Owner, Partner, Member, President, Treasurer
Form MW3
CITY OF GENEVA – INCOME TAX DEPARTMENT
44 NORTH FOREST STREET, GENEVA, OH 44041
PHONE: (440) 466-3913 • www.genevaohio.org
1. Number of W-2’s attached ..............$_________________
2. Number of employees working
in Geneva at year end .....................$_________________
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 Geneva tax withheld
per W-2’s .........................................$_________________
8. Quarter ended March 31 .................$_________________
9. Quarter ended June 30....................$_________________
10. Quarter ended September 30..........$_________________
11. Quarter ended December 31...........$_________________
12. Credits from prior year.....................$_________________
13. Total remitted for year......................$_________________
14. Amount due or overpaid*.................$_________________
Difference between Lines 6 and 13
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) works(s) in the
City of Geneva?
Courtesy
Works in Geneva
*Refunds are NOT automatically issued.
If refund of overpayment is requested
please attach explantation. If additional
tax is due, enclose payment with return.
EMPLOYER NAME/ADDRESS
Account No.
Email
Phone
WITHHOLDING TAX RECONCILIAT ION
RETURN
FOR TAX YEAR
MUST BE RETURNED WITH W-2’S BY THE END OF FEBRUARY
Please change tax year if necessary