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 1099-NEC EARNINGS REPORT
JAN.                  APRIL                   JULY     OCT.                                TOTAL WAGES SUBJECT NUMBER OF W-2’S 
                                                                                           TO KETTERING TAX    ATTACHED
FEB.                  MAY                     AUG.     NOV.
                                                                                           TOTAL KETTERING TAX NUMBER OF EMPLOYEES
MARCH                 JUNE                    SEPT.    DEC.                                WITHHELD PER W-2’S  AT CALENDAR YEAR END

1ST QTR.               2ND QTR.               3RD QTR. 4TH QTR.                            TOTAL TAX REMITTED
                                                                                                               Tax Rate 2.25%

                                                                                           DIFFERENCE DUE      If overpaid, check one:  
                                                                                           OR OVERPAID           Refund
SUBMIT THIS FORM WITH W-2’S BY FEBRUARY 28.                                                                      Credit

Account Number / FEIN:                                                    1099-NEC Earnings Report
                                                       Number of Kettering Form(s) 1099-NEC Issued   #_______________
Name:  
                                                       Kettering Form(s) 1099-NEC Earnings Reported   $_______________
Address:  
                                                       Courtesy Withholding:
City ST Postal Code:                                       Your business performs no work in the City of Kettering and you 
                                                            are withholding Kettering tax as a courtesy to your employees who 
                                                            reside in Kettering.
Responsible Officer Signature                 Date     Change of Status:
                                                           Out of Business:               Date: 
Responsible Officer Name (Please Print)                    Merged:                        Date: 

                                                    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. Please note that employers who are required and/or choose to submit wage information via electronic media must also 
complete the Annual Withholding Reconciliation (Form KW-3). The completed Form KW-3 should be attached to the CD-Rom or diskette 
containing corresponding wage records. Submit completed returns and corresponding W-2 Forms or magnetic media to the City of 
Kettering, Income Tax Division, P.O. Box 293100, Kettering, OH 45429-9100. Your Annual Withholding Reconciliation including 
all corresponding Forms W-2 or 1099-NEC shall be due on or before the last day of February of each year.

Form 1099-NEC Reporting: All taxpayers who issue Forms 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-NEC 
may be submitted in lieu of such listing. 

                                                       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 KW-3 (REV. 11/21)