FORM W1 12 EMPLOYER'S WITHHOLDING - QUARTERLY
1. Number of Taxable Employees. . . . . . . . . . . . . . . . . . . . . . . . .      1
2. Total Salaries, Wages, Commissions and other                                                                 Tax Year  2024
Compensation paid all employees. . . . . . . . . . . . . . . . . . . . . . . . .                         I hereby certify that the information and statements contained here 
                                                                                                       2 in and in any schedules or exhibits attached are true and correct.
3. Less payroll not subject to tax. . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 Signed
4. Taxable Earnings (line 2 minus 3). . . . . . . . . . . . . . . . . . . . . . .                      4 Title                          Date
5. Actual Tax Withheld at 0.000 %. . . . . . . . . . . . . . . . . . . . . . . . . 5                     Phone #
6. Adjustments of Tax for Prior Period. . . . . . . . . . . . . . . . . . . . . . 6                            THIS RETURN MUST BE FILED ON
7. Interest . . . . . . .7% per annum (.58% per month). . . . . . . . . . . 7                                  OR BEFORE APRIL  30, 2024
8. Penalty. . . . . . 50% (1 time charge). . . . . . . . . . . . . . . . . . . . .                     8
                                                                                                               MAKE CHECK OR MONEY ORDER TO:
9. Total (Include Interest and Penalty if Due). . . . . . . . . . . . . . . . . 9
                                                                                                                VILLAGE OF EVENDALE
                                                                                                                10500 READING RD
Name                                                                                                            EVENDALE  OH   45241-2574

And                                                                                                            Voice  513-563-2671  Ext Fax  513-563-4636

Address                                                                                                  Period Ending JAN-FEB-MAR
                                                                                                         TAX ID
                                                                                                         NOTIFY INCOME TAX DEPARTMENT PROMPTLY OF ANY CHANGE IN OWNERSHIP OR NAME AND ADDRESS.

FORM W1 12 EMPLOYER'S WITHHOLDING - QUARTERLY
1. Number of Taxable Employees. . . . . . . . . . . . . . . . . . . . . . . . .      1
2. Total Salaries, Wages, Commissions and other                                                                 Tax Year  2024
Compensation paid all employees. . . . . . . . . . . . . . . . . . . . . . . . .                         I hereby certify that the information and statements contained here 
                                                                                                       2 in and in any schedules or exhibits attached are true and correct.
3. Less payroll not subject to tax. . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 Signed
4. Taxable Earnings (line 2 minus 3). . . . . . . . . . . . . . . . . . . . . . .                      4 Title                          Date
5. Actual Tax Withheld at 0.000 %. . . . . . . . . . . . . . . . . . . . . . . . . 5                     Phone #
6. Adjustments of Tax for Prior Period. . . . . . . . . . . . . . . . . . . . . . 6                            THIS RETURN MUST BE FILED ON
7. Interest . . . . . . .7% per annum (.58% per month). . . . . . . . . . . 7                                  OR BEFORE JULY  31, 2024
8. Penalty. . . . . . 50% (1 time charge). . . . . . . . . . . . . . . . . . . . .                     8
                                                                                                               MAKE CHECK OR MONEY ORDER TO:
9. Total (Include Interest and Penalty if Due). . . . . . . . . . . . . . . . . 9
                                                                                                                VILLAGE OF EVENDALE
                                                                                                                10500 READING RD
Name                                                                                                            EVENDALE  OH   45241-2574

And                                                                                                            Voice  513-563-2671  Ext Fax  513-563-4636

Address                                                                                                  Period Ending APR-MAY-JUN
                                                                                                         TAX ID
                                                                                                         NOTIFY INCOME TAX DEPARTMENT PROMPTLY OF ANY CHANGE IN OWNERSHIP OR NAME AND ADDRESS.

FORM W1 12 EMPLOYER'S WITHHOLDING - QUARTERLY
1. Number of Taxable Employees. . . . . . . . . . . . . . . . . . . . . . . . .      1
2. Total Salaries, Wages, Commissions and other                                                                 Tax Year  2024
Compensation paid all employees. . . . . . . . . . . . . . . . . . . . . . . . .                         I hereby certify that the information and statements contained here 
                                                                                                       2 in and in any schedules or exhibits attached are true and correct.
3. Less payroll not subject to tax. . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 Signed
4. Taxable Earnings (line 2 minus 3). . . . . . . . . . . . . . . . . . . . . . .                      4 Title                          Date
5. Actual Tax Withheld at 0.000 %. . . . . . . . . . . . . . . . . . . . . . . . . 5                     Phone #
6. Adjustments of Tax for Prior Period. . . . . . . . . . . . . . . . . . . . . . 6                            THIS RETURN MUST BE FILED ON
7. Interest . . . . . . .7% per annum (.58% per month). . . . . . . . . . . 7                                  OR BEFORE OCTOBER  31, 2024
8. Penalty. . . . . . 50% (1 time charge). . . . . . . . . . . . . . . . . . . . .                     8
                                                                                                               MAKE CHECK OR MONEY ORDER TO:
9. Total (Include Interest and Penalty if Due). . . . . . . . . . . . . . . . . 9
                                                                                                                VILLAGE OF EVENDALE
                                                                                                                10500 READING RD
Name                                                                                                            EVENDALE  OH   45241-2574

And                                                                                                            Voice  513-563-2671  Ext Fax  513-563-4636

Address                                                                                                  Period Ending JUL-AUG-SEP
                                                                                                         TAX ID
                                                                                                         NOTIFY INCOME TAX DEPARTMENT PROMPTLY OF ANY CHANGE IN OWNERSHIP OR NAME AND ADDRESS.

FORM W1 12 EMPLOYER'S WITHHOLDING - QUARTERLY
1. Number of Taxable Employees. . . . . . . . . . . . . . . . . . . . . . . . .      1
2. Total Salaries, Wages, Commissions and other                                                                 Tax Year  2024
Compensation paid all employees. . . . . . . . . . . . . . . . . . . . . . . . .                         I hereby certify that the information and statements contained here 
                                                                                                       2 in and in any schedules or exhibits attached are true and correct.
3. Less payroll not subject to tax. . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 Signed
4. Taxable Earnings (line 2 minus 3). . . . . . . . . . . . . . . . . . . . . . .                      4 Title                          Date
5. Actual Tax Withheld at 0.000 %. . . . . . . . . . . . . . . . . . . . . . . . . 5                     Phone #
6. Adjustments of Tax for Prior Period. . . . . . . . . . . . . . . . . . . . . . 6                            THIS RETURN MUST BE FILED ON
7. Interest . . . . . . .7% per annum (.58% per month). . . . . . . . . . . 7                                  OR BEFORE JANUARY  31, 2025
8. Penalty. . . . . . 50% (1 time charge). . . . . . . . . . . . . . . . . . . . .                     8
                                                                                                               MAKE CHECK OR MONEY ORDER TO:
9. Total (Include Interest and Penalty if Due). . . . . . . . . . . . . . . . . 9
                                                                                                                VILLAGE OF EVENDALE
                                                                                                                10500 READING RD
Name                                                                                                            EVENDALE  OH   45241-2574

And                                                                                                            Voice  513-563-2671  Ext Fax  513-563-4636

Address                                                                                                  Period Ending OCT-NOV-DEC
                                                                                                         TAX ID
                                                                                                         NOTIFY INCOME TAX DEPARTMENT PROMPTLY OF ANY CHANGE IN OWNERSHIP OR NAME AND ADDRESS.