                                ANNUAL RECONCILIATION (FORM W-3) 
GENERAL INFORMATION 
On or before February 28 of each year,          each employer must file a withholding reconciliation on the City of Springfield Form W-3.                                                                                       Copies of all W-2 forms 
applicable to the reconciliation must be attached.All W-2 forms must furnish the name, address,                                                                  social security numbe r                    gross wages,        all city tax withheld, 
name of city for which tax was withheld, and any other compensation paid to the individual. If copies of the W-2 forms are not available, each employer 
must provide a listing of all employees subject to the City of Springfield tax.The listing must contain the same information as required on the W-2 form. 
An adding machine tape listing the amounts of the City of Springfield income tax withheld,as indicated by the individual employee W-2 statements, 
should be included with the W-3.  Electronic submission of W-2 data in SSA EFW2 format is not required but is greatly appreciated. 
SPECIFIC FILING INFORMATION 
The Form W-3 must show a breakdown of all withholding payments made in the boxes provided.Lines 1-9 must also be completed.The amount paid 
and the amount withheld should be equal. If line 9 indicates a balance due of $1.00 or more,submit the payment along with Form W-3 on or before 
February 28.If line 9 indicates an over payment of more than $10.00,either request a refund or use a credit on your next withholding voucher.The 
completed Form W-3 and all attachments must be submitted to the City of Springfield, Income Tax Division, PO                                                                                         Box 5200, Springfield,Ohio 45501 on 
or before February 28.    If you are filing a W-1 or W-3 for a tax year prior to 2018, please see our website, springfieldohio.gov, for correct form. 
Contact the City of Springfield Income Tax Division at (937) 324-7357 for assistance, or email:TaxFilingHelp@springfieldohio.gov.

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                                 WITHHOLDING WORKSHEET 
 
                                 (Keep for your records - Do not file) 
 
  Period    Due                  Check    Period                       Due                   Check 
  Ending    Date    Amount  Date Number   Ending                       Date     Amount  Date Number 
                                                                              
  1/31      2/15                          7/31                         8/15                          

  2/28      3/15                          8/31                         9/15                          
  3/31      4/15                          9/30                         10/15                         
  1st Qtr.  4/30                          3rd Qtr.                     10/31                         

  4/30      5/15                          10/31                        11/15                         
  5/31      6/15                          11/30                        12/15                         
  6/30      7/15                          12/31                        1/15                          
 2nd Qtr.   7/31                          4th Qtr.                     1/31

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