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FORM BC W-3 
                                CITY OF BATTLE CREEK

                         EMPLOYER'S ANNUAL RECONCILIATION OF 
                                BC-501 PAYMENTS 

An employer is required to file with the City a reconciliation of BC-501 payments on or before the last day of February 
following each calendar year in which the employer withheld Battle Creek City Income Tax from employee compensation. 
If  there  is  a  balance  due  when  the  reconciliation  is  filed,  this  amount  is  payable  at  that  time.  If  the  employer  made 
BC-501 payments in excess of the amount withheld, the City upon verification will refund the overpayment. 

In addition, all W-2's must be submitted with the annual reconciliation (BC W-3). The W-2 (s) must show the following: 

Employee's Name 
Complete Address 
Social Security Number 
Total amount of compensation paid during the year (box 1). 
Locality name of city withholding (box 20).
Total amount of compensation earned in Battle Creek (box 18), whether or not you actually withheld the 
tax from this amount. 
The amount of Battle Creek City Income Tax withheld (box 19).

Any variation of the standard W-2 form must be pre-approved by the City. 

If an employer goes out of business or otherwise ceases to be an employer, the reconciliation form ( BC W-3 ) and 
the information returns (W-2's) are to be filed with the City by the next BC-501 due date. 

BC-W-3
                                CITY OF BATTLE CREEK

                         ANNUAL RECONCILIATION OF INCOME TAX WITHHELD 

THIS REPORT IS DUE ON OR BEFORE                                          FEIN:
FEBRUARY 28,                                                                               1. Total tax withheld.
                                                                         2. TAX PAID - total from reverse side 
                                  3. BALANCE DUE - (Line 1 less line 2) Pay in full with this return 
                                4. OVER PAYMENT - if line 2 is greater than line 1. Attach explanation
Employers name & address 
                                           Signature:
                                           Print Name: 
                                           Title:
                                           Date:                                           Phone #

RETURN WITH W-2'S TO:    CITY OF BATTLE CREEK INCOME TAX DEPARTMENT 
                         P O BOX 1657 BATTLE CREEK MI 49016-1657



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            SUMMARY 
List payments made with Form BC-501 Employer's Returns

                               QTR ENDING  
JANUARY FEBRUARY    MARCH 
                               MARCH 31

                               QTR ENDING  
APRIL   MAY         JUNE
                               JUNE 30

                               QTR ENDING  
JULY    AUGUST      SEPTEMBER
                               SEPT 30

                               QTR ENDING  
OCTOBER NOVEMBER    DECEMBER
                               DEC 31

                    Total Paid 
                    Enter total on line 2 on reverse side 






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