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2018 CITY OF LORAIN OHIO, EMPLOYER’S RETURN OF TAX WITHHELD                                                                          AMENDED               Return with Payment
No. of Employees Represented on line No. 1 Below                                                                     I hereby certify that the information and statements
1. Taxable Earnings paid all Employees subject to                                                                    contained herein are true and correct.
City of Lorain, Ohio, 2.5% (.025) Income Tax
Is this a courtesy withholding? YES                                                                                  (Signed)
Is this a final return?         YES         NO
If yes, attach explanation                                1                                                          (Official Title)
                                                                                                                                                                         Date
2. Actual Tax Withheld in reporting period for City                                                                  Federal ID No.
Income Tax                                                2
3. Adjustment of Tax for prior quarter (see instructions) 3                                                          Email
4. Penalty (See Instructions)                             4                                                          Phone
5. Interest (See Instructions)                            5                                                                          THIS RETURN MUST BE FILED
6. Total – (Lines 2-5)                                    6                                                               ON OR BEFORE THE DUE DATE SHOWN BELOW
                                                                                                                             MAKE CHECK OR MONEY ORDER PAYABLE TO:
If no wages paid this quarter, mark “NONE” and return this form with explanation.                                            LORAIN DEPARTMENT OF TAXATION
EMPLOYER NAME/ADDRESS          Account No.                             FOR THE MONTH(S) OFPlease select period below                 MAIL TO:
                                                                                                                                     DEPARTMENT OF TAXATION
                                                                                                                                     CITY OF LORAIN
                                                                       MUST BE RECEIVED BY                                           605 W. 4th Street
                                                                                                                                     Lorain, OH 44052
                                                                                                                                     (440) 204-1002
Notify the Department of Taxation promptly of any change in ownership.                                                       If receipt is desired, submit additional copy
FORM MW1                                                                                                                     and enclose self-addressed, stamped envelope.

                                                                                                                                         Return to Form
                      INSTRUCTIONS FOR PREPARING AND FILING WITHHOLDING RETURN (FORM MW-1)
Who Must File:                                                                                pay taxes imposed by the Ordinance, shall be liable in addition thereto, to a late penalty 
                                                                                              penalty of 50% of the unpaid tax and a late file penalty of $25.00 per mouth or fraction
 Each employer within the City of Lorain, Ohio who employs one or more persons is             of a month with a maximum of $150.00.
required to withhold the tax of two and one half percent (2.5%) from all compensation
paid  to  employees  at  the  time  such  compensation  is  paid,  and  to  file  Withholding In addition, any taxpayer who shall fail or refuse to make any return or declaration 
Return (Form W-1) and remit the tax to the Lorain Income Tax Division.                        required by the Ordinance, or any taxpayer who shall refuse to permit the Tax Admin-
                                                                                              istrator to examine their books, or who shall knowingly make any incomplete, false or 
Deposit Requirements:                                                                         fraudulent return, or who shall attempt to avoid the payment of tax, shall be guilty of a 
                                                                                              misdemeanor and shall be fined not more than $1000 or imprisoned for not more than 
Quarterly - If less than $200 per month is withheld, the deposit is due by the last day       six months or both. The failure of any taxpayer to receive a return or declaration form 
of the month following the last day of each calendar quarter.                                 shall not excuse them from filing a return or declaration or from paying the tax.
Monthly - If more than $200 is withheld for a monthly period, the deposit is due by           How to Prepare This Form:
the fifteenth (15th) day of the following month.
                                                                                              Line 1 – Enter total compensation PAID to all taxable employees during the period for 
 For a complete description of deposit requirements, you may request a copy of the            which return is made. If no compensation was paid during the period so indicate and 
tax ordinance for the City of Lorain or access the city code at www.cityoflorain.org.         return Form MW-1. A MW-1 form is required regardless if there were no withholdings 
                                                                                              for that period.
Failure to File Return and Pay Tax:                                                           Line 2 – Enter total ACTUAL tax withheld from taxable employees during the period for 
 All taxes, including taxes withheld or required to be withheld from wages by an              CITY OF LORAIN INCOME TAX.
employer,  and  remaining  unpaid  after  they  become  due  shall  bear  interest  on  the   Line 3 – Adjust current payment of actual tax withheld for under payment in previous 
amount of the unpaid tax (see City website for rates). The interest rate is based on          period. For overpayment in previous period, file amended return for that period.
the Federal rate and may change annually. The taxpayers upon whom said taxes are 
imposed, and the employees required by the Ordinance to deduct, withhold and                  Line 6 – Enter total amount to be remitted.