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                                                             Detach this section at perforation and return.
Collector of Revenue                                         EMPLOYER’S QUARTERLY EARNINGS TAX RETURN
City of St. Louis                                                               OF TAXES WITHHELD                                              W-10
1) NUMBER OF TAXABLE EMPLOYEES                               QUARTER ENDING                                                DOLLARS                 CENTS
2) Total taxable earnings for quarter (See Instruction A if no wages were paid)                              2)
3) Tax withheld at 1% (.01) of line 2                                                                        3)
4) Less amount deposited in quarter if monthly deposits are required. (See Instruction B)                    4)
5) NET TAX DUE                                                                                               5)

6) Penalty (See Instruction E)                                                                               6)
7) Interest (See Instruction E)                                                                              7)
8) TOTAL DUE                                                                                                 8)
If business is sold, transferred or terminated write "Final"                    MAKE CHECKS PAYABLE TO: GREGORY F.X. DALY, COLLECTOR OF REVENUE
here              , and follow instructions on reverse side.                    MAIL TO: EARNINGS TAX DIVISION, P.O. BOX 66966, ST. LOUIS, MO 63166-6966

                                                                                          FEIN:
                                                                                          I hereby certify that the statements herein are true.

                                                                                                             Signature
                                                                                          Title                                                Date
                                                                                          Business Telephone:

                                                             Detach this section at perforation and return.
Collector of Revenue                  PAYROLL EXPENSE TAX — QUARTERLY RETURN
City of St. Louis                                            QUARTER ENDING                                                                        P-10
1) NUMBER OF EMPLOYEES Subject to payroll expense tax this quarter:                                                        DOLLARS                 CENTS
2) Payroll within City of St. Louis for this quarter                                                         2) $
3) Tax Due 1/2 of 1% (.005) of Line 2                                                                        3) $

4) Penalty (See Instructions)                                                                                4) $
5) Interest (See Instructions)                                                                               5) $
6) TOTAL DUE                                                                                                 6) $
If business is sold, transferred or terminated write "Final" MAKE CHECKS PAYABLE TO: GREGORY F.X. DALY, COLLECTOR OF REVENUE 
here              , and follow instructions on reverse side. MAIL TO: PAYROLL EXPENSE TAX DEPT., P.O. BOX 66966, ST. LOUIS, MO 63166-6966

                                                                                          FEIN:
                                                                                          I hereby certify that the statements herein are true.

                                                                                                             Signature
                                                                                          Title                                                Date
                                                                                          Business Telephone:

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INSTRUCTIONS
EVERY EMPLOYER OR NON-RESIDENT EMPLOYER, WHO EMPLOYS ONE OR MORE PERSONS, WORKING OR LIVING IN THE CITY, IS REQUIRED TO WITH-
HOLD ST. LOUIS CITY EARNINGS TAX ON GROSS EARNINGS FROM THOSE EMPLOYEES. GROSS EARNINGS SHALL INCLUDE, BUT IS NOT LIMITED TO:
SALARIES, WAGES, COMMISSIONS, FEES, BONUSES, EXTRA LIFE INSURANCE, FELLOWSHIPS, YEAR END PROFIT SHARING, RETIREMENT INCENTIVE,
SEVERANCE PAY, TIPS OR OTHER COMPENSATION BASIS.
A — When No Wages Are Paid. If you temporarily discontinue paying salaries, wages, etc., (for example seasonal activities), or if no salaries etc., were paid during the
quarter, you must nevertheless file a return. The return should be filed with the word "NONE" entered on line 2.
B — To Receive Credit For Monthly Deposits. List on line 4 the total earnings tax withheld and previously deposited for the 1st and/or 2nd month(s) of this
quarter. (this applies only to employers that withhold $1,500.00 or more earnings tax during either of the first 2 months of any quarter).
C — To File A "Final" Return. If a business is sold, transferred, or terminated you must file a "Final" return and so indicate in the space provided, on this return. If a business
is sold or transferred by one employer to another, each employer must file a separate return. The seller of the business must attach a statement showing the name and address
of the new owner, and the date of the sale or transfer. If a business is terminated you must notify this Office of the effective date of termination.

D — Quarterly Returns and Due Dates
Quarter ending: DUE ON OR BEFORE:
March 31 April 30
June 30 July 31
September 30 October 31
December 31 January 31
E — Penalty and Interest. Failure to file and remit when due will result in a penalty of 5% of the amount of tax for each month or fraction thereof, to a maximum of 25%
until tax is paid. Interest will be 1% of the amount of tax, for each month or fraction thereof, from due date until tax is paid.
F — SIGN AND DATE RETURN G — FOR INFORMATION, CALL (314) 622-4071 or visit our website at: www.stlouiscollector.com
Pursuant to the Revised Code of the City of St. Louis, § 5.22.100, the Collector of Revenue or his duly authorized agent has the
authority to audit facilities or tax returns of an employer or taxpayer subject to this section of the Tax Code.

Pursuant to the Revised Code of the City of St. Louis, § 5.22.100, the Collector of Revenue or his duly authorized agent has the
INSTRUCTIONS authority to audit facilities or tax returns of an employer or taxpayer subject to this section of the Tax Code.
EVERY EMPLOYER, RESIDENT OR NON-RESIDENT, WHO EMPLOYS INDIVIDUALS TO PERFORM WORK OR RENDER SERVICE WITHIN THE CITY OF
ST. LOUIS IS REQUIRED TO FILE AND PAY PAYROLL EXPENSE TAX ON A QUARTERLY BASIS. IF YOU DID NOT HAVE ANY PAYROLL WITHIN
ST. LOUIS DURING THE QUARTER, YOU MUST FILE A RETURN WITH THE WORD "NONE" ENTERED ON LINE 2.
A. On Line 1: Enter number of employees subject to the tax.
B. On Line 2: Enter payroll for the quarter within City of St. Louis.
C. On Line 3: Payroll Expense Tax — 1/2 of 1% (.005) of Line 2.
D. On Line 4: Penalty — Failure to file and remit when due will result in a penalty of 5% of the amount of tax for each month or fraction thereof, to a maximum
of 25% until tax is paid.
E. On Line 5: Interest — In addition to penalty, there will be interest of 1% of the amount of tax for each month or fraction thereof from the due date until
tax is paid.
F. On Line 6: Total due (including penalty and interest, if applicable).
G. TO FILE A "FINAL" RETURN
If a business is sold, transferred or terminated you must file a "Final" return, and so indicate in the space
provided on this return. If the business is sold or transferred by one employer to another, each employer
must file a separate return. The seller of the business must attach a statement showing the name and
address of the new owner, and the date of the sale or transfer. If a business is terminated you must notify this
office of the effective date of termination. A final return will be verified by this office.
H. QUARTERLY RETURN DUE DATES
Quarter Ending: Due on or Before:
March 31 April 30
June 30 July 31
September 30 October 31
December 31 January 31
I. SIGN AND DATE RETURN J. FOR INFORMATION, CALL (314) 622-4071 or visit
our webiste at: www.stlouiscollector.com

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