CITY OF LAKEWOOD WITHHOLDING TAX RECONCILIATION

RECONCILIATION OF INCOME TAX WITHHELD
                                                        FORM W-3

QUANTITIES OF 25 OR MORE W-2s ARE REQUIRED TO BE SUBMITTED
                                         VIA MAGNETIC MEDIA

FORM W-3 is the year end reconciliation for employee withholding.This form should be filed by the last day of February following the
end of the calendar year.We accept text files of spreadsheets of your employee wage information on diskettes, CD's, mag tapes, 
and the standard paper W-2's. (Required file layout of electronic media can be found at www.onelakewood.com)

1 Enter number of employees represented by W-2 statements or payroll tabulation.
2 Enter total amount of payroll that is subject to Lakewood tax at 1.5%.
3 Enter total amount of tax paid at 1.5%.
4 Enter total amount of residence tax withheld as a courtesy to your employees.
5 Enter the monthly or quarterly total of your deposits.
6 Enter amount of adjustments made with this return (please attach explanation).
7 Enter balance due or credit to be applied to next year (place parentheses around Credit).