Coupon Packet—Included in this packet are Employer Withholding Coupons for the
period January 01-December 31 and a year-end Annual Reconciliation Form. Also
included is an Annual Withholding Tax Worksheet for you to keep track of your
payments. If you have any questions, contact our office at 740-203-1225. Additional
coupon forms and information are available on the City of Delaware website at
www.DelawareOhio.net.
Who must file—Any employer within or doing business within the City of Delaware,
Ohio, who employs one or more persons is required to withhold the current tax rate
from all qualifying wages paid to or accrued by the employee(s) and to file these
coupon forms and remit tax to the City of Delaware Income Tax Department pursuant
to the Delaware Income Tax Ordinance.
Deposit Requirements—The City of Delaware income tax must be remitted to the
Income Tax Department on a monthly basis unless withholding amounts are less than
two hundred dollars ($200.00) per month. Each employer is required to file the
“Employer’s Return of Tax Withheld” coupon along with the monthly or quarterly
Quarterly—If tax withheld or required to be withheld is less than $200 per
month, remittance is due by the last day of the month following the end of a
quarterly period (April 30, July 31, October 31, January 31).
Monthly—If more than $200 is withheld or required to be withheld per month,
remittance is due by the fifteenth day of the following month.
Failure To File Return and Pay Tax—All taxes, including taxes withheld or required to
be withheld from wages by an employer and remaining unpaid after they become
due, shall bear interest on the amount of the unpaid tax at the current annual
short term rate plus five percent (5%) and a late payment penalty of fifty percent
(50%) of the tax due. The failure to receive a withholding deposit coupon form
shall not excuse an employer from making a return and depositing the taxes
withheld.
1 S SANDUSKY ST / P.O. BOX 496
DELAWARE, OH 43015
740-203-1225 / FAX: 740-203-1249
WWW.DELAWAREOHIO.NET
INCOMETAX@DELAWAREOHIO.NET
020
INCOME TAX DEPARTMENT
QUALIFYING WAGES FOR WITHHOLDING (Ohio Revised Code, Sec 718.03)
Medicare Wages
An employer is required to withhold only on “qualifying wages,” which are wages as
defined in Internal Revenue Code Section 3121(a), generally the Medicare Wage Box
of Form W-2.
Medicare Exempt Employees—These employees are subject to the requirements
for “qualifying wages” in the Medicare Wage Box of FormW-2 even though that
box will remain blank.
Cafeteria Plans—Internal Revenue Code Section 125 wages are not included in
the definition of Medicare wages and do not need to be deducted from the
Medicare Wage Box.
401(k), 457, and Supplemental Unemployment Compensation Benefits—These
items should all be included in the Medicare Wage Box and are subject to
withholding requirements.
Nonqualified Deferred Compensation Plan—Income from nonqualified plans is
included in the definition of “qualifying wages” at the time the income is deferred
and is subject to withholding requirements.
Stock Options—Income from the exercise of stock options is included in the
definition of “qualifying wages” and is subject to withholding requirements.
Disqualifying Disposition of an Incentive Stock Option—Employer is not required
to withhold, but the income is considered “qualifying wages,” and the recipient is
liable for the tax.
Note: As an employer, if the Medicare Wage Box is not the largest wage figure on
the W-2 Form, a written explanation will be required.
Questions? Contact the City of Delaware Income Tax Department:
740-203-1225 or IncomeTax@DelawareOhio.Net
Line 1— Enter tax withheld on all qualifying wages paid to or accrued by all
employees working within the City of Delaware.
Line 2—Enter tax withheld as courtesy to Delaware City residents and indicate
percentage used. If unsure of proper courtesy rate, please call the Income Tax
Department.
Line 3—Enter total of Lines 1 and 2.
Line 4—Adjust current payment of actual tax withheld for under payment or over
payment in previous period. Attach explanation.
Lines 5 & 6—See instructions under Failure To File Return and Pay Tax.
Line 7—Enter total amount to be remitted.
COMPLETING THE WITHHOLDING COUPON FORMS
ANNUAL WITHHOLDING TAX WORKSHEET
PD ENDING DUE DATE AMT DATE CHECK # PD ENDING DUE DATE AMT DATE CHECK #
1/31 2/28
7/31
8/15
2/28
3/15
8/31
9/15
3/31
4/15
9/30
10/15
1ST QTR
4/30
3RD QTR
10/31
4/30
5/15
10/31 11/15
5/31
6/15
11/30
12/15
6/30 7/15 12/31 1/15
2ND QTR
7/31
4TH QTR 1/31
2/15
2019 CURRENT RATE: 1.85%
MONTHLY EMPLOYER CITY TAX WITHHOLDING PACKET
withholding payments on or before the due dates as shown below to the Income Tax
Department. The failure of any employer to receive or procure the forms shall not
excuse him from making this return or from remitting the tax withheld.
CITY OF DELAWARE ANNUAL RECONCILIATION INSTRUCTIONS
On or before the last day of February of each year, each employer must
file a withholding reconciliation using the City of Delaware form.
Copies of all W-2 Forms applicable to the reconciliation must be
attached.
All W-2’s must furnish the name, address, social security number,
qualifying wages, city tax withheld, name of city for which tax was
withheld, and any other compensation paid to the individual. If copies
of the W-2 Forms are not available, each employer must provide a
listing of all employees subject to Delaware tax. The listing shall
require the same type of information as is required on the W-2 Form.
Any individual, association, or business entity that is required under the
Internal Revenue Code to issue Form 1099 to any person shall, on or
before the last day of February of each year, file copies of said 1099’s
to the Income Tax Department. If 1099 copies are not available, a
listing with the same information as contained on Form 1099 may be
submitted. Failure to comply may result in penalty assessment.
The front of the Annual Reconciliation Form must show a breakdown of
all withholding payments made either quarterly or monthly in the
boxes provided. Sections 1, 2, 3, 4, and 5 must be completed.
The total tax paid should be equal to the current City of Delaware
income tax rate (or the reduced courtesy withholding rate) of Box 2.
The completed Annual Reconciliation Form and all attachments must
be submitted to the City of Delaware Income Tax Department on or
before the last
day of February each year. Failure to file the Annual
Reconciliation Form with attachments by the last day of February
each year will result in a penalty assessment. Any questions
regarding this form should be referred to the Income Tax
Department at 740-203-1225.
Special Notice: The City of Delaware will now accept electronic
filing of year-end W-2 and reconciliation information. Employer
must use the SSA format that includes local tax information.
Close Account: _____
2019 CURRENT RATE: 1.85% CITY OF DELAWARE ANNUAL RECONCILIATION FORM
Payment Enclosed: _____
Refund Requested: _____
CITY OF DELAWARE INCOME TAX EMPLOYER’S ANNUAL RECONCILIATION OF TAX WITHHELD
Make check or money order payable to
CITY OF DELAWARE INCOME TAX
Mail to
CITY OF DELAWARE INCOME TAX
PO BOX 496
DELAWARE OH 43015
740-203-1225
Email to IncomeTax@DelawareOhio.Net
Due on or before the last day of February with W-2’s attached. All sections must be completed.
1. Total #
Delaware
W-2’s
#__________
2. Workplace
wages
$__________
3. Workplace
tax
withheld
$__________
5. Total taxes
paid to
Delaware
$__________
6. BALANCE
DUE OR
REFUND
$__________
4. Residence
tax
withheld
$__________
Delaware Tax ID: ________________ -W FIN: ________________________________________
Company Name and Address: ______________________________________________________________
______________________________________________________________
______________________________________________________________
I hereby certify that the information and statements contained herein
and in any schedules or exhibits attached are true and correct.
Printed Name: __________________________________ Signature: _______________________________________
Official Title: _________________________________________ Date: _____________________________________
Email: ___________________________________________ Phone Number: ________________________________
JAN JULY
FEB AUG
MAR SEP
1ST QTR 3RD QTR
APR OCT
MAY NOV
JUN DEC
2ND QTR 4TH QTR
click to sign
signature
click to edit
2019 DELAWARE TAX RATE: 1.85%
CITY OF DELAWARE INCOME TAX
EMPLOYER’S RETURN OF TAX WITHHELD
I hereby certify that the information and statements
contained herein and in any schedules or exhibits
attached are true and correct.
Print Name: ____________________________________
Signed: ________________________________________
Official Title: ____________________________________
Date: __________________________________________
Make check or money order payable to
CITY OF DELAWARE INCOME TAX
Mail to
City of Delaware Income Tax
PO Box 496
Delaware OH 43015
740-203-1225
This return must be filed on or before the due date shown.
1. Tax withheld on income earned in Delaware
1.
2. Courtesy tax withheld at __________________% (reduced credit rate)
2.
3. Total tax withheld in period for Delaware.
3.
4. Adjustment of tax for prior period (explain on back)
4.
5.
Interest (.58% per month)
5.
6.
Penalty (50% of tax due)
6.
7. TOTAL (including interest and penalty if due)
7.
Delaware Tax ID: ______________ -W FIN: _____________________________
Company Name and Address: __________________________________________________
__________________________________________________
__________________________________________________
Company Email: _________________________________________ Phone Number: ___________________________
Period Ending DECEMBER 31, due on or before JANUARY 15
DEC
DEC
DEC
2019 DELAWARE TAX RATE: 1.85%
CITY OF DELAWARE INCOME TAX
EMPLOYER’S RETURN OF TAX WITHHELD
I hereby certify that the information and statements
contained herein and in any schedules or exhibits
attached are true and correct.
Print Name: ____________________________________
Signed: ________________________________________
Official Title: ____________________________________
Date: __________________________________________
Make check or money order payable to
CITY OF DELAWARE INCOME TAX
Mail to
City of Delaware Income Tax
PO Box 496
Delaware OH 43015
740-203-1225
This return must be filed on or before the due date shown.
1. Tax withheld on income earned in Delaware
1.
2. Courtesy tax withheld at __________________% (reduced credit rate)
2.
3. Total tax withheld in period for Delaware.
3.
4. Adjustment of tax for prior period (explain on back)
4.
5.
Interest (.58% per month)
5.
6.
Penalty (50% of tax due)
6.
7. TOTAL (including interest and penalty if due)
7.
Delaware Tax ID: ______________ -W FIN: _____________________________
Company Name and Address: __________________________________________________
__________________________________________________
__________________________________________________
Company Email: _________________________________________ Phone Number: ___________________________
Period Ending NOVEMBER 30, due on or before DECEMBER 15
NOV
NOV
NOV
2019 DELAWARE TAX RATE: 1.85%
CITY OF DELAWARE INCOME TAX
EMPLOYER’S RETURN OF TAX WITHHELD
I hereby certify that the information and statements
contained herein and in any schedules or exhibits
attached are true and correct.
Print Name: ____________________________________
Signed: ________________________________________
Official Title: ____________________________________
Date: __________________________________________
Make check or money order payable to
CITY OF DELAWARE INCOME TAX
Mail to
City of Delaware Income Tax
PO Box 496
Delaware OH 43015
740-203-1225
This return must be filed on or before the due date shown.
1. Tax withheld on income earned in Delaware
1.
2. Courtesy tax withheld at __________________% (reduced credit rate)
2.
3. Total tax withheld in period for Delaware.
3.
4. Adjustment of tax for prior period (explain on back)
4.
5.
Interest (.58% per month)
5.
6.
Penalty (50% of tax due)
6.
7. TOTAL (including interest and penalty if due)
7.
Delaware Tax ID: ______________ -W FIN: _____________________________
Company Name and Address: __________________________________________________
__________________________________________________
__________________________________________________
Company Email: _________________________________________ Phone Number: ___________________________
Period Ending OCTOBER 31, due on or before NOVEMBER 15
OCT
OCT
OCT
click to sign
signature
click to edit
click to sign
signature
click to edit
click to sign
signature
click to edit
2019 DELAWARE TAX RATE: 1.85%
CITY OF DELAWARE INCOME TAX
EMPLOYER’S RETURN OF TAX WITHHELD
I hereby certify that the information and statements
contained herein and in any schedules or exhibits
attached are true and correct.
Print Name: ____________________________________
Signed: ________________________________________
Official Title: ____________________________________
Date: __________________________________________
Make check or money order payable to
CITY OF DELAWARE INCOME TAX
Mail to
City of Delaware Income Tax
PO Box 496
Delaware OH 43015
740-203-1225
This return must be filed on or before the due date shown.
1. Tax withheld on income earned in Delaware
1.
2. Courtesy tax withheld at __________________% (reduced credit rate)
2.
3. Total tax withheld in period for Delaware.
3.
4. Adjustment of tax for prior period (explain on back)
4.
5.
Interest (.58% per month)
5.
6.
Penalty (50% of tax due)
6.
7. TOTAL (including interest and penalty if due)
7.
Delaware Tax ID: ______________ -W FIN: _____________________________
Company Name and Address: __________________________________________________
__________________________________________________
__________________________________________________
Company Email: _________________________________________ Phone Number: ___________________________
Period Ending SEPTEMBER 30, due on or before OCTOBER 15
SEP
SEP
SEP
2019 DELAWARE TAX RATE: 1.85%
CITY OF DELAWARE INCOME TAX
EMPLOYER’S RETURN OF TAX WITHHELD
I hereby certify that the information and statements
contained herein and in any schedules or exhibits
attached are true and correct.
Print Name: ____________________________________
Signed: ________________________________________
Official Title: ____________________________________
Date: __________________________________________
Make check or money order payable to
CITY OF DELAWARE INCOME TAX
Mail to
City of Delaware Income Tax
PO Box 496
Delaware OH 43015
740-203-1225
This return must be filed on or before the due date shown.
1. Tax withheld on income earned in Delaware
1.
2. Courtesy tax withheld at __________________% (reduced credit rate)
2.
3. Total tax withheld in period for Delaware.
3.
4. Adjustment of tax for prior period (explain on back)
4.
5.
Interest (.58% per month)
5.
6.
Penalty (50% of tax due)
6.
7. TOTAL (including interest and penalty if due)
7.
Delaware Tax ID: ______________ -W FIN: _____________________________
Company Name and Address: __________________________________________________
__________________________________________________
__________________________________________________
Company Email: _________________________________________ Phone Number: ___________________________
Period Ending AUGUST 31, due on or before SEPTEMBER 15
AUG
AUG
AUG
2019 DELAWARE TAX RATE: 1.85%
CITY OF DELAWARE INCOME TAX
EMPLOYER’S RETURN OF TAX WITHHELD
I hereby certify that the information and statements
contained herein and in any schedules or exhibits
attached are true and correct.
Print Name: ____________________________________
Signed: ________________________________________
Official Title: ____________________________________
Date: __________________________________________
Make check or money order payable to
CITY OF DELAWARE INCOME TAX
Mail to
City of Delaware Income Tax
PO Box 496
Delaware OH 43015
740-203-1225
This return must be filed on or before the due date shown.
1. Tax withheld on income earned in Delaware
1.
2. Courtesy tax withheld at __________________% (reduced credit rate)
2.
3. Total tax withheld in period for Delaware.
3.
4. Adjustment of tax for prior period (explain on back)
4.
5.
Interest (.58% per month)
5.
6.
Penalty (50% of tax due)
6.
7. TOTAL (including interest and penalty if due)
7.
Delaware Tax ID: ______________ -W FIN: _____________________________
Company Name and Address: __________________________________________________
__________________________________________________
__________________________________________________
Company Email: _________________________________________ Phone Number: ___________________________
Period Ending JULY 31, due on or before AUGUST 15
JUL
JUL
JUL
click to sign
signature
click to edit
click to sign
signature
click to edit
click to sign
signature
click to edit
2019 DELAWARE TAX RATE: 1.85%
CITY OF DELAWARE INCOME TAX
EMPLOYER’S RETURN OF TAX WITHHELD
I hereby certify that the information and statements
contained herein and in any schedules or exhibits
attached are true and correct.
Print Name: ____________________________________
Signed: ________________________________________
Official Title: ____________________________________
Date: __________________________________________
Make check or money order payable to
CITY OF DELAWARE INCOME TAX
Mail to
City of Delaware Income Tax
PO Box 496
Delaware OH 43015
740-203-1225
This return must be filed on or before the due date shown.
1. Tax withheld on income earned in Delaware
1.
2. Courtesy tax withheld at __________________% (reduced credit rate)
2.
3. Total tax withheld in period for Delaware.
3.
4. Adjustment of tax for prior period (explain on back)
4.
5.
Interest (.58% per month)
5.
6.
Penalty (50% of tax due)
6.
7. TOTAL (including interest and penalty if due)
7.
Delaware Tax ID: ______________ -W FIN: _____________________________
Company Name and Address: __________________________________________________
__________________________________________________
__________________________________________________
Company Email: _________________________________________ Phone Number: ___________________________
Period Ending JUNE 30, due on or before JULY 15
JUN
JUN
JUN
2019 DELAWARE TAX RATE: 1.85%
CITY OF DELAWARE INCOME TAX
EMPLOYER’S RETURN OF TAX WITHHELD
I hereby certify that the information and statements
contained herein and in any schedules or exhibits
attached are true and correct.
Print Name: ____________________________________
Signed: ________________________________________
Official Title: ____________________________________
Date: __________________________________________
Make check or money order payable to
CITY OF DELAWARE INCOME TAX
Mail to
City of Delaware Income Tax
PO Box 496
Delaware OH 43015
740-203-1225
This return must be filed on or before the due date shown.
1. Tax withheld on income earned in Delaware
1.
2. Courtesy tax withheld at __________________% (reduced credit rate)
2.
3. Total tax withheld in period for Delaware.
3.
4. Adjustment of tax for prior period (explain on back)
4.
5.
Interest (.58% per month)
5.
6.
Penalty (50% of tax due)
6.
7. TOTAL (including interest and penalty if due)
7.
Delaware Tax ID: ______________ -W FIN: _____________________________
Company Name and Address: __________________________________________________
__________________________________________________
__________________________________________________
Company Email: _________________________________________ Phone Number: ___________________________
Period Ending MAY 31, due on or before JUNE 15
MAY
MAY
MAY
2019 DELAWARE TAX RATE: 1.85%
CITY OF DELAWARE INCOME TAX
EMPLOYER’S RETURN OF TAX WITHHELD
I hereby certify that the information and statements
contained herein and in any schedules or exhibits
attached are true and correct.
Print Name: ____________________________________
Signed: ________________________________________
Official Title: ____________________________________
Date: __________________________________________
Make check or money order payable to
CITY OF DELAWARE INCOME TAX
Mail to
City of Delaware Income Tax
PO Box 496
Delaware OH 43015
740-203-1225
This return must be filed on or before the due date shown.
1. Tax withheld on income earned in Delaware
1.
2. Courtesy tax withheld at __________________% (reduced credit rate)
2.
3. Total tax withheld in period for Delaware.
3.
4. Adjustment of tax for prior period (explain on back)
4.
5.
Interest (.58% per month)
5.
6.
Penalty (50% of tax due)
6.
7. TOTAL (including interest and penalty if due)
7.
Delaware Tax ID: ______________ -W FIN: _____________________________
Company Name and Address: __________________________________________________
__________________________________________________
__________________________________________________
Company Email: _________________________________________ Phone Number: ___________________________
Period Ending APRIL 30, due on or before MAY 15
APR
APR
APR
click to sign
signature
click to edit
click to sign
signature
click to edit
click to sign
signature
click to edit
2019 DELAWARE TAX RATE: 1.85%
CITY OF DELAWARE INCOME TAX
EMPLOYER’S RETURN OF TAX WITHHELD
I hereby certify that the information and statements
contained herein and in any schedules or exhibits
attached are true and correct.
Print Name: ____________________________________
Signed: ________________________________________
Official Title: ____________________________________
Date: __________________________________________
Make check or money order payable to
CITY OF DELAWARE INCOME TAX
Mail to
City of Delaware Income Tax
PO Box 496
Delaware OH 43015
740-203-1225
This return must be filed on or before the due date shown.
1. Tax withheld on income earned in Delaware
1.
2. Courtesy tax withheld at __________________% (reduced credit rate)
2.
3. Total tax withheld in period for Delaware.
3.
4. Adjustment of tax for prior period (explain on back)
4.
5.
Interest (.58% per month)
5.
6.
Penalty (50% of tax due)
6.
7. TOTAL (including interest and penalty if due)
7.
Delaware Tax ID: ______________ -W FIN: _____________________________
Company Name and Address: __________________________________________________
__________________________________________________
__________________________________________________
Company Email: _________________________________________ Phone Number: ___________________________
Period Ending MARCH 31, due on or before APRIL 15
MAR
MAR
MAR
2019 DELAWARE TAX RATE: 1.85%
CITY OF DELAWARE INCOME TAX
EMPLOYER’S RETURN OF TAX WITHHELD
I hereby certify that the information and statements
contained herein and in any schedules or exhibits
attached are true and correct.
Print Name: ____________________________________
Signed: ________________________________________
Official Title: ____________________________________
Date: __________________________________________
Make check or money order payable to
CITY OF DELAWARE INCOME TAX
Mail to
City of Delaware Income Tax
PO Box 496
Delaware OH 43015
740-203-1225
This return must be filed on or before the due date shown.
1. Tax withheld on income earned in Delaware
1.
2. Courtesy tax withheld at __________________% (reduced credit rate)
2.
3. Total tax withheld in period for Delaware.
3.
4. Adjustment of tax for prior period (explain on back)
4.
5.
Interest (.58% per month)
5.
6.
Penalty (50% of tax due)
6.
7. TOTAL (including interest and penalty if due)
7.
Delaware Tax ID: ______________ -W FIN: _____________________________
Company Name and Address: __________________________________________________
__________________________________________________
__________________________________________________
Company Email: _________________________________________ Phone Number: ___________________________
Period Ending FEBRUARY 28, due on or before MARCH 15
FEB
FEB
FEB
2019 DELAWARE TAX RATE: 1.85%
CITY OF DELAWARE INCOME TAX
EMPLOYER’S RETURN OF TAX WITHHELD
I hereby certify that the information and statements
contained herein and in any schedules or exhibits
attached are true and correct.
Print Name: ____________________________________
Signed: ________________________________________
Official Title: ____________________________________
Date: __________________________________________
Make check or money order payable to
CITY OF DELAWARE INCOME TAX
Mail to
City of Delaware Income Tax
PO Box 496
Delaware OH 43015
740-203-1225
This return must be filed on or before the due date shown.
1. Tax withheld on income earned in Delaware
1.
2. Courtesy tax withheld at __________________% (reduced credit rate)
2.
3. Total tax withheld in period for Delaware.
3.
4. Adjustment of tax for prior period (explain on back)
4.
5.
Interest (.58% per month)
5.
6.
Penalty (50% of tax due)
6.
7. TOTAL (including interest and penalty if due)
7.
Delaware Tax ID: ______________ -W FIN: _____________________________
Company Name and Address: __________________________________________________
__________________________________________________
__________________________________________________
Company Email: _________________________________________ Phone Number: ___________________________
Period Ending JANUARY 31, due on or before FEBRUARY 15
JAN
JAN
JAN
click to sign
signature
click to edit
click to sign
signature
click to edit
click to sign
signature
click to edit