FORM N5-2022                                                                                         EMPLOYER’S WITHHOLDING 
   NORWOOD RECONCILIATION OF TAX WITHHELD FOR                             2022                        RETURNS 
   NORWOOD TAX OFFICE 4645                                                  5. WITHHOLDING TAX LIABILITY OF 2% OF LINE 4 
   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, 2023 ATTACH 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, 2023 
   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 2023 
                                                                               DUE ON OR BEFORE:                       APRIL 15, 2023 

                                                                               (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 2023 
                                                                    DUE ON OR BEFORE:                     JULY 15, 2023 
 
                                                                   (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 2023 
                                                                    DUE ON OR BEFORE:                     OCTOBER 15, 2023 
 
                                                                   (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 2023 
                                                                    DUE ON OR BEFORE:                     JANUARY 15, 2024 

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