DAYTON, OHIO FORM DW-3 Annual Reconciliation W-2 Withholding and 1099 MISC/NEC Earnings Report
      File with: City of Dayton, Division of Tax and Accounting Administration, PO Box 2806, Dayton, OH 45401-2806
            Reconciliation is due on or before February 28.  For assistance, contact the Tax Office at (937) 333-3500.
NOTE: Employers having "100 or more employee records" are required to submit the required information on 
electronic media.  Please refer to the electronic media specifications posted on our website at www.daytonohio.gov. 
This requirement does not refer to submitting 1099 MISC/NEC earnings report to our office.
                                      DO NOT SEND PAYMENTS WITH THIS FORM
IF YOU NEED TO SEND ANY PAYMENTS, mail separately using Form DW-1 along with a letter of explanation to City of 
Dayton, Division of Tax and Accounting Administration, PO Box 643700, Cincinnati, OH 45264-3700.

Tax Year                                                                  W-2 Withholding Amounts Withheld in Tax Year
Federal ID #
Company Name                                                              January     April                 July        October
Address
City/State/ZIP
                                                                          February    May                   August      November
   Number of W-2 Employees Reported        1) #
Dayton Gross Payroll per employer records  2) $
                   Dayton Tax @ 2.5%       3) $                           March       June                  September   December
Additional Courtesy/Resident Withholding   4) $
              TOTAL Dayton Tax Withheld  5) $
                                                                          1st Quarter 2nd Quarter           3rd Quarter 4th Quarter

Number of Dayton 1099 MISC/NEC Issued      6) #
1099 MISC/NEC Dayton Earnings Reported     7) $
                                                                          Total W-2 Withholding Paid for Year  8) $

I certify that the information contained therein is true and correct.

Signed
Printed Name                                                              Office Location: 101 W Third St, Dayton, OH 45402
Title                                                                     First Floor Income Tax Office
Date
Phone #
E-Mail Address                                                            Office Hours Monday-Friday 8:00 AM-5:00 PM
                                      DO NOT SEND PAYMENTS WITH THIS FORM
                                                 GENERAL INFORMATION

On or before February 28 of each year, each employer must file a withholding reconciliation on the City of Dayton Form DW-3.
Copies of all W-2 forms applicable to the reconciliation must be attached.  All W-2s must furnish the following name; address; social 
security number; gross wages; city tax withheld; name of city(ies) of 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 the W-2 form.  The listing must contain 
the same information as required of the W-2 form.

City of Dayton requires businesses operating in Dayton to submit copies of their 1099 MISC and 1099 NEC forms.
                                                 SPECIFIC FILING INFORMATION

The Form DW-3 must show a breakdown of all withholding payments made either quarterly or monthly in the boxes provided.  
Lines 1 through 8 must also be completed.  The amount paid and the amount withheld should be equal.  If they are not equal attach an 
explanation for any discprepancy.
If Line 5 indicates a balance due, the amount must be paid on or before February 28.  If Line 5 indicates an overpayment, amended 
returns for the months or quarters in which the overpayment occurred must be filed on or before February 28.
(Revised 1/2021)