ANNUAL WITHHOLDING RECONCILIATION
         AND FORM 1099-MISC/1099-NEC EARNINGS REPORT

                            GENERAL INFORMATION

On or before the last day of February of each year, every employer must file an Annual Withholding Reconciliation (Form KW-
3) including copies of all corresponding W-2 Forms. Each W-2 Form shall furnish employee name, address, social security 
number, qualifying wages, local tax withheld, name of locality for which tax was withheld, and any other compensation 
allocated or set aside for or paid to the employee. In lieu of the actual W-2 Forms, an employer may provide a listing which 
furnishes the same information as contained on a W-2 Form. 

Employers who are required to submit IRS Form W-2 information electronically for Federal purposes shall also submit 
the wage information required by the City of Kettering in electronic format, along with the completed Annual Withholding 
Reconciliation (Form KW-3). The completed Form KW-3 should be attached to the CD-Rom containing corresponding wage 
records. 

Your Annual Withholding Reconciliation including all corresponding Forms W-2 and/or Forms 1099-MISC/1099-
NEC shall be due on or before the last day of February of each year. Submit completed returns and corresponding 
forms or magnetic media to:

                            City of Kettering
                            Income Tax Division
                            P.O. Box 293100
                            Kettering, OH 45429-9100

         ANNUAL WITHHOLDING RECONCILIATION FILING INSTRUCTIONS

Enter a breakdown of all withholding payments made either on a monthly or quarterly basis in the corresponding boxes 
found on this return. You must also enter the total wages subject to Kettering tax, amount of tax paid to the City of Kettering, 
the amount of Kettering tax withheld (as shown on W-2 Forms), the number of W-2 Forms included with your reconciliation 
and the number of employees subject to Kettering tax at calendar year end. The total amount of tax paid and tax withheld 
should be equal amounts. In the event of an overpayment, please check the appropriate box to indicate whether you would 
like to have the overpayment refunded to you or credited to the following year. If you have a balance due, your payment 
must accompany this return. 

         FORM 1099-MISC/1099-NEC REPORTING INSTRUCTIONS

All taxpayers who issue Forms 1099-MISC/1099-NEC to individuals or entities for services performed shall also report such 
payments to the City of Kettering when the services were performed in Kettering. The information may be submitted to the 
Tax Division on a listing that includes all identifying information of the recipients and the amount of payments made to each. 
Forms 1099-MISC/1099-NEC may be submitted in lieu of such listing. 

                                                                   FORM KW-3 (REV. 10/23)

MAIL  TO:
CITY OF KETTERING INCOME TAX DIVISION
P.O. Box 293100 • Kettering, OH  45429-9100
Phone: (937) 296-2502  • Fax:  (937) 296-3242 
www.ketteringoh.org

                   (YEAR) _________ ANNUAL WITHHOLDING RECONCILIATION
                      AND FORM 1099-MISC/1099-NEC EARNINGS REPORT
                       (RECONCILIATION AND FORMS W-2 DUE ON OR BEFORE FEBRUARY 29.)

Enter Monthly Withholding Payments
JAN                   APRIL                   JULY        OCT                         TOTAL WAGES SUBJECT               NUMBER OF W-2’S 
                                                                                      TO KETTERING TAX                  ATTACHED

FEB                   MAY                     AUG         NOV                                                         NUMBER OF EMPLOYEES
                                                                                                                      AT CALENDAR YEAR END
                                                                                      TOTAL KETTERING TAX 
                                                                                      WITHHELD PER W-2’S
MARCH                 JUNE                    SEPT        DEC                                                         Tax Rate 2.25%

Enter Quarterly Withholding Payments
1ST QTR               2ND QTR                 3RD QTR     4TH QTR                     TOTAL TAX REMITTED

                                                                                                                      If overpaid, check one:
                                                      DIFFERENCE DUE OR ( OVERPAID)                                    Refund       Credit

Account Number / FEIN:                                           Withholding Type:
                                                                    Work in City (Required Withholding)
Name:  
                                                                    Remote Employee(s) (Required Withholding)
Address:                                                            Courtesy Withholding (Resident Only, Optional Withholding)

City ST Postal Code:                                             Change of Status:
                                                                    Out of Business:             Date: 
                                                                    Merged:                      Date: 
                                                                 
Responsible Officer Signature                 Date                   Ownership Change:            Date: 
                                                                     New Owner Name and Address:

Responsible Officer Name (Please Print)
                                                                     New Owner EIN: 

                                       Form 1099-MISC/1099-NEC Earnings Report
                      (Forms 1099-MISC/1099-NEC or complete listing of recipients must be attached. See instructions.)

Number of Kettering Form(s) 1099-MISC/1099-NEC Issued:  
Kettering Form(s) 1099-MISC/1099-NEC Earnings Reported: $ 

                                                                                                          FORM KW-3 (REV. 10/23)