Form W 1-  

EMPLOYER’S RETURN OF TAX WITHHELD 

CITY OF VANDALIA                                                          

1.   Payroll this period ………………… 
                                                                         
2.   Tax (2%)……………………………                    
                                                           
3.   Adjustment (provide explanation)… 
                                                           
4.   Amount remitted ………………...             

                                                                                                        Is this a courtesy withholding? 
For period ending ________________             Due on or before __________________ 
                                                                                                                   Yes  /         No 
Account # _______________________              Federal ID # ______________________                      Is this a final return? 

Name _______________________________________________________________                                               Yes  /         No 
                                                                                                        Is this an amended return? 
Address _____________________________________________________________                                              Yes  /         No 

____________________________________________________________________                                    Please attach explanation if necessary. 

Phone # _____________________________________________________________ 

I hereby certify that the information and statements contained herein are true and correct.           Please make check or money order payable to:  
                                                                                                      CITY OF VANDALIA 
Signed _________________________________________________________________                              Mail to: VANDALIA TAX OFFICE       
                                                                                                               PO BOX 727 
Official Title ___________________________________  Date ____________________ 
                                                                                                               VANDALIA, OH 45377-0727           
 
Each employer within or doing business within the City of Vandalia who employs one or more persons is required to withhold the tax from all  
qualifying wages paid to employees at the time the compensation is paid, file Form W-1, and remit the tax to the Vandalia Tax Office, PO Box 727, 
Vandalia, OH 45377-0727. 
MONTHLY: All returns and payments are due no later than fifteen (15) days after the last day of each month.     
QUARTERLY: All returns and payments are due no later than the last day of the month following the last day of each calendar quarter.          
Withholding payments must be less than $200.00 per month to be eligible for quarterly filing.  
Delinquent payments shall be subject to penalty, interest and late filing fee charges as provided in the Tax Ordinance.  Postage meter dates are not 
recognized as a verification of timely filing. 
The failure of any employer to receive or procure Form W-1 shall not excuse him/her from filing this return or from remitting the tax withheld.   
 
How to prepare this form: 
         Line 1— Enter total qualifying wages paid to all taxable employees during the period for which the return is being filed.    
                   If no compensation was paid during the period, so indicate and return Form W 1.-  
         Line 2— Compute tax due.   
         Line 3— Show  any adjustments to tax due; i.e., additional tax withheld at employee request, second city payment, etc.      
         Line 4— Enter amount remitted.   Online filing and payments can be made on our website. 
 
PHONE (937) 415-2240                                      EMAILtax@vandaliaohio.org                             WEBSITE www.vandaliaohio.org