General Information

2. Online Payment Information

   Please note that a convenience fee of 2.50% with a minimum of $1.95 for credit cards or $1.50 for echecks will be added to the Withholding Tax payment. When Withholding Tax general information is submitted you will be taken to Forte Payment Systems for on-line payment. The Withholding Tax payment amount and convenience fee will appear as separate charges on your billing statement. You will receive two (2) confirmation emails to complete the Withholding Tax payment and payment process. One (1) verifying Withholding Tax payment general information and one (1) confirming credit card or echeck payment from Forte. If you do not receive two (2) confirmation emails the online process was not completed.

   Please note that a convenience fee of 2.50% with a minimum of $1.95 for credit cards or $1.50 for echecks will be added to the Withholding Tax payment. When Withholding Tax general information is submitted you will be taken to Forte Payment Systems for on-line payment. The Withholding Tax payment amount and convenience fee will appear as separate charges on your billing statement. You will receive two (2) confirmation emails to complete the Withholding Tax payment and payment process. One (1) verifying Withholding Tax payment general information and one (1) confirming credit card or echeck payment from Forte. If you do not receive two (2) confirmation emails the online process was not completed.

4. Business Name*

5. Tax Period Ending*
   -- Select One --1st Quarter - March 31st2nd Quarter - June 30th3rd Quarter - September30th4th Quarter - December 31st

7. City Occupational Account Number*

8. Federal ID Number*

10. Total Number of Local Employees*

11. Total Wages During Period*

13. Tax Due for Period*

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14. 1. Receive an email copy of this form.
15. Email address

    This field is not part of the form submission.

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