MAIL IN SUPPLIED ENVELOPE
HIGHLAND PARK INCOME TAX WITHHELD
IF FINAL RETURN, CHECK HERE AND COMPLETE
QUESTIONS ON THE REVERSE SIDE
1
TITLE DATE
PERIOD
1-1-07 to 3-31-07
DUE ON
4-30-07
IDENTIFICATION NO.
HP941-501
MAKE CHECK
& MAIL TO
CITY OF HIGHLAND PARK
Withholding Payment
P.O BOX 239
EATON RAPIDS, MI 48827-0239
VALIDATION AREA BELOW
AMOUNT WITHHELD
1ST MONTH THIS QTR
1
AMOUNT WITHHELD
2ND MONTH THIS QTR
2
AMOUNT WITHHELD
3RD MONTH THIS QTR
3
TOTAL TAX WITHHELD
THIS QUARTER
4
ADJUSTMENT
5
ADJUSTED TAX
WITHHELD
6
AMOUNT
DUE
7
MAIL IN SUPPLIED ENVELOPE
HIGHLAND PARK INCOME TAX WITHHELD
IF FINAL RETURN, CHECK HERE AND COMPLETE
QUESTIONS ON THE REVERSE SIDE
2
SIGNATURE
TITLE DATE
PERIOD
4-1-07 to 6-30-07
DUE ON
7-31-07
IDENTIFICATION NO.
HP941-501
MAKE CHECK
& MAIL TO
CITY OF HIGHLAND PARK
Withholding Payment
VALIDATION AREA BELOW
AMOUNT WITHHELD
1ST MONTH THIS QTR
1
AMOUNT WITHHELD
2ND MONTH THIS QTR
2
AMOUNT WITHHELD
3RD MONTH THIS QTR
3
TOTAL TAX WITHHELD
THIS QUARTER
4
ADJUSTMENT
5
ADJUSTED TAX
WITHHELD
6
AMOUNT
DUE
7
MAIL IN SUPPLIED ENVELOPE
HIGHLAND PARK INCOME TAX WITHHELD
IF FINAL RETURN, CHECK HERE AND COMPLETE
QUESTIONS ON THE REVERSE SIDE
3
SIGNATURE
TITLE DATE
PERIOD
7-1-07 to 9-30-07
DUE ON
10-31-07
IDENTIFICATION NO.
HP941-501
MAKE CHECK
& MAIL TO
CITY OF HIGHLAND PARK
Withholding Payment
VALIDATION AREA BELOW
AMOUNT WITHHELD
1ST MONTH THIS QTR
1
AMOUNT WITHHELD
2ND MONTH THIS QTR
2
AMOUNT WITHHELD
3RD MONTH THIS QTR
3
TOTAL TAX WITHHELD
THIS QUARTER
4
ADJUSTMENT
5
ADJUSTED TAX
WITHHELD
6
AMOUNT
DUE
7
MAIL IN SUPPLIED ENVELOPE
HIGHLAND PARK INCOME TAX WITHHELD
IF FINAL RETURN, CHECK HERE AND COMPLETE
QUESTIONS ON THE REVERSE SIDE
4
SIGNATURE
TITLE DATE
PERIOD DUE ON
1-31-08
IDENTIFICATION NO.
HP941-501
MAKE CHECK
& MAIL TO
CITY OF HIGHLAND PARK
Withholding Payment
VALIDATION AREA BELOW
AMOUNT WITHHELD
1ST MONTH THIS QTR
1
AMOUNT WITHHELD
2ND MONTH THIS QTR
2
AMOUNT WITHHELD
3RD MONTH THIS QTR
3
TOTAL TAX WITHHELD
THIS QUARTER
4
ADJUSTMENT
5
ADJUSTED TAX
WITHHELD
6
AMOUNT
DUE
7
MAIL IN SUPPLIED ENVELOPE
SIGNATURE
TITLE DATE
CITY OF HIGHLAND PARK–ANNUAL RECONCILIATION•INCOME TAX WITHHELD
DUE ON OR BEFORE IDENTIFICATION NO.
February 28, 2008
RETURN WITH FORMS
W-2 TO
CITY OF HIGHLAND PARK
INCOME TAX
HPW-3
NUMBER OF
W-2’S SUBMITTED
TAX WITHHELD
AS SHOWN ON
ATTACHED W2’S
1
TAX PAID
TOTALS FROM
REVERSE SIDE
2
BALANCE
DUE
PAY IN FULL
THIS RETURN
3
OVERPAYMENT
ATTACH
EXPLANATION
4
1-1-12 to 3-31-12
4-1-12 to 6-30-12
4-30-12
7-31-12
7-1-12 to 9-30-12 10-31-12
10-1-12 to 12-31-12 1-31-13
February 28, 2013
P.O BOX 239
EATON RAPIDS, MI 48827-0239
P.O BOX 239
EATON RAPIDS, MI 48827-0239
P.O BOX 239
EATON RAPIDS, MI 48827-0239
P.O Box 239
Eaton Rapids, MI 48827-0239
SIGNATURE
PHONE #
PHONE #
PHONE #
PHONE #
PHONE #
4-1-12 to 6-30-12
4-30-12
7-31-19
10-31-12
10-1-21 to 12-31-21 1-31-22
7-1-21 to 9-30-21 10-31-21
4-1-21 to 6-30-21 7-31-21
1-1-21 to 3-31-21 4-30-21
2-28-22
1. Last pay period on which Highland Park
taxes were withheld__________________
2. Check reason for “Final Return” and answer
applicable questions:
Business permanently discontinued
Business permanently discontinued
Operations will be resumed on
(Date)___________________________
Still operating - Ceased paying wages.
Wages will be paid starting
(Date)___________________________
Business sold to:
Name __________________________
Street __________________________
City ____________________________
Moved out of Highland Park
3. Your current address:
Street __________________________
City ____________________________
4. Other: __________________________
________________________________
________________________________
1. Last pay period on which Highland Park
taxes were withheld__________________
2. Check reason for “Final Return” and answer
applicable questions:
Business permanently discontinued
Business permanently discontinued
Operations will be resumed on
(Date)___________________________
Still operating - Ceased paying wages.
Wages will be paid starting
(Date)___________________________
Business sold to:
Name __________________________
Street __________________________
City ____________________________
Moved out of Highland Park
3. Your current address:
Street __________________________
City ____________________________
4. Other: __________________________
________________________________
________________________________
1. Last pay period on which Highland Park
taxes were withheld__________________
2. Check reason for “Final Return” and answer
applicable questions:
Business permanently discontinued
Business permanently discontinued
Operations will be resumed on
(Date)___________________________
Still operating - Ceased paying wages.
Wages will be paid starting
(Date)___________________________
Business sold to:
Name __________________________
Street __________________________
City ____________________________
Moved out of Highland Park
3. Your current address:
Street __________________________
City ____________________________
4. Other: __________________________
________________________________
________________________________
1. Last pay period on which Highland Park
taxes were withheld__________________
2. Check reason for “Final Return” and answer
applicable questions:
Business permanently discontinued
Business permanently discontinued
Operations will be resumed on
(Date)___________________________
Still operating - Ceased paying wages.
Wages will be paid starting
(Date)___________________________
Business sold to:
Name __________________________
Street __________________________
City ____________________________
Moved out of Highland Park
3. Your current address:
Street __________________________
City ____________________________
4. Other: __________________________
________________________________
________________________________
_______________________
JANUARY
____________________
FEBRUARY
____________________
MARCH
____________________
QUARTER ENDED MARCH 31 $
_______________________
APRIL
____________________
MAY
____________________
JUNE
____________________
QUARTER ENDED JUNE 30 $
_______________________
JULY
____________________
AUGUST
____________________
SEPTEMBER
____________________
QUARTER ENDED SEPT 30 $
_______________________
OCTOBER
____________________
NOVEMBER
____________________
DECEMBER
____________________
QUARTER ENDED DEC. 31 $
_______________________
TOTAL PAID $ ________
SUMMARY
LIST PAYMENTS MADE WITH HP941/501
EMPLOYERS RETURNS.