FORM N5-202 3                                                                                  EMPLOYER’S WITHHOLDING 
  NORWOOD RECONCILIATION OF TAX WITHHELD FOR                          202  3                   RETURNS 
   NORWOOD TAX OFFICE                                                 5. WITHHOLDING TAX LIABILITY OF 2% OF LINE 4
   4645 MONTGOMERY ROAD                                               6. TOTAL INCOME TAX WITHHELD FROM WAGES AND PAID TO
                                                                             CITY OF NORWOOD DURING  21
   NORWOOD  OH 45212                                                         QUARTER ENDING MARCH 31                          $........ 
   PHONE   513 458-4590                                                      QUARTER ENDING JUNE 3                             $........ 
1. TOTAL NUMBER OF TAXABLE EMPLOYEES...                                      QUARTER ENDING SEPTEMBER 3                       $....... 
. TOTAL PAYROLL FOR THE YEAR. .....................   $                      QUARTER ENDING DECEMBER 31                        $......... 
3. LESS PAYROLL NOT SUBJECT TO TAX ............  $
4. PAYROLL SUBJECT TO TAX ................................  $
                                                                             TOTAL FOR YEAR                                   $....... 
  ACCOUNT NO: 
                                                                      7.OVERPAYMENT $.....OR TAX  DUE                          $....... 
                                                                             (SUBTRACT TOTAL OF LINE 6 FROM LINE 5) 
                                                                                               THIS FORM MUST BE FILED ON OR BEFORE 
                                                                                               FEBRUARY 28, 202 4ATTACH COPIES OF 
                                                                                          W-2 FORMS AND INCLUDE 1099 MISC FORMS 

                                                                             TAX[USEOFFICEONLY                                                             ] 

           DO NOT SEND THE RECONCILIATION TO: NORWOOD P.O. BOX 640332 
           THIS LOCK BOX IS ONLY FOR QUARTERLY OR MONTHLY PAYMENTS 

                           REMIT THIS RECONCILIATION FORM & W-2 FORMS TO: 

                                                             NORWOOD TAX OFFICE 
                                                             4645 MONTGOMERY ROAD 
                                                             NORWOOD, OH 45212 

                                                             RECONCILIATION INSTRUCTIONS 

   Original of this reconciliation form must be filed with the Tax Commissioner of Norwood, OH on or before February 28, 202 4
   together with copies of W-2 Forms or a list of employees withheld from as requested under line No. 7. List must include 
   employee's name, address, Social Security Number, taxable earnings, and amount of Norwood earnings tax withheld. 
   Make a copy of this form for your records. 

EMPLOYER’S QUARTERLY RETURN OF TAX WITHHELD 

  CITY OF NORWOOD                       MAKE CHECK PAYABLE TO:               NUMBER OF TAXABLE EMPLOYEES →                        DOLLARS                  CENTS 
  EARNINGS TAX DEPT.                                                  2. TOTAL SALARIES, WAGES, COMMISSIONS, AND OTHER
  P.O Box 640332                                                            COMPENSATION PAID ALL EMPLOYEES (*) ⎯⎯→ 
  CINCINNATI, OH 45264-0332                                           3. LESS: NON-TAXABLE ITEMS (COMPENSATION PAID NON- 
                                           MAILING LABELS                    RESIDENTS FOR SERVICES OUTSIDE NORWOOD) → 
                                                             PROVIDED 
  PHONE 513-458-4590                       MAKE COPIES FOR            4. TAXABLE EARNINGS (ITEM 2 MINUS ITEM 3)     ⎯→ 
  FAX 513-458-4581                         YOUR RECORDS 
                                                                      5. ACTUAL TAX WITHHELD AT 2.0%⎯⎯⎯⎯⎯→
  ACCOUNT NO:                                                         (*) IF NO WAGES PAID THIS QUARTER MARK “NONE” AND RETURN THIS FORM WITH  EXPLANATION 
                   NOTIFY INCOME TAX DEPARTMENT PROMPTLY OF ANY 
                   CHANGES IN OWNERSHIP OR NAME AND ADDRESS                  FOR THE MONTHS OF:                     JAN, FEB, MARCH 202 4
                                                                             DUE ON OR BEFORE:                      APRIL 15, 2024

                                                                             (SIGNED) 
                                                                             PRINTED 
                                                                      ( NAME       )
                                                                                      I HEREBY CERTIFY THAT THE INFORMATION AND 
                                                                                      STATEMENTS CONTAINED ARE TRUE AND CORRECT. 

EMPLOYER’S QUARTERLY RETURN OF TAX WITHHELD 
  CITY OF NORWOOD 
  EARNINGS TAX DEPT.                    MAKE CHECK PAYABLE TO:  NUMBER OF TAXABLE EMPLOYEES →                     DOLLARS                            CENTS 
  P.O Box 640332                                                2. TOTAL SALARIES, WAGES, COMMISSIONS, AND OTHER
                                                                  COMPENSATION PAID ALL EMPLOYEES (*) ⎯⎯→ 
  CINCINNATI, OH 45264-0332
                                                                3. LESS: NON-TAXABLE ITEMS (COMPENSATION PAID NON-
                                           MAILING LABELS       RESIDENTS FOR SERVICES OUTSIDE NORWOOD) → 
  PHONE 513-458-4590                       PROVIDED 
  FAX 513-458-4581                         MAKE COPIES FOR      4. TAXABLE EARNINGS (ITEM 2 MINUS ITEM 3) ⎯→
                                           YOUR RECORDS 
                                                                5. ACTUAL TAX WITHHELD AT 2.0%⎯⎯⎯⎯⎯→
  ACCOUNT NO:                                                   (*) IF NO WAGES PAID THIS QUARTER MARK “NONE” AND RETURN THIS FORM WITH  EXPLANATION 
                   NOTIFY INCOME TAX DEPARTMENT PROMPTLY OF ANY 
                   CHANGES IN OWNERSHIP OR NAME AND ADDRESS     FOR THE MONTHS OF:            APR, MAY, JUN 202 4
                                                                DUE ON OR BEFORE:             JULY 15, 202 4
                                                                (SIGNED) 
                                                                PRINTED 
                                                                ( NAME ) 
                                                                         I HEREBY CERTIFY THAT THE INFORMATION AND 
                                                                         STATEMENTS CONTAINED ARE TRUE AND CORRECT. 

EMPLOYER’S QUARTERLY RETURN OF TAX WITHHELD 

  CITY OF NORWOOD                       MAKE CHECK PAYABLE TO:  NUMBER OF TAXABLE EMPLOYEES →                     DOLLARS                            CENTS 
  EARNINGS TAX DEPT.                                            2. TOTAL SALARIES, WAGES, COMMISSIONS, AND OTHER
  P.O Box 640332                                                  COMPENSATION PAID ALL EMPLOYEES (*) ⎯⎯→ 
  CINCINNATI, OH 45264-0332                                     3. LESS: NON-TAXABLE ITEMS (COMPENSATION PAID NON-
                                           MAILING LABELS       RESIDENTS FOR SERVICES OUTSIDE NORWOOD) → 
                                           PROVIDED 
  PHONE 513-458-4590                       MAKE COPIES FOR      4. TAXABLE EARNINGS (ITEM 2 MINUS ITEM 3) ⎯→
  FAX 513-458-4581                         YOUR RECORDS 
                                                                5. ACTUAL TAX WITHHELD AT 2.0%⎯⎯⎯⎯⎯→
  ACCOUNT NO:                                                   (*) IF NO WAGES PAID THIS QUARTER MARK “NONE” AND RETURN THIS FORM WITH  EXPLANATION 
                   NOTIFY INCOME TAX DEPARTMENT PROMPTLY OF ANY 
                   CHANGES IN OWNERSHIP OR NAME AND ADDRESS     FOR THE MONTHS OF:            JUL,  AUG,  SEP  202 4
                                                                DUE ON OR BEFORE:             OCTOBER 15, 202 4

                                                                (SIGNED) 
                                                                PRINTED 
                                                                ( NAME ) 
                                                                         I HEREBY CERTIFY THAT THE INFORMATION AND 
                                                                         STATEMENTS CONTAINED ARE TRUE AND CORRECT. 

EMPLOYER’S QUARTERLY RETURN OF TAX WITHHELD 
  CITY OF NORWOOD 
                                        MAKE CHECK PAYABLE TO: 
  EARNINGS TAX DEPT.                                            NUMBER OF TAXABLE EMPLOYEES →                     DOLLARS                            CENTS 
  P.O Box 640332                                                2. TOTAL SALARIES, WAGES, COMMISSIONS, AND OTHER
                                                                  COMPENSATION PAID ALL EMPLOYEES (*) ⎯⎯→ 
  CINCINNATI, OH 45264-0332
                                                                3. LESS: NON-TAXABLE ITEMS (COMPENSATION PAID NON-
                                           MAILING LABELS       RESIDENTS FOR SERVICES OUTSIDE NORWOOD) → 
  PHONE 513-458-4590                       PROVIDED 
  FAX 513-458-4581                         MAKE COPIES FOR      4. TAXABLE EARNINGS (ITEM 2 MINUS ITEM 3) ⎯→
                                           YOUR RECORDS 
                                                                5. ACTUAL TAX WITHHELD AT 2.0%⎯⎯⎯⎯⎯→
  ACCOUNT NO:                                                   (*) IF NO WAGES PAID THIS QUARTER MARK “NONE” AND RETURN THIS FORM WITH  EXPLANATION 
                   NOTIFY INCOME TAX DEPARTMENT PROMPTLY OF ANY 
                   CHANGES IN OWNERSHIP OR NAME AND ADDRESS     FOR THE MONTHS OF:            OCT, NOV, DEC 202 4
                                                                DUE ON OR BEFORE:             JANUARY 15, 202 5

                                                                (SIGNED) 
                                                                PRINTED 
                                                                ( NAME ) 
                                                                         I HEREBY CERTIFY THAT THE INFORMATION AND 
                                                                         STATEMENTS CONTAINED ARE TRUE AND CORRECT.