City of Kansas City, Missouri - Revenue Division
RD-110
2019                               EMPLOYER'S QUARTERLY RETURN
                                   OF EARNINGS WITHHELD

                                   Phone: (816) 513-1120
                                   E-file: kcmo.gov/quicktax

Legal Name:                                                        Mailing Address:
DBA Name:
FEIN or SSN:                                                       Business Address:
Account ID:

Period From:                           Period To:
                                                                                                  DOLLARS                CENTS
1. Kansas City Taxable Earnings                                          1          $                                   .
2. Tax Withheld    (1% of Line 1)                                        2          $                                   .
3. Penalties & Interest                                                  3          $                                   .
4. Amount Due                                                            4          $                                   .
5. Prior Payments                                                        5          $                                   .

6. Amount of Remittance                                                  6          $                                   .
7. "X" Box if Amended                                                    7
8. Enter Date Business Closed                                            8                                            /              /
                                                                                                                   MM   DD             YY
Notes:
The RD-110 form must be filed at the end of each quarter.
Do not use this form (RD-110) in place of monthly or quarter-monthly (RD-130) payment coupon.

Contact the TAXPAYER SERVICE UNIT at (816) 513-1120 or refunds@kcmo.org for refund inquiries.

              Instructions for preparing and filing Employer's Quarterly Return of Earnings Tax Withheld
Line 1.   Enter total portion of compensation which is taxable under the earnings tax ordinance (Kansas City, Missouri earnings only).
Line 2.   Enter the tax withheld (1% of Line 1).
Line 3.   Enter penalties and interest due (Penalty - 5% of Line 2, per month, not to exceed 25%; Interest - 1% of Line 2, per month,
               until paid in full).
Line 4.   Enter amount due (Line 2 plus Line 3).
Line 5.   Enter total tax previously paid for the quarter.
Line 6.   Enter the amount of remittance included with this return.
Line 7.   "X" if this is an amended return.
Line 8.   If no longer in business, enter date business closed.

DO NOT SEND CASH. Make check payable to: KCMO City Treasurer
Mail to: City of Kansas City, Missouri, Revenue Division, PO Box 842875 Kansas City, MO 64184-2875
For changes to name, address or FEIN/SSN, please contact us at revenue@kcmo.org or (816) 513-1120.
I authorize the Commissioner of Revenue or delegate to discuss my return and attachments with my preparer.         Yes               No
Under penalties of perjury, I declare this return to be true, correct, and complete accounting for the taxable year
stated.

Print Name of Taxpayer                 Signature                   Title                          Date                Phone

Preparer Name (if other than taxpayer) Signature                   Title                          Date                Phone