Enlarge image
FORM W1 12 EMPLOYER'S WITHHOLDING - MONTHLY
1. Number of Taxable Employees. . . . . . . . . . . . . . . . . . . . . . . . . 1
2. Total Salaries, Wages, Commissions and other Tax Year 2022
Compensation paid all employees. . . . . . . . . . . . . . . . . . . . . . . . . I hereby certify that the information and statements contained here
2 in and in any schedules or exhibits attached are true and correct.
3. Less payroll not subject to tax. . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 Signed
4. Taxable Earnings (line 2 minus 3). . . . . . . . . . . . . . . . . . . . . . . 4 Title Date
5. Actual Tax Withheld at 1.200 %. . . . . . . . . . . . . . . . . . . . . . . . . 5 Phone #
6. Adjustments of Tax for Prior Period. . . . . . . . . . . . . . . . . . . . . . 6 THIS RETURN MUST BE FILED ON
7. Interest . . . . . . 5% per annum (.42% per month). . . . . . . . . . . 7 OR BEFORE FEBRUARY 15, 2022
8. Penalty. . . . . . 50% (1 time charge). . . . . . . . . . . . . . . . . . . . . 8
MAKE CHECK OR MONEY ORDER TO:
9. Total (Include Interest and Penalty if Due). . . . . . . . . . . . . . . . . 9
VILLAGE OF EVENDALE
10500 READING RD
Name EVENDALE OH 45241-2574
And Voice 513-563-2671 Fax 513-563-4636
Address Period Ending JANUARY
TAX ID
NOTIFY INCOME TAX DEPARTMENT PROMPTLY OF ANY CHANGE IN OWNERSHIP OR NAME AND ADDRESS.
FORM W1 12 EMPLOYER'S WITHHOLDING - MONTHLY
1. Number of Taxable Employees. . . . . . . . . . . . . . . . . . . . . . . . . 1
2. Total Salaries, Wages, Commissions and other Tax Year 2022
Compensation paid all employees. . . . . . . . . . . . . . . . . . . . . . . . . I hereby certify that the information and statements contained here
2 in and in any schedules or exhibits attached are true and correct.
3. Less payroll not subject to tax. . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 Signed
4. Taxable Earnings (line 2 minus 3). . . . . . . . . . . . . . . . . . . . . . . 4 Title Date
5. Actual Tax Withheld at 1.200 %. . . . . . . . . . . . . . . . . . . . . . . . . 5 Phone #
6. Adjustments of Tax for Prior Period. . . . . . . . . . . . . . . . . . . . . . 6 THIS RETURN MUST BE FILED ON
7. Interest . . . . . . 5% per annum (.42% per month). . . . . . . . . . . 7 OR BEFORE MARCH 15, 2022
8. Penalty. . . . . . 50% (1 time charge). . . . . . . . . . . . . . . . . . . . . 8
MAKE CHECK OR MONEY ORDER TO:
9. Total (Include Interest and Penalty if Due). . . . . . . . . . . . . . . . . 9
VILLAGE OF EVENDALE
10500 READING RD
Name EVENDALE OH 45241-2574
And Voice 513-563-2671 Fax 513-563-4636
Address Period Ending FEBRUARY
TAX ID
NOTIFY INCOME TAX DEPARTMENT PROMPTLY OF ANY CHANGE IN OWNERSHIP OR NAME AND ADDRESS.
FORM W1 12 EMPLOYER'S WITHHOLDING - MONTHLY
1. Number of Taxable Employees. . . . . . . . . . . . . . . . . . . . . . . . . 1
2. Total Salaries, Wages, Commissions and other Tax Year 2022
Compensation paid all employees. . . . . . . . . . . . . . . . . . . . . . . . . I hereby certify that the information and statements contained here
2 in and in any schedules or exhibits attached are true and correct.
3. Less payroll not subject to tax. . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 Signed
4. Taxable Earnings (line 2 minus 3). . . . . . . . . . . . . . . . . . . . . . . 4 Title Date
5. Actual Tax Withheld at 1.200 %. . . . . . . . . . . . . . . . . . . . . . . . . 5 Phone #
6. Adjustments of Tax for Prior Period. . . . . . . . . . . . . . . . . . . . . . 6 THIS RETURN MUST BE FILED ON
7. Interest . . . . . . 5% per annum (.42% per month). . . . . . . . . . . 7 OR BEFORE APRIL 15, 2022
8. Penalty. . . . . . 50% (1 time charge). . . . . . . . . . . . . . . . . . . . . 8
MAKE CHECK OR MONEY ORDER TO:
9. Total (Include Interest and Penalty if Due). . . . . . . . . . . . . . . . . 9
VILLAGE OF EVENDALE
10500 READING RD
Name EVENDALE OH 45241-2574
And Voice 513-563-2671 Fax 513-563-4636
Address Period Ending MARCH
TAX ID
NOTIFY INCOME TAX DEPARTMENT PROMPTLY OF ANY CHANGE IN OWNERSHIP OR NAME AND ADDRESS.
