PDF document
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FORM W1 12 EMPLOYER'S WITHHOLDING - QUARTERLY
1. Number of Taxable Employees. . . . . . . . . . . . . . . . . . . . . . . . . .                        1
2. Total Salaries, Wages, Commissions and other  Compensation                                                     Tax Year  2023
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 1.200 %. . . . . . . . . . . . . . . . . . . . . . . . . . 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, 2023
8. Penalty. . . . . . 50% (1 time charge). . . . . . . . . . . . . . . . . . . . . . . 8
                                                                                                                 MAKE CHECK OR MONEY ORDER TO:
9. Total (Include Interest and Penalty if Due). . . . . . . . . . . . . . . . . . 9
To pay electronically visit https://evendaleohio.org/tax-department                                               VILLAGE OF EVENDALE
                                                                                                                  10500 READING RD
Name                                                                                                              EVENDALE  OH   45241-2574

And                                                                                                              Voice  513-563-2671 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  Compensation                                                     Tax Year  2023
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 1.200 %. . . . . . . . . . . . . . . . . . . . . . . . . . 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, 2023
8. Penalty. . . . . . 50% (1 time charge). . . . . . . . . . . . . . . . . . . . . . . 8
                                                                                                                 MAKE CHECK OR MONEY ORDER TO:
9. Total (Include Interest and Penalty if Due). . . . . . . . . . . . . . . . . . 9
To pay electronically visit https://evendaleohio.org/tax-department                                               VILLAGE OF EVENDALE
                                                                                                                  10500 READING RD
Name                                                                                                              EVENDALE  OH   45241-2574

And                                                                                                              Voice  513-563-2671 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  Compensation                                                     Tax Year  2023
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 1.200 %. . . . . . . . . . . . . . . . . . . . . . . . . . 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, 2023
8. Penalty. . . . . . 50% (1 time charge). . . . . . . . . . . . . . . . . . . . . . . 8
                                                                                                                 MAKE CHECK OR MONEY ORDER TO:
9. Total (Include Interest and Penalty if Due). . . . . . . . . . . . . . . . . . 9
To pay electronically visit https://evendaleohio.org/tax-department                                               VILLAGE OF EVENDALE
                                                                                                                  10500 READING RD
Name                                                                                                              EVENDALE  OH   45241-2574

And                                                                                                              Voice  513-563-2671 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.



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FORM W1 12 EMPLOYER'S WITHHOLDING - QUARTERLY
1. Number of Taxable Employees. . . . . . . . . . . . . . . . . . . . . . . . . .                        1
2. Total Salaries, Wages, Commissions and other  Compensation                                                     Tax Year  2023
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 1.200 %. . . . . . . . . . . . . . . . . . . . . . . . . . 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, 2024
8. Penalty. . . . . . 50% (1 time charge). . . . . . . . . . . . . . . . . . . . . . . 8
                                                                                                                 MAKE CHECK OR MONEY ORDER TO:
9. Total (Include Interest and Penalty if Due). . . . . . . . . . . . . . . . . . 9
To pay electronically visit https://evendaleohio.org/tax-department                                               VILLAGE OF EVENDALE
                                                                                                                  10500 READING RD
Name                                                                                                              EVENDALE  OH   45241-2574

And                                                                                                              Voice  513-563-2671 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.






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