Ashland Municipal Income Tax                      RECONCILIATION OF INCOME TAX
218 Luther Street                                         WITHHELD FROM WAGES                                                   PART 1
Ashland, Ohio 44805-3128                                                                                    Instructions on bottom panel
          W-2's MUST ACCOMPANY THIS FORM                            3. Total Ashland Income Tax Withheld For
1.  Total number of employees as presented by                            January              $____________ July           $_____________
     W-2 Forms submitted herewith………….....….…_____________               February              ___________  August          ______________
2.  Total Ashland Income Tax withheld from wages as                      March                 ___________  September       ______________
     shown by employee's statements for the year                         April                 ___________  October         ______________
                                                                         May                   ___________  November  ______________
          transmitted herewith…….....………..$_____________                 June                  ___________  December        ______________
                                                                    4.  …………………………………...…....               TOTAL          $_____________0
ACCOUNT NUMBER                                                      5.  Difference between Lines 2 & 4…….....….            $_____________0
          NAME                                                                          Due on or before February 28th
                                                                              If line 5 indicates a balance due, the amount should accompany this
                                                                              return.  If line 5 indicates an overpayment, a refund requestsigned  
          ADDRESS                                                            by the employer should be made
                                                                                       DO NOT CONSIDER AMOUNTS UNDER $10.00

   W-3                                    RETURN PART 1 - KEEP PART 2 FOR YOUR RECORDS

Ashland Municipal Income Tax                      RECONCILIATION OF INCOME TAX
218 Luther Street                                         WITHHELD FROM WAGES                                                   PART 2
Ashland, Ohio 44805-3128                                                                                    Instructions on bottom panel
          W-2's MUST ACCOMPANY THIS FORM                            3. Total Ashland Income Tax Withheld For
1.  Total number of employees as presented by                            January              $____________ July           $_____________
     W-2 Forms submitted herewith………….....….…_____________               February              ___________  August          ______________
2.  Total Ashland Income Tax withheld from wages as                      March                 ___________  September       ______________
     shown by employee's statements for the year                         April                 ___________  October         ______________
                                                                         May                   ___________  November  ______________
          transmitted herewith…….....………..$_____________                 June                  ___________  December        ______________
                                                                    4.  ………………………….………...…..                TOTAL          $_____________0
ACCOUNT NUMBER                                                      5.  Difference between Lines 2 & 4…….....….            $_____________0
                                                                                        Due on or before February 28th
          NAME                                                                If line 5 indicates a balance due, the amount should accompany this
                                                                              return.  If line 5 indicates an overpayment, a refund requestsigned  
          ADDRESS                                                                      DO NOT CONSIDER AMOUNTS UNDER $10.00

   W-3                                   RETURN PART 1 - KEEP PART 2 FOR YOUR RECORDS

                                        FORM W-3  INSTRUCTIONS
          The W-3 must be filed with the City of Ashland Income Tax Department on or before February 28th of the following
year.  An extension of time to file may be granted due to computer or printing problems if a written request is received prior to 
the February 28th due date.  W-2 copies of the employees that have tax withheld for the City of Ashland must be attached to the
completed W-3 Formwith a summary of the City of Ashland tax withheld as well as a reconciliation between tax withheld and 
tax paid.  A listing of employees showing tax withheld will not be acceptable unless the listing has all the information on it that   
is on the W-2.  If a difference greater than $10.00 (ten) dollars exists the balance due should accompany the return.  A refund or
credit request greater then $10.00 (ten) dollars should be supported with a proper written explanation.
NOTE:  Per House Bill 5, the new City ordinance states that  the City of Ashland may impose a penalty of twenty five dollars
 ($25.00) for each failure to timely file each return, regardless of the liability shown thereon for each month, of any fraction
thereof, during which the return remains unfiled. The penalty shall not exceed one hundred fifty dollars ($150.00)     for each 
failure.
Notify the City of Ashland Income Tax Department promptly of any changes in ownership to include, name, address or Federal
I.D.number
                                 ashlandincometax.com   Phone # 419-289-0386