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                                 INSTRUCTIONS FOR REMITTING                      2023WITHHOLDING TAX

GENERAL INFORMATION FOR EMPLOYERS

Every employer located within or doing business within the City of Fairfield who employs one or more persons is required to
withhold the City of Fairfield municipal tax at the rate of 1.50 % from wages subject to withholding. Monthly withholding is
due on the 15th day of the month following the end of month. Your payment must be postmarked on or before the due date to be
considered on time and to prevent a late penalty described herein, there is no grace period. Electronic filing through the
Ohio Business Gateway (OBG) is another way to remit your withholding. The date used for determining timeliness of the
electronic filing will be the date submitted. Information and instructions on how to register and remit payments through the
OBG may be found at business.ohio.gov. Eligibility for Monthly or Quarterly withholding is based on the following "Look
Back" provisions. If your business remitted more than $2399 in the previous year or more than $200 any month in the
previous quarter, you will be required to remit monthly. If your business remitted less than $2399 in the previous year or less
than $200 any month on the previous quarter, you would remit quarterly.

PENALTY AND INTEREST RATES
Late withholding payments are penalized at the        rate of   50% of   the amount  not timely   filed. This is a     penalty prescribed by the        
ORC Chapter 718. Specific language          may be found at   http://codes.ohio.gov/orc/718.27. Interest      is calculated    using   the Federal      
Short Term Rate (rounded   to the nearest   percent)  +   5%. Late   return  filings, including   reconciliations,  will be penalized $25 per 
month     or a fraction thereof up to     a maximum of   $150. Reconciliations are   due the last  day of   February each  year   with     no grace     
period.

FORM INSTRUCTIONS
Be sure that the account number, federal identification number, business          name, and  address      appear on the  form     in   the appropriate  
designated place. Enter the gross    compensation     subject   to   withholding for the filing period.  If   there are no qualifying  wages     for    
this period, enter zero. Enter the total    City of   Fairfield tax withheld. Enter adjustments    (full  written explanation     of adjustments        
must accompany this form). The total        due must  be paid with the timely    filing of   this return. Be sure   to indicate   the number  of        
employees subject to city of tax during the period. Sign and date where indicated.

RECONCILIATION OF RETURNS
All reconciliation   of returns plus employee W-2's      must   be  mailed to: City of Fairfield   Income  Tax Division,701       Wessel     Dr.,       
Fairfield, OH 45014. Reconciliation of Returns and Employee W-2's  are due the last day of February each year.

WHERE TO MAIL PAYMENTS
Payments must be mailed to:
       City of Fairfield
       P. O. Box 181543
       Fairfield, OH 45018



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                                                                                                   Account # ___________
City of Fairfield RETURN OF INCOME TAX WITHHELD                      Tax Rate: 1.50%                     _______________
                                                                                                   FEIN: 
BUSINESS NAME _____________________                                  Withholding Period                  Due Date
                                                                     January                             02/15/2023
MAILING ADDRESS _______________________        COURTESY  WITHHOLDING 1. Gross Compensation
                                               ONLY  INDICATE MONTH                                $
                                               REPORTED:             Subject to Withholding
Printed Name of Responsible Party                                    2. Tax Withheld during Period $

Signature of Responsible Party            Date                       3. Adjustment to Prior Period $
Phone:                            E-Mail:                            4. Penalty                    $
       Remit form and payment to:                                    5. Interest                   $
       City of Fairfield
       P. O. Box 181543                                              6. TOTAL DUE                  $
       Fairfield, OH 45018                                    Number of employees during period              FORM TW-1

                                                                                                   Account #:
City of Fairfield RETURN OF INCOME TAX WITHHELD                      Tax Rate: 1.50%                     _____________
                                                                                                    FEIN:_________________ 
BUSINESS NAME _____________________
                                                                     Withholding Period                  Due Date
                                          COURTESY  WITHHOLDING      February                            03/15/2023
MAILING ADDRESS _______________________   ONLY  INDICATE      MONTH 
                                          REPORTED:                  1. Gross Compensation
                                                                     Subject to Withholding        $
Printed Name of Responsible Party                                    2. Tax Withheld during Period $

Signature of Responsible Party            Date                       3. Adjustment to Prior Period $
Phone:                            E-Mail:                            4. Penalty                    $
       Remit form and payment to:                                    5. Interest                   $
       City of Fairfield
       P. O. Box 181543                                              6. TOTAL DUE                  $
       Fairfield, OH 45018
                                                              Number of employees during period              FORM TW-1

                                                                                                   Account #:
City of Fairfield RETURN OF INCOME TAX WITHHELD                      Tax Rate: 1.50%                     _____________
                                                                                                   FEIN:_________________ 
BUSINESS NAME _____________________       COURTESY  WITHHOLDING      Withholding Period                  Due Date
                                          ONLY  INDICATE MONTH       March                               04/15/2023
MAILING ADDRESS _______________________   REPORTED:                  1. Gross Compensation
                                                                     Subject to Withholding        $
Printed Name of Responsible Party                                    2. Tax Withheld during Period $

Signature of Responsible Party            Date                       3. Adjustment to Prior Period $
Phone:                            E-Mail:                            4. Penalty                    $
       Remit form and payment to:                                    5. Interest                   $
        City of Fairfield
       P. O. Box 181543                                              6. TOTAL DUE                  $
       Fairfield, OH 45018                                    Number of employees during period              FORM TW-1

                                                                                                   Account #:
City of Fairfield RETURN OF INCOME TAX WITHHELD                      Tax Rate: 1.50%                     ____________
                                                                                                   FEIN:________________ 
BUSINESS NAME _____________________
                                                                     Withholding Period                  Due Date
                                                                                 April                   05/15/2023
MAILING ADDRESS _______________________        COURTESY WITHHOLDING  1. Gross Compensation
                                               ONLY INDICATE QUARTER                               $
                                               REPORTED:             Subject to Withholding
Printed Name of Responsible Party                                    2. Tax Withheld during Period $

Signature of Responsible Party            Date                       3. Adjustment to Prior Period $
Phone:                            E-Mail:                            4. Penalty                    $
       Remit form and payment to:                                    5. Interest                   $
       City of Fairfield
       P. O. Box 181543                                              6. TOTAL DUE                  $
       Fairfield, OH 45018                                    Number of employees during period              FORM TW-1



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                                                                                              Account #:
City of Fairfield RETURN OF INCOME TAX WITHHELD                 Tax Rate: 1.50%                    _____________
                                                                                              FEIN:_________________ 
BUSINESS NAME _____________________                             Withholding Period                 Due Date
                                                                            May                    06/15/2023
MAILING ADDRESS _______________________   COURTESY  WITHHOLDING 1. Gross Compensation
                                          ONLY  INDICATE MONTH                                $
                                          REPORTED:             Subject to Withholding
Printed Name of Responsible Party                               2. Tax Withheld during Period $

Signature of Responsible Party            Date                  3. Adjustment to Prior Period $
Phone:                            E-Mail:                       4. Penalty                    $
       Remit form and payment to:                               5. Interest                   $
       City of Fairfield
       P. O. Box 181543                                         6. TOTAL DUE                  $
       Fairfield, OH 45018                               Number of employees during period              FORM TW-1

                                                                                              Account #:
City of Fairfield RETURN OF INCOME TAX WITHHELD                 Tax Rate: 1.50%                         _____________
                                                                                              FEIN:_________________ 
BUSINESS NAME _____________________                             Withholding Period                 Due Date
                                                                            June                   07/15/2023
MAILING ADDRESS _______________________   COURTESY  WITHHOLDING 1. Gross Compensation
                                          ONLY  INDICATE MONTH                                $
                                          REPORTED:             Subject to Withholding
Printed Name of Responsible Party                               2. Tax Withheld during Period $

Signature of Responsible Party            Date                  3. Adjustment to Prior Period $
Phone:                            E-Mail:                       4. Penalty                    $
       Remit form and payment to:                               5. Interest                   $
       City of Fairfield
       P. O. Box 181543                                         6. TOTAL DUE                  $
       Fairfield, OH 45018                               Number of employees during period              FORM TW-1

                                                                                              Account #:
City of Fairfield RETURN OF INCOME TAX WITHHELD                 Tax Rate: 1.50%                         _____________
                                                                                              FEIN:_________________ 
BUSINESS NAME _____________________                             Withholding Period                 Due Date
                                                                            July                   08/15/2023
MAILING ADDRESS _______________________   COURTESY  WITHHOLDING 1. Gross Compensation
                                          ONLY  INDICATE MONTH                                $
                                          REPORTED:             Subject to Withholding
Printed Name of Responsible Party                               2. Tax Withheld during Period $

Signature of Responsible Party            Date                  3. Adjustment to Prior Period $
Phone:                            E-Mail:                       4. Penalty                    $
       Remit form and payment to:                               5. Interest                   $
       City of Fairfield
       P. O. Box 181543                                         6. TOTAL DUE                  $
       Fairfield, OH 45018
                                                         Number of employees during period              FORM TW-1

                                                                                              Account #:
City of Fairfield RETURN OF INCOME TAX WITHHELD                 Tax Rate: 1.50%                         ____________
                                                                                              FEIN:________________ 
BUSINESS NAME _____________________                             Withholding Period                 Due Date
                                                                August                             09/15/2023
MAILING ADDRESS _______________________   COURTESY  WITHHOLDING 1. Gross Compensation
                                          ONLY  INDICATE MONTH                                $
                                          REPORTED:             Subject to Withholding
Printed Name of Responsible Party                               2. Tax Withheld during Period $

Signature of Responsible Party            Date                  3. Adjustment to Prior Period $
Phone:                            E-Mail:                       4. Penalty                    $
       Remit form and payment to:                               5. Interest                   $
       City of Fairfield
       P. O. Box 181543                                         6. TOTAL DUE                  $
       Fairfield, OH 45018                               Number of employees during period              FORM TW-1



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                                                                                                     Account #:
City of Fairfield RETURN OF INCOME TAX WITHHELD                        Tax Rate: 1.50%                     ____________
BUSINESS NAME _____________________                                                                  FEIN: ________________ 
                                                                       Withholding Period                  Due Date
                                                                       September                           10/15/2023
MAILING ADDRESS _______________________        COURTESY  WITHHOLDING   1. Gross Compensation
                                               ONLY  INDICATE   MONTH                                $
                                               REPORTED:               Subject to Withholding
Printed Name of Responsible Party                                      2. Tax Withheld during Period $

Signature of Responsible Party            Date                         3. Adjustment to Prior Period $
Phone:                            E-Mail:                              4. Penalty                    $
       Remit form and payment to:                                      5. Interest                   $
       City of Fairfield
       P. O. Box 181543                                                6. TOTAL DUE                  $
       Fairfield, OH 45018                                      Number of employees during period               FORM TW-1

                                                                                                     Account #:
City of Fairfield RETURN OF INCOME TAX WITHHELD                        Tax Rate: 1.50%                         _____________
                                                                                                     FEIN:_________________ 
BUSINESS NAME _____________________                                    Withholding Period                  Due Date
                                                                       October                             11/15/2023
MAILING ADDRESS _______________________   COURTESY  WITHHOLDING        1. Gross Compensation
                                          ONLY  INDICATE        MONTH                                $
                                          REPORTED:                    Subject to Withholding
Printed Name of Responsible Party                                      2. Tax Withheld during Period $

Signature of Responsible Party            Date                         3. Adjustment to Prior Period $
Phone:                            E-Mail:                              4. Penalty                    $
       Remit form and payment to:                                      5. Interest                   $
        City of Fairfield
       P. O. Box 181543                                                6. TOTAL DUE                  $
       Fairfield, OH 45018                                      Number of employees during period               FORM TW-1

                                                                                                     Account #:
City of Fairfield RETURN OF INCOME TAX WITHHELD                        Tax Rate: 1.50%                         ____________
                                                                                                     FEIN: ________________
BUSINESS NAME _____________________                                    Withholding Period                  Due Date
                                               COURTESY WITHHOLDING    November                            12/15/2023
MAILING ADDRESS _______________________          ONLY  INDICATE MONTH  1. Gross Compensation
                                               REPORTED:                                             $
                                                                       Subject to Withholding
Printed Name of Responsible Party                                      2. Tax Withheld during Period $

Signature of Responsible Party            Date                         3. Adjustment to Prior Period $
Phone:                            E-Mail:                              4. Penalty                    $
       Remit form and payment to:                                      5. Interest                   $
       City of Fairfield
       P. O. Box 181543                                                6. TOTAL DUE                  $
       Fairfield, OH 45018                                      Number of employees during period               FORM TW-1

                                                                                                     Account #: ___________
City of Fairfield RETURN OF INCOME TAX WITHHELD                        Tax Rate: 1.50%
                                                                                                     FEIN: _______________
BUSINESS NAME _____________________                                    Withholding Period                  Due Date
                                                                       December                            01/15/2024
MAILING ADDRESS _______________________   COURTESY  WITHHOLDING        1. Gross Compensation
                                          ONLY  INDICATE        MONTH                                $
                                          REPORTED:                    Subject to Withholding
Printed Name of Responsible Party                                      2. Tax Withheld during Period $

Signature of Responsible Party            Date                         3. Adjustment to Prior Period $
Phone:                            E-Mail:                              4. Penalty                    $
       Remit form and payment to:                                      5. Interest                   $
       City of Fairfield
       P. O. Box 181543                                                6. TOTAL DUE                  $
       Fairfield, OH 45018
                                                                Number of employees during period               FORM TW-1






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