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INSTRUCTIONS FOR FILING RECONCILIATION OF RETURNS FOR TAX YEAR 2022
GENERAL INFORMATION
On or before February 28th of each year, every employer must file a withholding Reconciliation of Returns. (This filing will
include wages reportable and 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
All Reconciliations of Returns plus attachments must be mailed to City of Fairfield, Division of Taxation, 701 Wessel
Dr., Fairfield, OH 45014.
In the appropriate boxes, enter the amounts of tax withheld for each period, the number of employees (Box A), the total
compensation subject of City of Fairfield Income Tax (Box B), the tax due on said compensation at 1.5% (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 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.
Overpayments of less than $10.00 will not be refunded. Be sure to attach copies of all W-2 forms.
Account # ______________________________
FEIN ________________________________
2022 City of Fairfield ANNUAL RECONCILIATION OF RETURNS
JANUARY JULY
Business Name
FEBRUARY AUGUST
Mailing Address MARCH/1ST QTR SEPTEMBER/3RD QTR
APRIL OCTOBER
SUBMIT BY FEB 28, 2023. W-2'S MUST BE ATTACHED.
MAY NOVEMBER
I hereby certify that the information and statements contained herein are true and
correct.
JUNE/2ND QTR DECEMBER/4TH QTR
Printed Name of Responsible Party
Box A Number of employees:
Signature of Responsible Party Phone Box B Total Gross Compensation:
Date E-mail:
Box C Tax Due at 1.5%:
MAIL TO: City of Fairfield Box D Tax Withheld :
Division of Taxation Box E Tax Paid:
701 Wessel Dr. Box F Balance Due or (Overpayment):
Fairfield, OH 45014
FORM TW-3
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