City of Fairfield
Annual
Income Tax Division Phone: 513-867-5327
Reconciliation 701 Wessel Dr Fax: 513-867-5333
Fairfield, OH 45014
Submit by
www.fairfield-city.org
February 29, 2024
GENERAL INFORMATION
On or before the last day of February each year , every employer must file a withholding Reconciliation. This filing will
include the tax paid in the prior calendar year on employee withholding for the City of Fairfield. Copies of all W-2
forms applicable to the Reconciliation must be attached. All W-2's must furnish the employee's name, address, full social
security number, qualifying wage compensation, and City of Fairfield tax withheld. If more than one city tax was withheld,
then the W-2's must show a breakdown of each city for which tax was withheld, the wages earned in each city, and the
amount of city tax withheld for each city.
RECONCILIATION FORM INSTRUCTIONS
In the appropriate boxes, enter the amounts of tax withheld for each period, the number of employees (Box A), the total
compensation subject to City of Fairfield Income Tax (Box B), the tax due on said compensation 1.5 at % (Box C), the amount
of tax withheld (Box D), the amount paid (Box E), and any difference (Box F). If there is a shortage greater than
$10.00, this balance due must be remitted immediately. Any withholding shortage , late payment, or missed payment
will be subject to penalty and interest charges. If there is an overpayment greater than $10.00, you
must attach an explanation. An overpayment of tax from an individual employee's wages will only be refunded
directly to the employee. Non-resident employees must complete a separate non-resident refund request. Overpayments of
less than $10.00 will not be refunded. Be sure to attach copies of all W-2 forms.
Mail Completed Reconciliation and W-2 Forms to:
City of Fairfield
Income Tax Division
701 Wessel Dr.
Fairfield, OH 45014
Inactivate Account
2023 City of Fairfield W-2(s) Attached REQUIRED (electronic file
Annual Reconciliation for importing perferred, see website for details)
JANUARY JULY
Business Name ___________________________ FEBRUARY AUGUST
FEIN _____________________________________ MARCH/1ST QTR SEPTEMBER/3RD QTR
APRIL OCTOBER
Mailing Address ___________________________
MAY NOVEMBER
________________________________________
JUNE/2ND QTR DECEMBER/4TH QTR
SUBMIT BY FEB 28, 2024. W-2'S MUST BE ATTACHED.
I hereby certify that the information and statements contained herein are true and Box A Number of employees:
correct. Box B Fairfield Wages:
Box C Tax Due at 1.5%:
Signature
Box D Tax Withheld :
Contact Person & Email Box E Tax Paid:
*Box F Balance Due or Overpayment:
Date Phone *If greater than $10.00