DW1 Dayton, Ohio
Employer’s return of employee income tax withheld.
Dayton payroll this period $___________
Dayton payroll tax (@ 2.5%) $___________ Is this an amended return? I certify that the information and statements contained herein
Dayton resident withholding (various %) $___________ NO are true and correct. (DECLARATION SIGNATURE IS REQUIRED)
Total Dayton tax withheld $___________ YES (Signed) ____________________________
Prior period adjustment $___________ Additional Withholding (Print Name / Title)_______________________
(If adjusted, provide explanation on back of this form) Is this a Final return? Date ___________ Phone # ______________
Amount remitted $___________ NO Federal tax ID# _________________________
YES Returns are due 15 days after the end of the withholding period (for
Number of employee’s ___________ Monthly) and the last day of the month after the end of the
ACCOUNT NUMBER ______________ For the tax period ending withholding period (for Quarterly).
_____________________
YOU MUST STATE THE MONTH AND YEAR ENDING THIS PAYMENT IS FOR Make Check or money order payable to
NAME AND ADDRESS Filing Monthly City of Dayton and Mail only to:
Filing Quarterly*
_______________________________ *Quarterly cannot exceed $600.00. City of Dayton
_______________________________ P. O. Box 643700
_______________________________
Cincinnati, Ohio 45264-3700
________ ________
CUT HERE
NEW TAX FORM IMPORTANT DO NOT ALTER any pre-printed payment coupon
Please fill in your account information, then with a bar-code at the bottom. Your payment will
copy this form for future use. WITHOLDING only be processed electronically to the account and
Your account number should be the same as specific tax period encoded on that line, regardless
your Federal Tax ID#, plus the suffix –1. NOTICE! of any comments you write on the form.
The City of Dayton Finance Department
administers on the Municipal Income Tax for DO NOT USE THIS FORM TO SUBMIT PAYMENT OF ANY
PRIOR BALANCE DUE THAT HAS ALREADY BEEN
the City of Dayton, Ohio. REPORTED.
For additional information call 937-333-3500 or
E-mail taxquestions@daytonohio.gov or visit Dayton Income Tax Ordinance: 36.111 VIOLATIONS AND
www.daytonohio.gov for more tax forms. PENALTIES.
1. Each employer within or doing business within the City of Any person shall be guilty of a separate misdemeanor of the
Dayton, who employs one or more persons is required to first degree if he shall:
withhold the tax from all Employee compensation and remit Fail, neglect or refuse to make any return or declaration
the amount to the City of Dayton. required by this chapter; or
2. A fully completed return of withholding taxes withheld Knowingly make an incomplete, false or fraudulent
(Form DW1) and payment is due on the 15 day (Monthly)th
or last day of the month (Quarterly) after the end of the return; or
Willfully fail, neglect or refuse to pay the tax, penalties or
withholding period. Certifying declaration signature is
interest imposed by this chapter; or
required. Attempt to do anything whatever to avoid the payment
3. Every employer, resident or non-resident, required to of the whole or any part of the tax, penalties or interest
withhold the tax at the source, is liable for payment of such imposed by this chapter.
tax whether or not actually withheld from his or her The failure of any employer, taxpayer or person to
employees income receive or procure a city income tax return, declaration
4. Employers are to file MONTHLY if tax withheld exceeded or other required form shall not excuse such employer,
$600.00 for the previous quarter or $2,399.00 for the taxpayer or person from making any information return
previous calendar year.
5. Delinquent payments are subject to interest and penalty or city income tax return or declaration, from filing such
charges as provided by ordinance. return or from paying city income tax.
6. Failure to receive or procure forms shall not excuse the
employer from filing a return and remitting the tax due on
schedule.
7. Do not report names of employees with this form. See
DW3 year end reconciliation for instructions on individuals
W2 reported information.
DW1 REVISED 12-2016