Form Ph W3 – Fill Out and Use This PDF

	Form		City of Port Huron Income Tax	2009
	PH-W3
			Reconciliation of Port Huron Income Tax Withheld
	Instructions are on the reverse side			DUE FEBRUARY 28, 2010
	1.	Total Port Huron tax withheld during the year, as shown on the enclosed withholding statements (W-2's)
	2.	Total number of withholding statements (W-2's) sent with this reconciliation

INSTRUCTIONS FOR FORM PH-W3

1.By the last day of February following each calendar year, you must furnish to the city the following:

a)A completed copy of this form (PH-W3).

b)An information return for each person who had income subject to city tax. The form must state the employee's name, social security number, address, compensation received and city tax withheld. The return must be a copy of the federal W-2 or a form furnished or approved by the city. Employers wishing to file W-2 information via magnetic media are encouraged to do so. Specifications are available from the city on request.

2.Show the total Port Huron tax withheld (as reported on the enclosed forms W-2) on line 1. Show the total tax withheld that you paid to the city on line 4. Detail payments made in the appropriate area of the form. If a difference exists between the tax withheld reported on the W-2's and the total paid to the city, show the difference on line 5. Any underpayment over $1.00 must be paid with this form. Attach a brief statement explaining any overpayment. The city will verify and refund overpayments reported on form PH-W3 .

3. Mail this form, along with Forms W-2 and any payment to:		Income Tax Division
		100 McMorran Boulevard
		Port Huron, MI 48060
Make checks payable to: Treasurer, City of Port Huron.	Questions? please call (810) 984-9741

If you remitted the payments monthly, please list the amounts: