Fillable Form W-3: RETURN CITY OF PORT CLINTON DEPARTMENT

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Form W-3: RETURN CITY OF PORT CLINTON DEPARTMENT

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Owner, Partner, Member, President, Treasurer
Form W-3
CITY OF PORT CLINTON – DEPARTMENT OF TAXATION
1868 East Perry Street, Port Clinton, OH 43452-1499
Voice (419) 734-5522 • Fax (419) 732-6558
1. Number of W-2’s attached ..............$ _________________
2. Number of employees working
in Port Clinton at year end ...............$_________________
3. Total payroll for the year ..................$_________________
4. Less payroll not subject to tax ........$ _________________
Attach explanation
5. Payroll subject to tax .......................$ _________________
6. Withholding tax liability at
1.5% of Line 5.................................$_________________
7. Total Port Clinton tax withheld
per W-2’s .........................................$_________________
January...................$
February .................$
March/Qtr. 1 ...........$
April ........................$
May.........................$
June/Qtr. 2..............$
Total remitted for year .............................................................................$
Difference between Lines 6 & 20 (amount due/overpaid) .......................$
8.
9.
10.
11.
12.
13.
20.
21.
July .........................$
August ....................$
September/Qtr. 3....$
October ..................$
November...............$
December/Qtr. 4.....$
14.
15.
16.
17.
18.
19.
_________________
_________________
_________________
_________________
_________________
_________________
_________________
_________________
_________________
_________________
_________________
_________________
_________________
_________________
FID#
I hereby certify that the information and statements contained herein are
true and correct.
Signed By _________________________________________________________
Date ______________________________________________________________
Print Name ________________________________________________________
Official Title________________________________________________________
Non-resident Employers
Do you withhold tax as a courtesy
or because the employee(s) work(s)
in the City of Port Clinton?
*Refunds are NOT automatically issued.
If refund of overpayment is requested
please attach explantation. If additional
tax is due, enclose payment with return.
Courtesy
Works in Port Clinton
EMPLOYER NAME/ADDRESS
Account No.
Email
Phone
WITHHOLDING TAX RECONCILIATION
RETURN
FOR TAX YEAR
MUST BE RETURNED WITH W-2’S BY THE END OF FEBRUARY
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2015
Please change tax year if necessary
GENERAL INFORMATION
On or before the end of February of each year, each employer must file a withholding reconciliation on the City of Port Clinton Form W-3.
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,
gross 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 Port Clinton tax. The listing shall
require the same type of information as is required on the W-2 form.
Any individual(s) or business entity compensating individuals on a commission or contract labor basis must furnish copies of the
1099 or appropriate earning statement on or before the end of February of each year. All 1099’s or earnings statements shall require the
same type of information as is required on the W-2 forms as stated above.
SPECIFIC FILING INFORMATION
The front of the Form W-3 must show a breakdown of all withholding payments made quarterly, or monthly, in the boxes provided.
Lines 1-7 must be completed. The total tax paid should be equal to 1.5% of line 5. The completed W-3 form and all attachments must be
submitted to the Department of Taxation, City of Port Clinton,1868 East Perry Street, Port Clinton, OH 43452-1499, on or before the end of
February of each year. Any questions in completing the Form W-3 should be referred to the Department of Taxation at (419) 734-5522.
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Form W-3: RETURN CITY OF PORT CLINTON DEPARTMENT

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Completed 10 March 2022

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