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2023 FORM 17 INSTRUCTIONS
Form 17-Reconciliation of Income Tax Withheld and W-2/1099-NEC Transmittal
General Instructions:
A Reconciliation of Income Tax Withheld is required to be filed on or before the last day of February following the
calendar year in which employee withholding deductions have been made by an employer. For a current list of RITA
municipalities and their tax rates, visit ritaohio.com.
1 Enter the tax year, company’s federal employer identification number, name, and address in the proper area.
2 List the amount of workplace wages, workplace tax withheld, and any residence tax withheld for each period a Form 11
was filed. For example: If you file Form 11 monthly, complete the annual Form 17 on a monthly basis; periods 1-12. If
you file Form 11 quarterly, complete the annual Form 17 on a quarterly basis; periods, 3, 6, 9, 12. NOTE: Do not
report wages for residence tax withheld.
3 List the total number of RITA Forms W-2 and 1099-NEC issued and list the total number of employees working at year
end for which municipal income tax has been withheld. In Section 5 , distribute the total number of employees to each
municipality where the employee worked.
4 Total the workplace wages, workplace tax withheld, and residence tax withheld. These amounts must be distributed on
Page 2 of Form 17.
5 Distribute totals to each municipality where the wages were earned and the workplace (or residence tax) was withheld.
New for 2023: Check the Working from Home (WFH) Indicator box if the municipality in which wages earned and
workplace tax withheld includes wages earned working in one or more employee home(s). Note: If an employee works
from home or lives and works in the same municipality, the tax should be reported to RITA as workplace and the
wages should be included in the wage amounts listed on the form. Note: Use the Additional Page 2 for Form 17 to
report additional municipalities.
6 Total all distributions. THE TOTAL WORKPLACE WAGES, WORKPLACE TAX WITHHELD, AND RESIDENCE TAX
WITHHELD IN SECTION 6 MUST EQUAL THE TOTALS REPORTED ON PAGE 1 OF FORM 17 IN SECTION 4.
7 Total the number of employees at year end who received a W-2.
8 If you are filing a Form 17 as a professional employer organization (PEO), common pay master, co-employer, or
other agent providing payroll services to related or unrelated third party employers, including, but not limited to,
clients, subsidiaries, other companies, etc., you must also provide specific information on each of these employers.
Use Schedule R-17 to report for each employer EIN and Name and to allocate the Workplace Wages, Workplace Tax
Withheld, Residence Tax Withheld and RITA Municipality.
9 Sign and date the form. Please provide a phone number where you can be reached if any questions arise.
DO NOT REMIT PAYMENT WITH THIS FORM. IF YOU ARE ADJUSTING ANY PERIOD YOU MUST FILE A FORM 11A
- ADJUSTED EMPLOYER’S MUNICIPAL TAX WITHHOLDING STATEMENT. SEE ritaohio.com.
See next page for mailing address and W-2 Transmittal Instructions
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