2016 CITY OF GRAND RAPIDS INCOME TAX DEPARTMENT

2016 CITY OF GRAND RAPIDS INCOME TAX DEPARTMENT WITHHOLDING TAX SPECIFICATIONS PACKET PUBLISHED ON NOVEMBER 24, 2015 This document contains a final/pr...

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2016 CITY OF GRAND RAPIDS INCOME TAX DEPARTMENT WITHHOLDING TAX SPECIFICATIONS PACKET PUBLISHED ON NOVEMBER 24, 2015 This document contains a final/production version of the Withholding Tax Forms and Specifications authorized by the City of Grand Rapids. These forms are issued pursuant to the Michigan Uniform City Income Tax Ordinance MCL 141.671. Paper submission of questions and return forms approval can be mailed to: John Schaut, Income Tax Administrator City of Grand Rapids Income Tax Department 300 Monroe Ave NW Suite 380 Grand Rapids MI 49503 Electronic submission of questions and return forms approval can be e-mailed to: John Schaut, Income Tax Administrator [email protected]

TABLE OF CONTENTS Revised 10/05/2015

Page 1 Page 2 Page 4

Title Page Table of Contents Instructions for Software Companies Page 4 Michigan Cities Levying an Income Tax Page 4 Michigan Cities Accepting Common Withholding Tax Forms Page 4 Michigan Cities Not Accepting Common Withholding Tax Forms Page 4 General Information Page 5 Governance Page 5 2016 Common Withholding Tax Forms, Schedules and Worksheets Page 5 Listing of Appendices Page 6 Approval of Forms Page 6 Submission of Written Questions or Printed Sample Forms Page 6 Electronic Submission of Questions or Sample Returns Page 5 Printing in Margins Page 6 Printing of Forms Page 6 Extension of Time to File Withholding Tax Return Page 7 Withholding Tax Guide Page 7 Who Must Withhold Page 7 Withholding as a Convenience to Employee Page 7 Registration Page 8 From Whom To Withhold Page 8 Forms CF-W-4 Required Page 9 From What Compensation to Withhold Page 9 Payments Not Subject to Withholding Page 9 Income Tax Rates Page 10 Calculating the amount to Withhold Page 10 Computer Preparation of Payroll Page 11 Resident Employee Who Works in another City Page 11 Nonresident – Job Partly in a City Levying an Income Tax Page 11 Nonresident – Predominate Place of Employment Page 12 Payment of Tax Withheld Page 12 Employer’s Monthly Deposit for the First or Second Month of a Quarter Page 12 Form CF-941- Employer’s Quarterly Return Page 12 Mailing Addresses for Mailing Withholding Tax Returns Page 12 Due Dates Page 13 Correction of Errors Over or Under Reporting Tax Withheld Page 13 Correction of Form W-2 Errors Over or Under Reporting Income Page 13 Annual Reports Page 14 Sale or Discontinuance of Business Page 14 Forms, Instructions and Information Page 14 Disclaimer Notice Page 15 Employer’s Withholding Tax Forms and Instructions Page 15 General Instructions Page 15 Who is Required to Withhold Page 15 Withhold at the Following Tax Rates Page 16 Listing of Forms, Instructions and Monthly and Quarterly Due Dates Page 17 Form CF-6-IT, Notice of Change or Discontinuance Page 18 Forms CF-501 and CF-941, First Quarter Withholding Tax Forms

Page 19 Forms CF-501 and CF-941, Second Quarter Withholding Tax Forms Page 20 Forms CF-501 and CF-941, Third Quarter Withholding Tax Forms Page 21 Forms CF-501 and CF-941, Fourth Quarter Withholding Tax Forms Page 22 Instructions for Forms CF-501 and CF-941 Page 23 Form CF-W-3, Employer’s Annual Reconciliation of Income Tax Withheld Page 24 Form CF-W-3S, Supplement to Employer’s Annual Reconciliation of Income Tax Withheld Page 25 Instructions for Form CF-W-3, Employer’s Annual Reconciliation of Income Tax Withheld and Form CF-W-3S, Supplement to Employer’s Annual Reconciliation of Income Tax Withheld Page 27 Penalty and Interest Worksheet Page 25 Other Withholding Tax Forms Page 28 Form CF-SS-4, Withholding Tax Registration Page 21 Instructions for Form CF-SS-4 Page 33 Form CF-2678, Employee/Payor Appointment of Agent Page 35 Instructions for Form CF-2678, Employee/Payor Appointment of Agent Page 36 Form CF-8655, Reporting Agent Authorization Page 37 Instructions for Form CF-8655, Reporting Agent Authorization Page 38 Form CF-W-4, Employee’s Withholding Certificate Page 39 Form 2848, Power of Attorney Authorization Page 40 Instructions for Form CF-2848, Power of Attorney Authorization Page 41 Appendices Page 41 Appendix A, Withholding Deposit Requirements Page 42 Appendix B, Exemption Amounts and Tax Rates for 2015 Page 43 Appendix C, Personal Exemptions Allowed for 2015 Page 44 Appendix D, Approved City Name Abbreviations to Use for Completing Form W-2, Box 20 Page 45 Appendix E, Mailing Addresses for Mailing Withholding Tax Returns Page 46 Appendix F, Withholding Tax Contacts for Michigan Cities Levying a City Income Tax Page 47 Appendix G, OCR Line Specifications for Withholding Tax Return forms CF-501, CF-941 or CF-W-3 Page 51 Appendix H, Three Character City Name Abbreviation Page 52 Appendix I, Tax ID Check Digit Specifications Page 53 Appendix J, Cities Accepting ACH Debit or Credit Withholding Payments and Return Filing and Cities Accepting Forms W-2 using Common Form CD-ROM Format Page 54 Appendix K, Withholding Tax Sections of the Michigan Uniform City Income Tax Ordinance and the Regulations Adopted by Most Michigan Cities Page 58 Appendix L, Withholding Tax Sections of the Michigan Uniform City Income Tax Ordinance Page 64 Updates, Changes and Corrections to Appendices, Forms, Schedules and Worksheets Page 64 Updates, Changes and Corrections to Appendices, Forms, Schedules and Worksheets

CITY OF GRAND RAPIDS INCOME TAX DEPARTMENT 2016 INCOME TAX WITHHOLDING INSTRUCTIONS FOR SOFTWARE COMPANIES, EMPLOYERS AND PAYROLL PROCESSORS General Information These instructions are to be used with the 2016 withholding tax forms contained in this packet. Additional information may be provided on the individual forms, form instructions or worksheets. Since the Internal Revenue Code was amended relative to professional employee organizations (PEO’s) effective January 1, 2016, Form GR-SS-4, Employers Withholding Registration, has been revised and new Forms GR-2678, Employer/Payor Appointment or Agent, and GR-8655, Reporting Agent Authorization have been added. The cities are, in essence, following the IRC relative to registering as an employer for income tax withholding and for filing returns and paying city income tax withheld. The City of Grand Rapids needs to know: which employers are liable for withholding; which employers are using a reporting agent to file the employer’s withholding tax returns and who the agents are; which employers are using a payor agent who files and pays the employer’s withholding tax returns under the agent’s FEIN; and which employers use a PEO and what the PEO’s responsibilities are under the PEO agreement. Form GR-W-3, Employer’s Annual Reconciliation of Income Tax Withheld, has been revised and reformatted to include the client employer’s name and FEIN when the Form GR-W-3 is filed under the withholding agent’s or CPEO’s FEIN. A new Form GR-W-3S, Supplement to Employer’s Annual Reconciliation of Income Tax Withheld, has been added. Form GR-W-3S is to be filed with form GR-W-3 when either or both of the following conditions exist: the withholding tax has been paid under more than one FEIN; and/or the related Forms W-2 are filed under more than one FEIN.

2016 Grand Rapids Withholding Tax Forms, Schedules and Worksheets Listing of Withholding Tax Guide, Forms and Worksheets  Withholding Tax Guide  Form GR-SS-4, Employer’s Withholding Registration  Form GR-2678, Employer/Payor Appointment of Agent  Form GR-8655, Reporting Agent Authorization  Employer’s Withholding Tax Forms and Instructions Booklet  General Instructions  Listing of Withholding Tax Forms in Booklet and Due Dates for Monthly (Form GR501) Deposits and Quarterly (Form GR-941) Returns  Form GR-6-IT, Notice of Change or Discontinuance  Forms GR-501 and Form GR-941, First Quarter Withholding Tax Forms  Forms GR-501 and Form GR-941, Second Quarter Withholding Tax Forms  Forms GR-501 and Form GR-941, Third Quarter Withholding Tax Forms  Forms GR-501 and Form GR-941, Fourth Quarter Withholding Tax Forms  Form GR-W-3, Employer’s Annual Reconciliation of Income Tax Withheld  Form GR-W-3S, Supplement to Employer’s Annual Reconciliation of Income Tax Withheld

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Instructions for forms GR-501, Employer’s Monthly Deposit of Income Tax Withheld and Form GR-941, Employer’s Quarterly Deposit of Income Tax Withheld  Penalty and Interest Worksheet Form GR-W-3S, Supplement to Employer’s Annual Reconciliation of Income Tax Withheld GR-W-4, Employee’s Withholding Certificate GR-2848, Power of Attorney Authorization

Listing of Appendices Appendix A, Cities Accepting Common Form Withholding Tax Returns, Exemption Amounts and Tax Rates for Tax Year 2016 Appendix B, Personal Exemptions Allowed Appendix C, Withholding Deposit Requirements Appendix D, Authorized City Name Abbreviations to Use for Completing Form W-2, Box 20, Locality Name and Related RS Record Data for EFW2 Transmittals Appendix E, Three Character City Name Abbreviation Mailing Addresses for Mailing Withholding Tax Returns Appendix F, Cities accepting ACH Debit or Credit Withholding Payments and Return Filing and Cities Accepting Forms W-2 using Common Form CD-ROM Format Withholding Tax Contacts for Michigan Cities Levying a City Income Tax Appendix G, Mailing Addresses for Mailing Returns to Cities Accepting the Withholding Tax Common Form Appendix H, Withholding Tax Contacts for Michigan Cities Levying a City Income Tax Appendix I, OCR Line Specifications for Withholding Tax Return forms GR-501, GR-941 or GR-W-3 Appendix J, Tax ID Check Digit Specifications Appendix K, Specifications for Employer Electronic Media Filing of City Forms W-2 Appendix L, Withholding Tax Sections of the Michigan Uniform City Income Tax Ordinance and the Regulations Adopted by Most Michigan Cities

Approval of Forms The Common Form as produced by software must be submitted for approval to the Income Tax Administrator of the City of Grand Rapids. For 2016, submission of completed set sample forms for a scanning test is required.

Submission of written questions or sample returns can be mailed to: John Schaut, Income Tax Administrator City of Grand Rapids Income Tax Department 300 Monroe Ave NW Suite 380 Grand Rapids, MI 49503 Phone: Fax: E-mail:

(616) 456-3823 (616) 456-4540 [email protected]

Electronic submission of questions or sample returns can be e-mailed to: John Schaut, Income Tax Administrator E-mail: [email protected]

Printing in Margins The printing of any information including taxpayer, preparer identification, firm identification and/or account information in the left, right, top and bottom margins of any return form, worksheet, schedule or voucher submitted to a city for processing is absolutely prohibited.

Printing of Forms The following forms are to be printed as laid out in the forms packet: GR-501, Employer’s Monthly Deposit of Income Tax Withheld GR-941, Employer’s Quarterly Return of Income Tax Withheld GR-W-3, Employer’s Annual Reconciliation of Income Tax Withheld GR-SS-4, Employer’s Withholding Registration GR-W-4, Employee’s Withholding Certificate GR-2848, Power of Attorney Authorization

Extension of Time to File a Withholding Tax Return No extensions of time are allowed relative to filing a return and making payment of income tax withheld. Revised 10/15/2015

CITY OF GRAND RAPIDS INCOME TAX DEPARTMENT WITHHOLDING TAX GUIDE Revised 10/15/2015

WHO MUST WITHHOLD An employer who: has a location in the city; or is “doing business” in the city, even though the employer has no location in the city; is required to withhold the city’s income tax from wages paid to employees. An employer is any “individual, partnership, association, corporation, nonprofit organization, governmental body or unit or agency, or any other entity that employs one or more persons on a salary, bonus, wage, commission or other basis, whether or not the employer is in a business.” Starting January 1, 2016 as a result of an amendment to IRC Sec. 3511(a)(1), a professional employer organization (PEO): 1. Who is recognized by the Internal Revenue Service (IRS) as a certified professional employer organization (CPEO); 2. Has a PEO agreement with a client employer: a. Who has a location in the city or is “doing business” in the city; b. Under which the PEO is responsible for withholding and paying income tax withheld from the client’s employees; 3. Meets the definition of employer under the Michigan Uniform City Income Tax Ordinance (MCL 141.606(2)); 4. Is considered to be a co-employer of the employees covered by the PEO agreement and the client is also considered to be a co-employer of such employees. 5. Is responsible for withholding the city income tax from wages paid to employees; and 6. Is liable for filing returns and payment of the income tax withheld or the income tax that should have been withheld from employee wages. Example: A construction company from Ohio doing work in a city levying an income tax is required to withhold tax for that city even though it has no business location in the city. An employer who is required to withhold tax for a city must withhold tax from all employees working in that city and from all residents of that city working anywhere for that employer. A nonprofit organization in the city is required to withhold from its employees (even though it is not engaging in business activity in the usual sense). WITHHOLDING AS A CONVENIENCE TO EMPLOYEE The City of Grand Rapids encourages employers not required to withhold tax to register and withhold for the convenience of their employees who are residents of that city. Convenience withholders must comply with the registration and filing requirements of the City’s Income Tax Ordinance. REGISTRATION Every employer required to withhold income tax for the city must register by filing Form GR-SS-4, Employer’s Withholding Registration with the city. The registration requirement applies to a CPEO responsible for withholding city income tax under an agreement with an employer who has a location in the city or is “doing business” in the city. The employer’s account number is their federal employer identification number (FEIN) followed by an uppercase W. An employer must immediately advise the city of a newly assigned FEIN by filing a Notice of Change or Discontinuance, Form GR-6-IT.

Employers using a reporting agent, an IRC Section 3504 Agent, or a PEO must file additional forms to provide information and disclosure of information to the payroll service provider. Reporting Agent and Form GR-8655 Employers using a reporting agent must file Form GR-8655, Reporting Agent Authorization, with the city to authorize the reporting agent to: sign and file withholding tax returns; make deposits and payments of withholding tax; receive or request copies of tax information and other communications from the city income tax department; and receive otherwise confidential taxpayer information from the city to assist in responding to certain city income tax notices relating to the Form W-2 series of information returns. The employer’s withholding tax is paid and all withholding tax forms are filed under the employer’s FEIN. An employer using this type of reporting agent is solely liable for the filing of withholding tax returns and payment of the withholding tax due. IRC Section 3504 Agent and Form GR-2678 An employer and a third party may file Form GR-2678, Employer/Payor Appoint of Agent, to authorize the third party as an agent of the employer under IRC section 3504, and for the third party to accept the appointment and become the employer’s agent. Under this section of the IRC, the employer is authorizing the city income tax department to disclose otherwise confidential tax information to the agent relating to the authority granted under this appointment, including disclosures required to process Form GR-2678. The agent may contract with a third party, such as a reporting agent or certified public accountant, to prepare or file the returns covered by this appointment, or to make any required deposits and payments. Such contract may authorize the city income tax department to disclose confidential tax information of the employer/payer and agent to such third party. If a third party fails to file the returns or make the deposits and payments, the agent and employer/payer remain liable. Professional Employer Organization PEO Prior to January 1, 2016 there is only one type of PEO, depending on the agreement with their client employer, which may or may not be a payroll service provider, a reporting agent or an IRC Section 3504 agent. After December 31, 2015 there are two types of PEOs. A certified PEO, one certified under IRC Sec. 3511(a)(1), and an uncertified PEO. Information about a CPEO is found at the beginning of this booklet under the heading, “Who Must Withhold.” An uncertified PEO is like all PEOs prior to January 1, 2016 as noted in the above paragraph. A completed registration, Form GR-SS-4, may be filed via E-mail, Fax or U.S. Mail. The e-mail address is [email protected], the Fax number is (616) 456-4540 and the mailing address is City of Grand Rapids Income Tax Dept. PO Box 347, Grand Rapids, MI 49501-0347. FROM WHOM TO WITHHOLD Employers are required to withhold from the following employees: 1) All residents of the city whether or not they work in the city; and 2) All nonresidents of the city who have the city as their predominant place of employment (see below). An employee is defined as “a person from whom an employer is required to withhold for either federal income tax or social security taxes” (MCL141.606(1). FORM GR-W-4 REQUIRED To determine each employee’s place of residence and predominant place of employment, an employer must have each employee fill out an Employee’s Withholding Certificate, Form GR-W-4. Only one Form GR-W-4 is required for each employee, even though the employee may be subject to withholding for two cities.

When properly filled out, Form GR-W-4 provides the employee’s city of residence and the two cities or communities in which the employee earns the greatest percentage of compensation from the employer. Most employees will only have one city of employment and will check the box indicating 100% as the percentage of compensation earned in that city. Form GR-W-4 is also the employee’s statement of the number of personal and dependency exemptions claimed. Form GR-W-4 is available on the city’s website. The website address for each city is listed in Appendix H. If an employee fails or refuses to complete Form GR-W-4 upon the request of the employer, tax shall be withheld from the employee’s compensation at the city’s resident tax rate. If the information submitted by an employee is not believed to be true, correct and complete, the city income tax department must be advised. Do not mail GR-W-4 forms to the city; these are for the employer’s use and must be retained in the employer’s files. FROM WHAT COMPENSATION TO WITHHOLD The Michigan Uniform City Income Tax Ordinance requires income tax be withheld from: 1) All compensation (salaries, wages, commissions, severance pay, bonuses, etc.) of a resident employee for services rendered or work performed regardless of whether such services or work are performed in or out of the city; and 2) All compensation of a nonresident employee for services rendered or work performed in the city where the city is the employee’s predominant place of employment. Vacation, holiday, sick, severance, bonus, etc. pay paid to a nonresident employee who performs part but not all of their work or services in the city are taxable to the same extent that their normal compensation is taxable. Example: A nonresident employee who is subject to withholding on 60% of their earnings, because 60% of their work is performed in a city levying a income tax, is also subject to withholding on 60% of their vacation, holiday, sick pay, severance pay, bonus, etc. pay. Wage payments during periods of sickness are also taxable. PAYMENTS NOT SUBJECT TO WITHHOLDING Withholding does not apply to: 1) Wages paid to domestic help; 2) Fees paid to independent contractors who are not employees; 3) Payments to nonresident employees for work or services performed in the city, if the predominant place of employment is not in that city; 4) Payment to a nonresident employee for work or services rendered outside of the city; 5) Pensions, annuities, worker’s compensation and similar benefits; 6) Amounts paid for sickness, personal injury or disability (so called excludable sick pay) to the same extent that these amounts are exempt from federal income tax, but the employer must withhold from such payments if federal tax is withheld; 7) Amounts paid to an employee as reimbursement for expenses incurred in performing services. An individual with income described in items 1, 2 and 3 above is not subject to withholding on such income. The individual is nevertheless required to file an annual return and report such income if the individual is a resident of a city levying an income tax, or is a nonresident earning such income in a city levying an income tax. INCOME TAX RATES The resident tax rate is 1.5% and the nonresident tax rate is 0.0075%.

CALCULATING THE AMOUNT TO WITHHOLD The amount of city income tax to withhold is a straight percentage on compensation after an adjustment for personal and dependency exemptions. The personal exemptions amount is $600. The dependency exemptions allowed by the city is the same as allowed for federal income tax purposes. For the various pay periods the exemption value is divided by the number of pay periods in a year. Some examples follow: Exemption Value $600.00 ` Weekly (52) $11.54 Bi-weekly (26) $23.08 Semi-monthly (24) $25.00 Monthly (12) $50.00 Per diem (365) $ 1.64 Personal exemptions are allowed for the employee and spouse. Additional personal exemptions are allowed for an employee or spouse who is: 65 years of age or older; blind (this is different from the federal rule); deaf; .or permanently disabled. An employee or spouse who is 65 years of age or older may not claim the additional personal exemption for being permanently disabled. Dependency exemptions are allowed to the same extent allowed for federal income tax purposes. The amounts in the preceding table are used to adjust gross pay for payroll withholding. The adjustment is the number of exemptions on Form GR-W-4 multiplied by the exemption value of the city. For a weekly payroll for an employee with three (3) exemptions working in a city with an exemption value of $600, the adjustment is 3 times $11.54, or $34.62. EXAMPLE: Gross pay is $200.00 per week and the employee is a resident of Grand Rapids with 3 exemptions. The amount from which tax is to be withheld is $200.00 (gross pay) less $34.62 (exemption amount) or $165.38. Apply the 1.5% resident tax rate (.015 times $165.38) and withhold $2.48 from the employee for this week’s compensation. For bonuses or other taxable earnings paid in addition to regular payroll, do not adjust for exemptions. Withhold the correct tax percentage from the entire bonus or other taxable earnings amount. COMPUTER PREPARATION OF PAYROLL Since hardware and software used to compute income tax withholding varies, it is impossible to give an actual program with which to compute withholding. The following is a description of the most commonly used method to compute the amount of tax to withhold. 1. Nonresident employee withholding calculation a. Compute the employee’s gross wages from which to withhold: i. Use gross earnings of the employee for work performed in the nonresident city; or ii. Use total gross earnings for the payroll period multiplied by the percent earned in the nonresident city; b. Multiply the employee’s number of exemptions by the appropriate exemption value for the city for the payroll period: c. Subtract the result of Step b from the result of Step a. d. Compute the amount of tax to withhold by multiplying the result from Step c by the nonresident tax rate for the city. 2. Resident employee withholding calculation a. Compute the employee’s gross earnings for the payroll period. b. Multiply the employee’s number of exemptions by the appropriate exemption value for the city for the payroll period; c. Subtract the result of Step b from the result of Step a; d. Multiply the result from Step c by the resident tax rate for the city.

e. If the employee worked in another city levying an income tax compute the credit for tax withheld for the other city; (This credit cannot exceed the amount of tax which would be withheld by the resident city using the nonresident tax rate of the resident city on the same amount of gross earnings of the employee for work performed in the nonresident city.) f. Compute the amount of tax to withhold by subtracting the result of Step e from the result of Step d. RESIDENT EMPLOYEE WHO WORKS IN ANOTHER CITY LEVYING AN INCOME TAX When an employee who is a resident of a city levying an income tax works at a job in another city levying a city income tax, the employer must withhold separately for both cities. The amount of income tax to withhold for the resident city depends on the credit allowed for the tax withheld for the other city. If the nonresident tax rate of the other city is less than or equal to the nonresident tax rate of the resident city, the amount to withhold for the resident city is calculated by computing the normal resident city withholding and then subtracting the amount of tax withheld for the other city. If the nonresident tax rate of the other city is greater than the nonresident tax rate of the employee’s resident city, the amount to withhold for the employee’s resident city is calculated by computing the normal resident city withholding and then subtracting an amount calculated by multiplying gross pay taxable in the other city by the resident city’s nonresident tax rate. NONRESIDENT – JOB PARTLY IN A CITY LEVYING AN INCOME TAX If a nonresident of the city works less than 100% of the time within the city for an employer, the amount withheld should be based only on wages earned in the city. If gross pay is $200.00 and only 60% of the employee’s work is in city, the gross pay for the city’s tax purposes is 60% of $200.00 or $120.00. In this example, compute the amount to be withheld for the nonresident city as if the employee earned $120.00 gross pay. NONRESIDENT – PREDOMINANT PLACE OF EMPLOYMENT A nonresident of a city levying an income tax is subject to withholding only when the city is the nonresident employee’s predominant place of employment. The Ordinance defines predominant place of employment as “that city imposing a tax under a uniform city income tax ordinance other than the city of residence, in which the employee estimates he will earn the greatest percentage of his compensation from the employer, which percentage is 25% or more.” See example below. A city is a nonresident’s predominant place of employment if: 1) The nonresident employee earns a greater percentage of his or her compensation in the city than any other city levying an income tax, except the employee’s city of residence; and 2) This greater percentage of his or her compensation in the city constitutes 25% or more of the nonresident employee’s total compensation from the employer. PAYMENT OF TAX WITHHELD Monthly or quarterly deposit (payment) of the tax withheld may be made in the following ways: 1. Via U.S mail or courier with the filing of a monthly or quarterly withholding tax return form; 2. ACH debit using the city’s withholding tax tool; 3. ACH credit with an addendum file through the employer’s bank. 4. Credit card. For ACH direct debit payments, instructions are available on the city’s website. For ACH credit payments, registration is required and a set up by the Income Tax Department is necessary. For cities accepting credit card payments, contact the city for instructions. Monthly and quarterly payment forms are available on the city’s website.

Grand Rapids like most cities does not mail withholding forms to employers. If withholding tax forms are needed, contact the Income Tax Dept. Withholding Tax Section. Grand Rapids provides preidentified withholding tax forms through use of their Withholding Tax Tool. Refer to the city’s website to see if and how to get pre-identified forms. EMPLOYER’S MONTHLY DEPOSIT FOR THE FIRST OR SECOND MONTH OF A QUARTER Many cities require monthly deposit of tax withheld for the first or second month of a quarter in which the tax withheld for the month exceeds $100.00. Employers who make a deposit for a month must use Form GR-501, Employer’s Monthly Deposit. FORM GR-941 - EMPLOYER’S QUARTERLY RETURN Every employer must file a Form GR-941, Employer’s Quarterly Return of Income Tax Withheld, for each calendar quarter. Form GR-941 must be filed even if no tax was withheld during a quarter or when all tax withheld was previously paid on Forms GR-501 for the quarter. The amount to remit with Form GR-941 is the amount tax withheld for the quarter not previously deposited for the first or second month of the quarter. MAILING ADDRESSES FOR MAILING WITHHOLDING TAX RETURNS The City’s mailing address is Grand Rapids Income Tax Dept. PO Box 347, Grand Rapids, MI 49501037. All checks, money orders, etc. in payment of withholding taxes should be made payable to City of Grand Rapids. All payments must be submitted with a monthly or quarterly withholding tax form. DUE DATES Each withholding deposit is due on the last day of the month following the month in which the tax withheld exceeds $100. Each quarterly return is due on the last day of the month following the end of the quarter. Example: GR-501 Monthly Deposit for January is due February 28 (or 29 if a leap year). GR-501 Monthly Deposit for February is due March 31. GR-941 Quarterly Return for 1st calendar quarter is due April 30. When the due date of a deposit or return falls on a Saturday, Sunday or holiday the due date is automatically extended to the next business day. CORRECTION OF ERRORS OVER OR UNDER REPORTING TAX WITHHELD Employer Errors Employer’s errors over or under withholding of tax or reporting tax withheld should be corrected as follows: 1) If an error is discovered in the same quarter in which it was made, the employer shall make the necessary adjustment in a subsequent withholding payment within the quarter. (Report the corrected amount of tax withheld on the quarterly return.) 2) If an error is discovered in a subsequent quarter of the same calendar year, the employer shall make the necessary adjustment in a subsequent withholding payment and include it as an adjustment on the next quarterly return. (Report the corrected amount of tax withheld on the quarterly return.) 3) If an error is discovered after the end of the year but before W-2 forms are issued to employees, the employer shall make the necessary adjustment when filing Form GR-W-3 and: a) Pay any additional withholding tax due with Form GR-W-3; or b) Report the overpayment of tax withheld on Form GR-W-3 by reporting that the withholding tax paid is greater than the total tax withheld as reported on the enclosed Forms W-2, and

include a separate written request for refund of the overpayment with a specific explanation of the error(s) causing the overpayment of tax withheld. Overpayments of withholding will not be credited toward tax due in a subsequent year. 4) If an error of underreporting tax withheld is discovered in a subsequent year after the issuance of Forms W-2 to employees, the employer shall notify the Income Tax Department of the error by filing an amended GR-W-3, including a copy of the corrected Form(s) W-2C issued to employee(s), and pay any additional withholding tax due with the amended Form GR-W-3. 5) If an error of over reporting tax withheld on a Form W-2 is discovered, the city will not refund the over withheld tax. The employer should seek to recover the over reported tax withheld from their employee. Employee Errors If an error causing over withholding of tax is due to an employee’s error or any reason other than an employer’s error, the employer shall neither refund the excess tax withheld to the employee nor offset the excess tax withheld by under withholding in a subsequent period. Example: an employee fails to timely provide employer with a Form GR-W-4. The employer is required to withhold tax from wages to the employee at the resident tax rate. The employee subsequently provides a properly completed form GR-W-4. The employer should start withholding at the correct tax rate from the date the Form GR-W-4 is received from the employee. The employer may not go back and correct the over withholding caused by the employees failure to file a timely Form GR-W-4. Another example is an employee claiming fewer exemptions than allowed filing a new Form CFW-4 to increase the number of exemptions. The increase number of exemptions may only affect withholding going forward from the date the new Form GR-W-4 was filed. CORRECTION OF FORM W-2 ERRORS OVER OR UNDERREPORTING INCOME An employer is required to file an amended Form GR-W-3 upon issuance of a Form W-2C to an employee correcting the reporting of: Box 1, wages; Box 11, nonqualified plans; or Box 16, wages. A copy of Form(s) W-2C must be submitted with the amended Form GR-W-3. ANNUAL REPORTS An Employer’s Annual Reconciliation of Income Tax Withheld, Form GR-W-3, is required to be filed by last day of February of the following year. A W-2 form for each employee subject to the city’s income tax withholding must be included with Form GR-W-3. Form GR-W-3 is included in the annual withholding tax booklet and is also available on each city’s website. A copy of Form W-2 issued to each employee subject to the city’s income tax must be filed whether the tax was withheld or not. The Form W-2 must provide the following information: 1) The name, address and federal identification number of the employer. 2) The name, home address and social security number of the employee. 3) The total gross wages paid the employee for the year even if the total wages did not have the tax withheld for the city. 4) The total tax withheld for the city for the year. The amount of tax withheld must be clearly labeled as being the city’s income tax withheld, and the city must be properly identified in the locality name box on the Wage and Tax Statement, Form W-2. Failure to properly and clearly identify the city for which the tax was withheld in the locality box of Form W-2 makes the form unacceptable. An improperly identified city in the locality name box of Form W-2 does not satisfy the withholding tax reporting requirements of the income tax ordinance of the city, and will not be accepted as the basis for a tax payment or refund when attached to an individual’s income tax return for the city.

Employers wishing to purchase one of the commercially available W-2 forms in order to combine the city, state and federal reporting in one operation are permitted to do so, provided one copy is submitted to the city by the employer. Grand Rapids accepts filing of employer’s Forms W-2 via CD-ROM in lieu of paper Forms W-2. Information and specifications for filing via CD-ROM are available on the city’s website. SALE OR DISCONTINUANCE OF BUSINESS An employer who sells or discontinues business must file a Notice of Change or Discontinuance. This form is included in the annual withholding tax forms booklet and also available on each city’s website. An employer who goes out of business or permanently ceases to be an employer must file Forms W-2 and a GR-W-3 by the date the final withholding payment is due. FORMS, INSTRUCTIONS AND INFORMATION Income tax forms, instructions and additional information are available on the city’s website. Withholding Tax Tables are available as a separate document on the city’s website. Each city provides withholding tax assistance on their website and via telephone. Copies of the Ordinance and the Rules and Regulations adopted by each city are usually available from the City Clerk’s office. Usually a city’s income tax ordinance is available from each city’s website under the City Clerk’s menu item Municipal Code, search for “income tax” to get to the ordinance. The Michigan Uniform City Income Tax Ordinance (MCL 141.601 et seq.) is available on the Michigan Legislature website at http://www.legislature.mi.gov. Search for “city income tax” under the Michigan Compiled Laws Search, MCL Content, next click on “Act 284 of 1964” (it should be the top item) and then click on Document “284-1964-2” to get to the Michigan Uniform City Income Tax Ordinance. Note that Document “284-1964-3” contains the alternative sections of the ordinance. DISCLAIMER NOTICE These instructions are interpretations of the Michigan Uniform City Income Tax Ordinance as adopted by the city. The city’s ordinance will prevail in any disagreement between the tax forms, instructions, information, etc. and each city’s ordinance.

RETURN TO: GRAND RAPIDS INCOME TAX} PO BOX 347 GRAND RAPIDS, MI 49501-0347 ADDRESS SERVICE REQUESTED

MAIL TO:

2016 CITY OF GRAND RAPIDS 2016 EMPLOYER'S WITHHOLDING TAX FORMS AND INSTRUCTIONS ONLINE FILING AND PAYMENT OF WITHHOLDING TAX SOME CITIES ALLOW ONLINE FILING OF EMPLOYER WITHHOLDING TAX WITH ELECTRONIC DIRECT DEBIT PAYMENT OF TAX DUE. SEE APPENDIX F FOR A LISTING OF THESE CITIES AND, GO TO THEIR WEBSITE FOR INSTRUCTIONS. WHO IS REQUIRED TO WITHHOLD? Every employer who: 1. Has a location in the city; or 2. Is doing business in the city.

QUESTIONS? CALL (616) 456-4083 OR VISIT www.grcity.us/taxforms

WITHHOLD AT THE FOLLOWING TAX RATE: 1. For a resident of the city withhold at the resident tax rate for an employee who: a. Works in the city; or b. Works outside the city but is not subject to withholding for the city where they work. 2. For a resident of the city working another city levying a city income tax: a. Calculate the amount to withhold at the resident tax rate on all wages paid to the employee; b. Calculate the amount of tax to withhold on the employee’s wages subject to withholding by the other city; c. Subtract the lesser of the actual tax withheld from the employee in step b or one-half of the tax calculated in step a from the amount of withholding calculated in step a. d. The amount calculated in step c is the amount to withhold for the employee’s city of residence. 3. For a nonresident of the city withhold at the nonresident tax rate on wages paid to the employee for work performed in the city.

2016 W-2 FORMS WILL BE ACCEPTED VIA ELECTRONIC MEDIA (CD-ROM). FOR SPECIFICATIONS AND INFORMATION REGARDING ELECTRONIC MEDIA FILING, GO TO THE CITY’S WEBSITE FOR INSTRUCTIONS.

City of Grand Rapids Income Tax Department 2016 INCOME TAX WITHHOLDING FORMS AND INSTRUCTIONS THIS BOOKLET CONTAINS THE FOLLOWING FORMS AND INSTRUCTIONS: A. B. C. D. E. F.

Notice of Change or Discontinuance (Form GR-6-IT). Employer’s Monthly Deposit of Income Tax Withheld, Form GR-501 (used for making monthly deposit of tax withheld for the first or second month of a quarter). Employer’s Quarterly Return of Income Tax Withheld, Form GR-941 (used to report income tax withheld during the quarter not previously deposited for the first or second month of the quarter). Employers Annual Reconciliation of Income Tax Withheld, Form CFW-3. The reconciliation must be filed on or before the last day of February of the subsequent tax year. Instructions for Form GR-501, Employer’s Monthly Deposit of Income Tax Withheld, and Form GR-941, Employer’s Quarterly Return of Income Tax Withheld. Penalty and Interest Worksheet.

The city requires monthly deposit for the first and/or second month of a quarter when the total amount of tax withheld for the city during the month exceeds $100.00 and quarterly deposit of all tax withheld during the quarter not deposited during the first or second month of the quarter.

IF TAX WITHHELD DURING A MONTH EXCEEDS $100 MONTHLY DEPOSITS, FORM GR-501, ARE DUE AS FOLLOWS: MONTH JANUARY FEBRUARY APRIL MAY

DUE DATE 02/28/2016 03/31/2016 05/31/2016 06/30/2016

MONTH JULY AUGUST OCTOBER NOVEMBER

DUE DATE 08/31/2016 09/30/2016 11/30/2016 12/31/2016

QUARTERLY RETURNS, FORM GR-941, ARE DUE AS FOLLOWS: QUARTER FIRST SECOND

DUE DATE 04/30/2016 07/31/2016

QUARTER THIRD FOURTH

DUE DATE 10/31/2016 01/31/2017

When the due date of a deposit or return falls on Saturday, Sunday or holiday the due date is automatically extended to the next business day. PREPARING W-2 FORMS – IF FORM W-2, BOX 20 IS LEFT BLANK OR DOES NOT CLEARLY IDENTIFY THE LOCALITY NAME, YOUR EMPLOYEE WILL EXPERIENCE A DELAY IN THE PROCESSING OF THEIR RETURN. THE ABBREVIATION FOR LOCALITY NAME IN BOX 20 IS MIGRR.

GR-6-IT

GRAND RAPIDS

Rev. 11/16/2014

Income Tax Department

NOTICE OF CHANGE OR DISCONTINUANCE ACCOUNT NUMBER (FEIN)

CHANGES EFFECTIVE ON (Date)

CURRENT LEGAL NAME

CHANGE LEGAL NAME TO:

DBA

CHANGE DBA TO:

CURRENT LEGAL BUSINESS ADDRESS

CHANGE LEGAL BUSINESS ADDRESS TO:

MAILING ADDRESS

CHANGE MAILING ADDRESS TO:

Instructions: Place an “X” in all boxes that apply. Complete all information for the change. Write any comments or explanations on back of form.

 1. The Internal Revenue Service assigned us Federal Employer Identification Number:  2. Our Federal Employer Identification Number is wrong. The correct number is:  3. We have incorporated. Our corporate name is:  4. Our new corporate Federal Employer Identification Number is:  5. Discontinue our withholding tax registration:  a. We no longer have any business activity in the City of GRAND RAPIDS.  b. We closed our business on:  c. We sold our  e. We sold our business to: entire business on:

 d. We sold part of our business on:

Their FEIN is:

 6. Address and phone number where we may be reached following discontinuance of business: Contact person

Street address

City

State

Zip Code

Phone no.

 7. Change in ownership. (Please explain on back)  8. Effective

, we changed our fiscal year ending from Month/Year

 9. Other changes. (Please explain on back SIGNATURE OF PREPARER

PRINTED NAME OF PREPARER

to Month

DATE PREPARED

Month PREPARER’S PHONE NUMBER

( MAIL TO: GRAND RAPIDS INCOME TAX DPT. PO BOX 347, GRAND RAPIDS, MI 49501-0347

)

GR-501

GRAND RAPIDS INCOME TAX DEPARTMENT EMPLOYER'S MONTHLY DEPOSIT OF INCOME TAX WITHHELD

DO NOT WRITE

1. IDENTIFICATION NUMBER

IN SPACE BELOW

«acct »

2. DEPOSIT PERIOD

JAN 2016

3. DUE ON OR BEFORE

941 01M

4. WITHHOLDING TAX DEPOSIT

02/28/2016

TAXPAYER

MONTHLY DEPOSIT REQUIRED IF TAX WITHHELD DURING THE FIRST MONTH OF QUARTER EXCEEDS $100

«name» «address» «city state zip»

SIGNATURE

DATE

PRINTED NAME OF SIGNER

TITLE

PAY TO:

CITY OF GRAND RAPIDS

MAIL TO:

{Address per Appendix G}

{3 digit city name abbreviation, Appendix E}«acct_»W«ckdig»201694101M

GR-501 DO NOT WRITE IN SPACE BELOW TAXPAYER

GRAND RAPIDS INCOME TAX DEPARTMENT EMPLOYER'S MONTHLY DEPOSIT OF INCOME TAX WITHHELD 1. IDENTIFICATION NUMBER

2. DEPOSIT PERIOD

«acct »

FEB 2016

3. DUE ON OR BEFORE

941 02M

4. WITHHOLDING TAX DEPOSIT

03/31/2016 MONTHLY DEPOSIT REQUIRED IF TAX WITHHELD DURING THE SECOND MONTH OF QUARTER EXCEEDS $100

«name» «address» «city state zip»

SIGNATURE

DATE

PRINTED NAME OF SIGNER

TITLE

PAY TO:

CITY OF GRAND RAPIDS

MAIL TO:

{Address per Appendix G}

{3 digit city name abbreviation, Appendix E}«acct_»W«ckdig»201694102M

GR-941 DO NOT WRITE IN SPACE BELOW TAXPAYER

GRAND RAPIDS INCOME TAX DEPARTMENT EMPLOYER'S QUARTERLY RETURN OF INCOME TAX WITHHELD 1. IDENTIFICATION NUMBER

«acct »

2. DEPOSIT PERIOD

ST

1

QTR 2016

3. DUE ON OR BEFORE

941 01Q

4. WITHHOLDING TAX DEPOSIT

04/30/2016 QUARTERLY DEPOSIT REQUIRED FOR BALANCE OF TAX WITHHELD DURING QUARTER THAT WAS NOT DEPOSITED FOR FIRST OR SECOND MONTH OF QUARTER

«name» «address» «city state zip»

SIGNATURE

DATE

PRINTED NAME OF SIGNER

TITLE

PAY TO:

CITY OF GRAND RAPIDS

MAIL TO:

{Address per Appendix G}

{3 digit city name abbreviation, Appendix E}«acct_»W«ckdig»201694101Q

GR-501

GRAND RAPIDS INCOME TAX DEPARTMENT EMPLOYER'S MONTHLY DEPOSIT OF INCOME TAX WITHHELD

DO NOT WRITE

1. IDENTIFICATION NUMBER

IN SPACE BELOW

«acct »

2. DEPOSIT PERIOD

APR 2016

3. DUE ON OR BEFORE

941 04M

4. WITHHOLDING TAX DEPOSIT

05/31/2016

TAXPAYER

MONTHLY DEPOSIT REQUIRED IF TAX WITHHELD DURING THE FIRST MONTH OF QUARTER EXCEEDS $100

«name» «address» «city state zip»

SIGNATURE

DATE

PRINTED NAME OF SIGNER

TITLE

PAY TO:

CITY OF GRAND RAPIDS

MAIL TO:

{Address per Appendix G}

{3 digit city name abbreviation, Appendix E}«acct_»W«ckdig»201694104M

GR-501 DO NOT WRITE IN SPACE BELOW TAXPAYER

GRAND RAPIDS INCOME TAX DEPARTMENT EMPLOYER'S MONTHLY DEPOSIT OF INCOME TAX WITHHELD 1. IDENTIFICATION NUMBER

2. DEPOSIT PERIOD

«acct »

MAY 2016

3. DUE ON OR BEFORE

941 05M

4. WITHHOLDING TAX DEPOSIT

06/30/2016 MONTHLY DEPOSIT REQUIRED IF TAX WITHHELD DURING THE SECOND MONTH OF QUARTER EXCEEDS $100

«name» «address» «city state zip» PAY TO: MAIL TO: SIGNATURE

DATE

PRINTED NAME OF SIGNER

TITLE

CITY OF GRAND RAPIDS {Address per Appendix G}

{3 digit city name abbreviation, Appendix E}«acct_»W«ckdig»201694105M

GR-941 DO NOT WRITE IN SPACE BELOW TAXPAYER

GRAND RAPIDS INCOME TAX DEPARTMENT EMPLOYER'S QUARTERLY RETURN OF INCOME TAX WITHHELD 1. IDENTIFICATION NUMBER

«acct »

2. DEPOSIT PERIOD ND

2

QTR 2016

3. DUE ON OR BEFORE

941 02Q

4. WITHHOLDING TAX DEPOSIT

07/31/2016 QUARTERLY DEPOSIT REQUIRED FOR BALANCE OF TAX WITHHELD DURING QUARTER THAT WAS NOT DEPOSITED FOR FIRST OR SECOND MONTH OF QUARTER

«name» «address» «city state zip»

SIGNATURE

DATE

PRINTED NAME OF SIGNER

TITLE

PAY TO:

CITY OF GRAND RAPIDS

MAIL TO:

{Address per Appendix G}

{3 digit city name abbreviation, Appendix E}«acct_»W«ckdig»201694102Q

GR-501

GRAND RAPIDS INCOME TAX DEPARTMENT EMPLOYER'S MONTHLY DEPOSIT OF INCOME TAX WITHHELD

DO NOT WRITE

1. IDENTIFICATION NUMBER

IN SPACE BELOW

«acct »

2. DEPOSIT PERIOD

JUL 2016

3. DUE ON OR BEFORE

941 07M

4. WITHHOLDING TAX DEPOSIT

08/31/2016

TAXPAYER

MONTHLY DEPOSIT REQUIRED IF TAX WITHHELD DURING THE FIRST MONTH OF QUARTER EXCEEDS $100

«name» «address» «city state zip»

SIGNATURE

DATE

PRINTED NAME OF SIGNER

TITLE

PAY TO:

CITY OF GRAND RAPIDS

MAIL TO:

{Address per Appendix G}

{3 digit city name abbreviation, Appendix E}«acct_»W«ckdig»201694107M

GR-501 DO NOT WRITE IN SPACE BELOW TAXPAYER

GRAND RAPIDS INCOME TAX DEPARTMENT EMPLOYER'S MONTHLY DEPOSIT OF INCOME TAX WITHHELD 1. IDENTIFICATION NUMBER

2. DEPOSIT PERIOD

«acct »

AUG 2016

3. DUE ON OR BEFORE

941 08M

4. WITHHOLDING TAX DEPOSIT

09/30/2016 MONTHLY DEPOSIT REQUIRED IF TAX WITHHELD DURING THE SECOND MONTH OF QUARTER EXCEEDS $100

«name» «address» «city state zip»

SIGNATURE

DATE

PRINTED NAME OF SIGNER

TITLE

PAY TO:

CITY OF GRAND RAPIDS

MAIL TO:

{Address per Appendix G}

{3 digit city name abbreviation, Appendix E}«acct_»W«ckdig»201694108M

GR-941 DO NOT WRITE IN SPACE BELOW TAXPAYER

GRAND RAPIDS INCOME TAX DEPARTMENT EMPLOYER'S QUARTERLY RETURN OF INCOME TAX WITHHELD 1. IDENTIFICATION NUMBER

«acct »

2. DEPOSIT PERIOD

RD

3

QTR 2016

3. DUE ON OR BEFORE

941 03Q

4. WITHHOLDING TAX DEPOSIT

10/31/2016 QUARTERLY DEPOSIT REQUIRED FOR BALANCE OF TAX WITHHELD DURING QUARTER THAT WAS NOT DEPOSITED FOR FIRST OR SECOND MONTH OF QUARTER

«name» «address» «city_state_zip» PAY TO: MAIL TO: SIGNATURE

DATE

PRINTED NAME OF SIGNER

TITLE

CITY OF GRAND RAPIDS {Address per Appendix G}

{3 digit city name abbreviation, Appendix E}«acct_»W«ckdig»201694103Q

GR-501

GRAND RAPIDS INCOME TAX DEPARTMENT EMPLOYER'S MONTHLY DEPOSIT OF INCOME TAX WITHHELD

DO NOT WRITE

1. IDENTIFICATION NUMBER

IN SPACE BELOW

«acct »

2. DEPOSIT PERIOD

OCT 2016

3. DUE ON OR BEFORE

941 10M

4. WITHHOLDING TAX DEPOSIT

11/30/2016

TAXPAYER

MONTHLY DEPOSIT REQUIRED IF TAX WITHHELD DURING THE FIRST MONTH OF QUARTER EXCEEDS $100

«name» «address» «city state zip»

SIGNATURE

DATE

PRINTED NAME OF SIGNER

TITLE

PAY TO:

CITY OF GRAND RAPIDS

MAIL TO:

{Address per Appendix G}

{3 digit city name abbreviation, Appendix E}«acct_»W«ckdig»201694110M

GR-501 DO NOT WRITE IN SPACE BELOW TAXPAYER

GRAND RAPIDS INCOME TAX DEPARTMENT EMPLOYER'S MONTHLY DEPOSIT OF INCOME TAX WITHHELD 1. IDENTIFICATION NUMBER

«acct »

2. DEPOSIT PERIOD

NOV 2016

3. DUE ON OR BEFORE

941 11M

4. WITHHOLDING TAX DEPOSIT

12/31/2016 MONTHLY DEPOSIT REQUIRED IF TAX WITHHELD DURING THE SECOND MONTH OF QUARTER EXCEEDS $100

«name» «address» «city state zip»

SIGNATURE

DATE

PRINTED NAME OF SIGNER

TITLE

PAY TO:

CITY OF GRAND RAPIDS

MAIL TO:

{Address per Appendix G}

{3 digit city name abbreviation, Appendix E}«acct_»W«ckdig»201694111M

GR-941 DO NOT WRITE IN SPACE BELOW TAXPAYER

GRAND RAPIDS INCOME TAX DEPARTMENT EMPLOYER'S QUARTERLY RETURN OF INCOME TAX WITHHELD 1. IDENTIFICATION NUMBER

«acct »

2. DEPOSIT PERIOD

TH

4 QTR 2016

3. DUE ON OR BEFORE

941 04Q

4. WITHHOLDING TAX DEPOSIT

01/31/2017 QUARTERLY DEPOSIT REQUIRED FOR BALANCE OF TAX WITHHELD DURING QUARTER THAT WAS NOT DEPOSITED FOR FIRST OR SECOND MONTH OF QUARTER

«name» «address» «city state zip» PAY TO: MAIL TO: SIGNATURE

DATE

PRINTED NAME OF SIGNER

TITLE

CITY OF GRAND RAPIDS {Address per Appendix G}

{3 digit city name abbreviation, Appendix E}«acct_»W«ckdig»201694104Q

City of Grand Rapids Income Tax Department INSTRUCTIONS FOR FORM GR-501, EMPLOYER'S MONTHLY DEPOSIT OF INCOME TAX WITHHELD, AND FORM GR-941, EMPLOYER'S QUARTERLY RETURN OF INCOME TAX WITHHELD A. MONTHLY DEPOSITS AND QUARTERLY RETURNS 1.

2.

3. 4. 5. 6. 7.

Grand Rapids requires a monthly deposit of income tax withheld for the first or second month of a quarter in which the amount withheld exceeds $100.00. Monthly deposits are made using Form GR-501. Remittance in full payable to the CITY OF GRAND RAPIDS is required. Monthly deposits are due on the last day of the month following the month. Example: The monthly deposit, Form GR-501, for May is due June 30. Quarterly returns of income tax withheld are filed using Form GR-941. Remittance payable to CITY OF GRAND RAPIDS is required. Quarterly returns and payments are due on the last day of the month following the end of the quarter. The quarterly return, Form GR-941, for the first quarter is due April 30. Mail monthly deposits, Form GR-501, and quarterly returns, Form GR-941, to the GRAND RAPIDS INCOME TAX DEPT. PO BOX 347 GRAND RAPIDS, MI 49501-0347. A monthly deposit is not required if less than $100 is withheld during a month. A quarterly return, Form GR-941, is required even though no tax was withheld during a quarter. Under such circumstances, a quarterly return, form GR-941, must be filed showing zero tax withheld. If the payment of wages has been temporarily discontinued for any reason, such as the seasonal nature of the business, the employer must continue to file returns. If you would like to get information on how to file your payments by ACH debit or credit please call THE Income Tax Department at (616) 456-4083.

B. INITIAL RETURNS 1. 2.

3. 4.

Registration forms can be found on the city’s website at www.grcity.us/taxforms. If you cannot wait for forms to timely file your first return, include a letter with your withholding tax payment providing the following information: Name of Business Owner(s), Type of Ownership, Federal Employer Identification Number (FEIN), d.b.a., physical address, mailing address and period covered. If you have applied for, but not yet received, an FEIN, write "FEIN Pending" in place of the FEIN. A temporary number will be assigned. Notify the Income Tax Department as soon as you receive your FEIN. If a business is sold or transferred at any point during a reporting period, both the old and new employer must file returns for the period. Neither employer should report tax withheld by the other; both employers should use their own FEIN numbers. Also see instructions for Final Returns.

C. FINAL RETURNS – NOTICE OF CHANGE OR DISCONTINUANCE 1. 2.

3.

If no wages are to be paid in the future, complete and file a Notice of Change or Discontinuance, Form GR-IT-6. If the business has been sold or transferred, provide the name of the new owner(s), the date transferred and their FEIN. Also, provide the name, address and telephone number of the person who will have custody of the books and records of the discontinued business. When discontinuing a business, the Employer's Annual Reconciliation of Income Tax Withheld, Form CFW-3, and a W-2 form for each employee must be filed. These forms are due by the end of the month following the end of the quarter of discontinuance.

D. ALL EMPLOYERS 1. 2.

3.

4.

Pre-printed forms should be used in filing returns. Forms can be obtained by contacting the Income Tax Department at (616) 456-4083. Verify the name, address and FEIN on the monthly deposit and quarterly return forms (GR-501 and GR-941). If an error is noted, the necessary corrections should be made on the form, and a Notice of Change or Discontinuance should be completed and filed. DO NOT TAKE CREDIT FOR A PRIOR YEAR'S WITHHOLDING OVERPAYMENT! A claim for refund of any prior year's overpayment must be submitted. See Form GR-W-3 for instructions for filing a refund claim. Calculate and remit penalty and interest on all delinquent tax payments and delinquent returns. A sample Penalty and Interest Worksheet, including penalty and interest rates and instructions, is reproduced on the back cover of this booklet. Attach a copy of the penalty and interest worksheet to all delinquent returns and remit the penalty and interest with the tax withheld.

2016 GR-W-3

CITY OF GRAND RAPIDS

GR-W-3 2016

EMPLOYER'S ANNUAL RECONCILIATION OF INCOME TAX WITHHELD 1. Employer's, IRC Sec. 3504 agent's or CPEO's name

6. Federal employer identification number

2. Address (number, street and room or suite number)

7. Due on or before

February 28, 2017 3. City, state and zip code

4. State

5. Zip code Revised 10/15/2015

8a. If line 1 is a Sec. 3504 agent or a CPEO, enter client employer's name

8b.FEIN of employer listed on line 8a

SUMMARY OF TAX WITHHELD AND WITHHOLDING TAX PAID TAX WITHHELD WITHHOLDING TAX PAID MONTH/QUARTER 01M 02M 01Q 04M 05M 02Q 07M 08M 03Q 10M 11M 04Q

January February March/First Quarter FIRST QUARTER TOTAL April May June/Second Quarter SECOND QUARTER TOTAL July August September/Third Quarter THIRD QUARTER TOTAL October November December/Fourth Quarter FOURTH QUARTER TOTAL

9. TOTAL WITHHOLDING TAX PAID (Sum of withholding tax X payments reported in column above) 10. NUMBER OF FORMS W-2 ATTACHED 11. TOTAL TAX WITHHELD PER FORMS W-2 12. BALANCE DUE (Line 9 less line 11) 13. OVERPAYMENT (Line 11 less line 9) *ATTACH EXPLANATION

9. 10. 11. 12. 13.

* Submit a letter to request a refund. Include a detailed explanation on the cause of the overpayment. Refunds will not be issued without an explanation. Attach Forms W-2 (elctronic format or paper copy) and payment of any balance due (line 11.) Under penalties of perjury, I declare that I have examined this return and accompanying documents and, to the best of my knowledge and belief, they are true, correct, and complete. 14. SIGNATURE

15. NAME AND TITLE (PLEASE PRINT)

16. DATE

17. PHONE NUMBER

Enclose the required copies of Forms W-2 and, if necessary, payment of any balance due and/or Form GR-W-3S with Form GR-W-3 Mail to Grand Rapids Income Tax Department PO Box 347, Grand Rapids, MI 49501-0347

2016 GR-W-3S

CITY OF GRAND RAPIDS

GR-W-3S 2016

SUPPLEMENT TO EMPLOYER'S ANNUAL RECONCILIATION OF INCOME TAX WITHHELD 1. Employer's, IRC Sec. 3504 agent's or CPEO's name

6. Federal employer identification number Revised 10/15/2015

SUMMARY OF WITHHOLDING TAX PAID If withholding tax payments for the year were made under one or more FEINs, enter the FEIN and the payments made under each FEIN in a separate column

▼ 1st FEIN ▼

MONTH OR QUARTER OF PAYMENT

FEIN UNDER WHICH PAYMENTS WERE SUBMITTED ▼ 2nd FEIN ▼ ▼ 3rd FEIN ▼ ▼ 4th FEIN ▼

WITHHOLDING TAX PAID

WITHHOLDING TAX PAID

WITHHOLDING TAX PAID

WITHHOLDING TAX PAID

JAN (01M) FEB (02M) MAR (01Q) APR (04M) MAY (05M) JUN (02Q) JUL (07M) AUG (08M) SEP (03Q) OCT (010M) NOV (011M) DEC (04Q) TOTALS (Enter total of each separate column) 9. TOTAL WITHHOLDING TAX PAID (Add totals from all columns; enter here and enter X on Form GR-W-3, line 9)

9.

SUMMARY OF FORMS W-2 SUBMITTED If the tax withheld as reported on Forms W-2, box 19, was reported under more than one FEIN (Form W-2, box b) enter the FEIN, the number of Forms W-2, the total tax withheld on the forms and the Locality name (Form W-2, box 20) on separate lines for each FEIN

EMPLOYER FEIN (Form W-2, box b)

NUMBER OF FORMS W-2 SUBMITTED

10. TOTAL NUMBER OF FORMS W-2 X (Total lines in column; enter here and on 10. XX Form GR-W-3, line 10) 11. TOTAL TAX WITHHELD PER W-2s XX (Total lines in column; enter here and on Form GR-W-3, line 11)

TOTAL TAX WITHHELD (Form W-2, box 19)

11.

LOCALITY NAME ON FORMS W-2 (Form W-2, box 20)

CITY OF GRAND RAPIDS INCOME TAX DEPARTMENT INSTRUCTIONS FOR FORM GR-W-3, EMPLOYERS ANNUAL RECONCILIATION OF INCOME TAX WITHHELD AND FORM GR-W-3S, SUPPLEMENT TO EMPLOYERS ANNUAL RECONCILIATION OF INCOME TAX WITHHELD Revised 10/15/2015

GENERAL INSTRUCTIONS Employers withholding city income tax are required to annually reconcile the city income tax withheld to the city income tax withholding paid. Form GR-W-3, Employer’s Annual Reconciliation of Income Tax Withheld, is the form used to make this reconciliation. A copy of each Form W-2 issued by the employer is required to be filed with Form GR-W-3. Electronic filing of Forms W-2 via CD-ROM or DVD is allowed by some cities. Refer to the city’s website for information about acceptance of electronic filing of Forms W-2 and the Form W-2 file formats accepted by the city. Forms W-2 cannot be submitted in PDF format. IRC Sec. 3405 Agent An employer’s withholding agent under Internal Revenue Code (IRC) Sec. 3405 must also become the employer’s withholding agent for the city. This is accomplished by the Employer and the IRC Sec. 3405 withholding agent filing Form GR-2678, Employer/Payor Appointment of Agent with the city. This type of withholding agent files city income tax Form GR-W-3 and the associated Forms W-2 under the withholding agent’s federal employer identification number (FEIN). When filing Form GR-W-3 with the city, the reporting agent shall report the employer’s name and FEIN on Form GR-W-3. A noncertified professional employer organization (PEO) may be an IRC Sec. 3405 reporting agent. Certified Professional Employer Organization (CPEO) Starting in year 2016, a PEO may be certified under IRC Sec. 3511(a)(1). A CPEO becomes the co-employer of record responsible for city income tax withholding and must register with the city by filing Form GR-SS-4, Employer’s Withholding Registration. The CPEO must file Form GR-W-3 and associated Forms W-2 under their FEIN. When filing Form GR-W-3 with the city, the CPEO shall report the employer’s name and FEIN on Form GRW-3. Common Paymaster A common paymaster must file Form GR-W-3 and associated Forms W-2 under the same FEIN as the one used on the federal Forms W-3 and W-2. Filing Form GR-W-3 Withholding Payments Made Under More Than One FEIN. When withholding tax paid was reported to the city under more than one FEIN, Form GR-W-3S, Employer’s Annual Reconciliation of Income Tax Withheld, must be filed with Form GR-W-3. Form GR-W-3S, Summary of Withholding Tax Paid section identifies all FEIN’s under which withholding tax payments were made and the month or quarter of each payment. The form totals the withholding tax payments made under each FEIN and

the totals all of the withholding tax payments made on line 9, The total of all withholding tax payments are also entered on Form GR-W-3, line 9. Tax Withheld on Forms W-2, Box 19, Reported under More Than One FEIN (Form W-2, box b) When the Forms W-2 filed with Form GR-W-3 report more than one employer FEIN in Form W-2, box b, Form GR-W-3S must be filed with Form GR-W-3. Form GR-W3S identifies all FEINs under which Forms W-2 were filed, the number of Forms W-2 filed under each FEIN and the locality name reported, Forms W-2, box 20. SPECIFIC INSTRUCTIONS FOR FORM GR-W-3 Line 1. Enter the name of the employer, IRC Sec. 3504 agent or CPEO. Line 2. Enter the street address including suite or room number of the person named on line 1. Lines 3, 4 and 5. Enter the city, state and zip code under the respective line number. Line 6. Enter FEIN of the person named on line 1. Line 7. Enter the due date if not already preprinted. Line 8. If the entry on line 1 is an IRS Sec. 3504 agent or a CPEO, enter the employer’s or co-employer’s FEIN Summary of withholding tax paid section. Under this section report the actual tax withheld each month and the withholding tax deposits and payment made each month or quarter. If withholding tax payments were made under FEIN’s in addition to the one reported on line 6, write across this section “SEE FORM GR-W-3S and complete the Summary of Withholding Tax Paid section of Form GR-W-3S. Line 9. Enter the total withholding tax paid from the lines above or if withholding tax was paid under more than one number, the total from form GR-W-3S, line 9. Line 10. Enter the number of Forms W-2 attached to this form or if Forms W-2 were filed under more than one FEIN, enter the total from Form GR-W-3S, line 11. Line 11. Enter the total tax withheld as reported on the attached Forms W-2 or if Forms W-2 were filed under FEINs other than the one reported on line 6, enter the total from Form GR-W-3S, line 11.

Forms W-2 must be submitted with Form GR-W-3. The preferred format is the federal EFW2 format. The city tax proprietary (CTP) format may also be used. Electronic format Form W-2 data must be submitted on CD-ROM or DVD. See Appendix K for specifications. Forms W-2 cannot be submitted in PDF format. Paper copies of the actual Forms W-2 are acceptable. A listing, summary or printout of Form W-2 data will not be accepted. Page 1 of 2

CITY OF GRAND RAPIDS INCOME TAX DEPARTMENT INSTRUCTIONS FOR FORM GR-W-3, EMPLOYERS ANNUAL RECONCILIATION OF INCOME TAX WITHHELD AND FORM GR-W-3S, SUPPLEMENT TO EMPLOYERS ANNUAL RECONCILIATION OF INCOME TAX WITHHELD Revised 10/15/2015

Submit only Forms W-2 for employees subject to the city’s income tax and Forms W-2 reporting city tax withheld for the city. Form W-2, box 20, data should only be an authorized locality name abbreviation. See Appendix D for a listing of authorized locality name abbreviations. Line 12. Enter the balance due, line 9 less line 11. If no balance due enter a zero (0). The balance due must be paid full with Form GR-W-3. Line 13. Enter any overpayment, line11 less line 9. If no overpayment, enter a zero (0). A refund of any overpayment will not be made unless a letter explaining the overpayment and requesting the refund is submitted with Form GR-W-3. Line 14. Have the individual responsible for preparing Form GR-W-3 sign the return on line 14. Line 15. Type or print the name and title of the individual signing the return on line 14. Line 16. Enter the date the reconciliation was signed. Line 17. Enter the phone number of the individual signing the return. After Form GR-W-3 is completed, please double check the entries on lines 1 through 6. Also, if Form GR-W-3 is submitted by a Sec 3504 agent or a CPEO, check the employer’s name and FEIN reported for the employer on lines 8a and 8b.

Summary of Forms W-2 submitted Complete this section only when Forms W-2, filed with Form GR-W-3, report more than one FEIN in box b. Use a separate line for each FEIN reported on Form W-2, box b. In the related column for each line enter the FEIN, the number of Forms W-2 filed under the FEIN, the total tax withheld under the FEIN and the abbreviation for the locality name of the city which for Grand Rapids is MIGRR. The abbreviation of MI-GRR is also acceptable for printed paeer W-2 forms only. Line 10. Total the number of forms W-2 listed in this column and enter the total on line 10. Also enter this total on Form GR-W-3, line 10. Line 11. Total the amount of tax withheld listed in this column and enter the total on line 11. Also enter this total on Form GR-W-3, line 11. Complete the reconciliation process by completing Form GR-W-3, lines 12 through 17. Submit this Form GR-W-3 along with Form GR-W-3 and the related forms W-2. DISCLAIMER NOTICE These instructions are interpretations of the Uniform City Income Tax Ordinance, MCLA 141.601 et seq. The Grand Rapids Income Tax Ordinance will prevail in any disagreement between these instructions and the ordinance.

Filing Form GR-W-3 Mail the completed Form GR-W-3 along with the Forms W-2, payment of any tax due, a letter explaining any overpayment and requesting a refund if necessary and Form GR-W-3S if necessary to: Grand Rapids Income Tax Department PO Box 347, Grand Rapids, MI 49501-0347 SPECIFIC INSTRUCTIONS FOR FORM GR-W-3S Line 1. On line one, enter the name as stated on Form GR-W-3 line 1. Line 6. Enter the FEIN of the person named on line 1. Summary of Withholding Tax Paid Complete this section only when withholding tax was paid to the city under more than one FEIN. Use a separate column to report withholding tax paid under each FEIN by listing the FEIN of the payor and the payments on the line for the corresponding month or quarter. Enter the total withholding tax paid under each FEIN on the totals line of the column. On line 9 enter the grand total of withholding tax paid under all FEINs. Also enter the total tax withheld on Form GR-W-3, line 9. Page 2 of 2

CITY OF GRAND RAPIDS INCOME TAX DEPARTMENT PENALTY AND INTEREST WORKSHEET FOR DELINQUENT WITHHOLDING TAX RETURNS RETURN PERIOD DUE DATE TAX DUE INTEREST PENALTY MINIMUM P & I TOTAL DUE

Attach a copy of completed worksheet to each delinquent return. INTEREST CALCULATION INSTRUCTIONS: Interest is due from the due date of a return until the tax is paid. Interest Rates: For period 1/1/2012 through 12/31/2012 the interest rate is 4.25% per year or 0.0001161 per day. For period 1/1/2013 through 12/31/2013 the interest rate is 4.25% per year or 0.0001164 per day. For period 1/1/2014 through 12/30/2014 the interest rate is 4.25% per year or 0.0001164 per day. For period 1/1/2015 through 12/31/2015 the interest rate is 4.25% per year or 0.0001164 per day. For period 1/1/2016 through 12/31/2016 use the interest rate listed for 2015 or the city for rate. Interest rates are set by the Michigan Department of Treasury. The interest rate changes every six months. Interest rates for current or past periods are found on the Michigan Department of Treasury web site, http://www.michigan.gov/treasury under Revenue Administrative Bulletins. Look for the most recent interest rate bulletin.

Interest Computation: For Interest Rate Period: 1/1/2012 to 12/31/2012: 1/1/2013 to 12/31/2013: 1/1/2014 to 12/31/2014: 1/1/2015 to 12/31/2015: 1/1/2016 to 12/31/2016: Total interest.

Number of days after due date: Number of days after due date: Number of days after due date: Number of days after due date: Number of days after due date:

_____ times 0.0001161 times tax due = $_________ _____ times 0.0001164 times tax due = $_________ _____ times 0.0001164 times tax due = $_________ _____ times 0.0001164 times tax due = $_________ _____ times 0.0001164 times tax due = $_________

Add the interest calculated on the lines above and Enter on the INTEREST line of the worksheet.

Total Interest

$_________

PENALTY CALCULATION INSTRUCTIONS: Penalty is due upon failure to timely file a return or failure to timely pay tax due.

Penalty Rate: One percent (1%) of the tax due per month (or portion thereof) per return. A penalty of one percent of the tax due is applied on the first day after the due date of the return. An additional penalty of one percent of the tax due is added on the first day of each subsequent month. Maximum penalty is 25% of the tax due per return.

Penalty Computation: Number of months delinquent times 1% (.01) times the tax due = $_________ Enter the penalty calculated on the PENALTY line of the worksheet.

MINIMUM PENALTY AND INTEREST CALCULATION: The minimum amount of penalty and interest combined is $2.00 per return. Calculation of minimum penalty and interest: If total penalty and interest is greater than $2.00 minimum does not apply. If total penalty and interest is less than $2.00, enter $2.00 on the MINIMUM P & I line of the worksheet.

City of Grand Rapids

GR-SS-4

GR-SS-4

INCOME TAX DEPARTMENT

PLEASE TYPE OR PRINT

PLEASE TYPE OR PRINT

Employer’s Withholding Registration

Part I. Identification and addresses of employer or certified professional employer organization 1. Employer application 2. Certified professional employer organization (CPEO) co-employer application 3. Complete company name (include, if applicable, Corp., Inc., LLC, etc.) 4. Federal Employer Identification Number 5. Business name, assumed name or DBA (if used)

6. Business phone number

7. Enter street number and name (include apartment or suite number after street name)

LEGAL ADDRESS

8. Enter Address Line 2: 9. City

10. State

11. Zip Code

12. Enter street number and name (include apartment or suite number after street name)

MAILING ADDRESS

13. Enter Address Line 2: 14. City

15. State

16. Zip Code

17. Enter street number and name (include apartment or suite number after street name)

PHYSICAL ADDRESS OF 18. Enter Address Line 2: PROJECT OR ACTIVITY 19. City IN CITY

20. State

21. Zip Code

Part II. General information 1. Date first wages subject to city withholding paid 1a. 2. Number of employees subject to city withholding 2a.

7. Reinstated old business; enter old FEIN7a.

3. Reasons for filing withholding registration

9. CPEO with new client in the city. Enter client's FEIN on line 11a and

4. Started a new business; enter date

8. Started "doing business" in city; enter date

4a.

complete items 11 and 12 below

5. Incorporated an existing busines

10. Other (explain)

8a.

9a.

10a.

6. Purchased a going business (complete items 11 and 12 below) 11. Name of previous owner or PEO's client

12. Will the previous owner or PEO's client continue to x have employees subject to city income tax withholding

13. Does your tax year end in December 31 13a. Yes

12a. Yes 12b. No

Month (MM) Day (DD)

13b. No If no, provide the fiscal year end month and day

13c.

Part. III. Income tax withholding - Filing and payment of income tax withheld Check box below to indicate how withholding tax returns are prepared and filed 1. Our withholding tax returns are prepared in house, filed and paid

5. An IRC Section 3504 agent is authorized to prepare, file and pay

X and all returns and Forms W-2 are filed and paid under our FEIN

X our withholding tax returns and Forms W-2; all withholding tax

2. A common paymaster prepares our withholding tax returns:

X returns and Forms W-2 are filed under the agents FEIN. Attach a

X Withholding tax is paid under FEIN 2a.

X copy of federal Form 2678. ATTACH A COMPLETED FORM

X Forms W-2 are filed under FEIN

X CF-2678 AS A PART OF THIS REGISTRATION

2b.

3. A payroll services provider prepares our withholding tax returns

6. A professional employer organization is authorized under a PEO

X and Forms W-2. Returns and Forms W-2 are filed and paid under

X agreement to prepare, file and pay our withholding tax returns

X our FEIN

X and Forms W-2 under their FEIN. Attach a copy of the PEO

4. A payroll reporting agent is authorized to prepare our withholding

X agreement. A certified PEO must be registered with the city as a

X tax returns and Forms W-2 which are filed and paid by the agent

X co-employer liable for filing and payment of withholding tax

X under our FEIN. Attach a copy of Form 8655 filed with the IRS.

7. We are a CPEO preparing, filing and paying or clients city X withholding tax under our FEIN. Attach a copy of the IRS

X ATTACH A COMPLETED FORM CF-8655 AS PART OF THIS X REGISTRATION

X certification.

Complete company name (include, if applicable, Corp., Inc., LLC, etc.)

Federal Employer Identification Number

Part IV. Type of business ownership (Check all boxes that apply) 1. Individual/Sole Proprietorship (Identify owner in X Part III below) 2. General Partnership X (Identify all partners in Part III below) 3. Limited Partnership (LP) X (Identify general partners in Part III below) 4. Professional Limited Liability 5. Partnership (LLP) (Identify all X General Partners in Part III below) 6. Limited Liability Company (LLC) X (Identify all members in Part III below) 7. Professional Limited Liability Company (PLLC) X (Identify all members in Part III below)

8. Michigan Corporation (Identify all corporation officers in X Part III below) 8a. Michigan Subchapter S Corporation 8b. Michigan Professional Corporation 9. Foreign (Non-Michigan) Corporation (Identify all corporation X officers in Part III below) 9a.Foreign Subchapter S Corporation 10. Nonprofit Corporation (Identify all corporation officers in X Part III below) 11. Government 12. Estate (Identify estate administrator or personal X representative in Part III below) 13. Trust (Identify trustee in Part III below) 14. Other (explain)

Part V. Identification of each owner, partner, member or corporate officer (Attach Part VII if more than 2) 1a. Name (last, first middle, suffix)

1g. Home Telephone Number

1b. Business Title

1h. Date of Birth

1c. Residence Address (street number and name including apartment number after street name)

1i. Social Security Number

1d. City

1j. Drivers License Number/ ST ID Number

1e. State

1f. Zip Code

2a. Name (last, first middle, suffix)

2g. Home Telephone Number

2b. Business Title

2h. Date of Birth

2c. Residence Address (street number and name including apartment number after street name)

2i. Social Security Number

2d. City

2j. Drivers License Number/ ST ID Number

2e. State

2f. Zip Code

Part VI. Contact information 1. Contact person for withholding tax questions

2. E-mail address of contact person

3. Phone number for contact person above. 4a.

Part VII. Signature area Under penalties of perjury, I declare that I have examined this application, and to the best of my knowledge and belief, it is true, correct, and complete. 1a. Signature (owner, member or officer who controls or is responsible for X

1b. Title

filing withholding tax returns and paying the income tax withheld)

1c. Type or print name of person signing above

1d. Date

Mail to: Grand Rapids Income Tax Dept. PO Box 347 Grand Rapids, MI 49501-0347

Form GR-SS-4, page 2, revised 11/19/2015

Information collected on this form is confidential pursuant to MCL 141.674(1), Michigan Uniform City Income Tax Ordinance; Sec.74(1). Information gained by the administrator, city treasurer or any other city official, agent or employee as a result of a return, investigation, hearing or verification required or authorized by this ordinance is confidential, except for official purposes in connection with the administration of the ordinance and except in accordance with a proper judicial order.

GR-SS-4 Questions about this application? Call the Income Tax Department at (616) 456-3415.

Complete company name (include, if applicable, Corp., Inc., LLC, etc.)

Federal Employer Identification Number

Part VII. Identification of each owner, partner, member or corporate officer (Part V Continued) 3a. Name (last, first middle, suffix)

3g. Home Telephone Number

3b. Business Title

3h. Date of Birth

3c. Residence Address (street number and name including apartment number after street name)

3i. Social Security Number

3d. City

3j. Drivers License Number/ ST ID Number

3e. State

34f. Zip Code

4a. Name (last, first middle, suffix)

4g. Home Telephone Number

4b. Business Title

4h. Date of Birth

4c. Residence Address (street number and name including apartment number after street name)

4i. Social Security Number

4d. City

4j. Drivers License Number/ ST ID Number

4e. State

4f. Zip Code

5a. Name (last, first middle, suffix)

5g. Home Telephone Number

5b. Business Title

5h. Date of Birth

5c. Residence Address (street number and name including apartment number after street name)

5i. Social Security Number

5d. City

5j. Drivers License Number/ ST ID Number

5e. State

5f. Zip Code

6a. Name (last, first middle, suffix)

6g. Home Telephone Number

6b. Business Title

6h. Date of Birth

6c. Residence Address (street number and name including apartment number after street name)

6i. Social Security Number

6d. City

6j. Drivers License Number/ ST ID Number

6e. State

6f. Zip Code

7a. Name (last, first middle, suffix)

7g. Home Telephone Number

7b. Business Title

7h. Date of Birth

7c. Residence Address (street number and name including apartment number after street name)

7i. Social Security Number

7d. City

7j. Drivers License Number/ ST ID Number

7e. State

7f. Zip Code

8a. Name (last, first middle, suffix)

8g. Home Telephone Number

8b. Business Title

8h. Date of Birth

8c. Residence Address (street number and name including apartment number after street name)

8i. Social Security Number

8d. City

8j. Drivers License Number/ ST ID Number

8e. State

8f. Zip Code

Form GR-SS-4, page 3, revised 09/29/2015

GRAND RAPIDS INCOME TAX DEPARTMENT INSTRUCTIONS FOR FORM GR-SS-4 EMPLOYERS WITHHOLDING TAX REGISTRATION

General Instructions Use these instructions to complete Form GR-SS-4, Employers Withholding Registration. Purpose of Form Form GR-SS-4 is used to register for withholding of income tax from wages paid to employees. Employer’s required to register and withhold Every employer having a location or “doing business” in the city is required to register and withhold city income tax.

Part I. Identification and addresses of employer or certified professional employer organization Line 1. If you are an employer registering to withhold tax; check (X) the box to the left of line 1 otherwise leave the box blank. Line 2. If you are a CPEO registering to withhold tax; check (X) the box to the left of line 2 otherwise leave the box blank. Line 3. Enter the complete legal name of the entity (or individual) registering.

An example is a contractor even though the contractor is physically located outside the city who is working as a subcontractor on a project in the city is “doing business” in the city and is required to withhold city income tax.

Line 4. Enter the FEIN of the entity (or individual) registering.

Employers not required to withhold city income tax are encouraged to voluntarily register and withhold tax from wages paid to their resident employees.

Line 6. Enter the business phone number of the entity (or individual) registering.

Certified Professional Employer Organization A certified professional employer organization (CPEO) is required to register: when the PEO is a co-employer under a PEO agreement with a client (co-employer) who is required to register and withhold city income tax; the PEO agreement makes the PEO responsible for filing withholding tax returns and payment of the income tax withheld or required to be withheld; and the PEO is designated as a CPEO by the internal Revenue Service (IRS) under Internal Revenue Code (IRC) Section 3511(a)(1). Withhold from wages paid to the following employees All wages paid to employees who are residents of the city whether or not they work in the city; All wages paid to employees who are non-residents of the city who work in the city. (Withhold only on wages earned in Grand Rapids). See the Withholding Tax Guide or the Michigan Uniform City Income Tax Ordinance, Sections 141.651 through 141.665 for more information relative to withholding city income tax.

Specific Instructions Follow the instructions for each line to expedite processing and to avoid unnecessary requests for additional information. Also, be sure to attach copies of IRS forms or certifications when requested by these instructions or the registration form.

Line 5. Enter the business name, trade name, assumed name or DBA of the registrant if one is used; otherwise enter N/A.

Lines 7 – 21. Enter the address data as requested for each Legal address, mailing address, and the physical, project or activity address located in the city. Part II. General information Line 1. Enter the first date wages subject to city income were paid. Line 2. Enter the number of employees currently subject to city’s income tax withholding. Line 3. Instruction only no entry required. Lines 4.-10. Check (X) number indicating the withholding registration. explanation is requested information requested.

the box to the left of the reason for filing this Where a date, FEIN or for a line checked, enter

Line 11. If the box on line 6 is checked, enter the name of the previous owner of the business and if the box on line 9 is checked enter the name of the CPEO’s client. Line 12. If one of the boxes on lines 6 or 9 is checked, check (X) box 12a if the previous owner or the CPEO client will continue to have employees subject to city income tax withholding; otherwise check (X) the box on line 12b. If the boxes on line 6 and line 9 are both not checked, leave blank. Part. III. Income tax withholding - Filing and payment of income tax withheld Lines 1 – 6. If this is an employer’s registration, check (X) the appropriate box to indicate how your

withholding tax returns are prepared and filed. An employer is liable for the filing, deposit and payment of withholding tax regardless of the type agent filing, depositing and paying the withholding tax except, after 1/1/2016, when an employer uses a CPEO who is registered to withhold the city’s income tax. A CPEO registering to withhold must check the box on line 7 of this part of the registration form. Part IV. Type of Business Ownership Check the box to the left of the line number to indicate the type of ownership of the person registering. If the box on line 8 is checked also check the box on line 8a if a Michigan Subchapter S corporation, or check the box on line 8b if a Michigan professional corporation. If the box on line 9 is checked, also check the box on line 9a if the foreign (not a Michigan) corporation is a foreign Subchapter S corporation. Part V. Identification of each owner, partner, member or corporate officer Lines 1a – 2j. Enter the requested information for each owner, partner, member or corporate officer of the business, including CPEOs. If there are more than two owners, partners, members or corporate officers, enter the data for the additional individuals in Part VII, a continuation of Part V. Part VI. Contact Information Lines 1 – 3a. Enter the contact person’s name on line 1, e-mail address on line 2 and phone number on line 3a. This information is important and must be updated when the contact person changes. Part VII. Signature area Line 1a. The registration must be signed by (a) the individual, if the applicant is an individual; (b) principal officer responsible for income tax withholding, if the applicant is a corporation; (c) the responsible and duly authorized member or officer responsible for income tax withholding, if the applicant is a partnership, LLC, government entity, or other unincorporated organization; or (d) the fiduciary, if the applicant is a trust or an estate. Line 1b. Print or type the title of the person signing the registration on line 1b. Line 1c. Print or type the name of the person signing the registration on line 1c. Line 1d. Enter the date the registration was signed on line 1d.

Related Forms  Withholding Tax Guide  Form GR-SS-4, Employer’s Withholding Registration  Form GR-2678, Employer/Payor Appointment of Agent  Form GR-8655, Reporting Agent Authorization  Employer’s Withholding Tax Forms and Instructions Booklet  General Instructions  Listing of Withholding Tax Forms in Booklet and Due Dates for Monthly (Form GR-501) Deposits and Quarterly (Form GR-941) Returns  Form GR-6-IT, Notice of Change or Discontinuance  Forms GR-501 and Form GR-941, First Quarter Withholding Tax Forms  Forms GR-501 and Form GR-941, Second Quarter Withholding Tax Forms  Forms GR-501 and Form GR-941, Third Quarter Withholding Tax Forms  Forms GR-501 and Form GR-941, Fourth Quarter Withholding Tax Forms  Form GR-W-3, Employer’s Annual Reconciliation of Income Tax Withheld  Instructions for forms GR-501, Employer’s Monthly Deposit of Income Tax Withheld and Form GR-941, Employer’s Quarterly Deposit of Income Tax Withheld  Penalty and Interest Worksheet  GR-W-4, Employee’s Withholding Certificate  GR-2848, Power of Attorney Authorization Disclosure of information Information collected on Form GR-SS-4 is confidential pursuant to MCL 141.674(1), Michigan Uniform City Income Tax Ordinance; Sec.74(1). Information gained by the administrator, city treasurer or any other city official, agent or employee as a result of a return, investigation, hearing or verification required or authorized by this ordinance is confidential, except for official purposes in connection with the administration of the ordinance and except in accordance with a proper judicial order. Disclaimer Notice These instructions are interpretations of the Uniform City Income Tax Ordinance, MCLA 141.601 et seq. The City’s ordinance will prevail in any disagreement between these instructions and the ordinance. Revised 11/20/2015

Form

GR-2678

City of Grand Rapids

Form

INCOME TAX DEPARTMENT Employer/Payor Appointment of Agent

GR-2678

Revised 09/28/2015

Use this form if you want to request approval to have an agent file returns and make deposits or payments of withholding taxes or if you want to revoke an existing appointment. • If you are an employer or payer who wants to request approval, complete Parts I and II and sign Part II. Then give it to the agent. Have the agent complete Part 3 and sign it. Note. This appointment is not effective until we approve your request. See the instructions for filing Form GR-2678 on page • If you are an employer, payer, or agent who wants to revoke an existing appointment, complete all three parts. In this case, only one signature is required. Part I. Why you are filing this form (Check one of the boxes below) 1. You want to appoint an agent for tax reporting, depositing, and paying. 2. You want to revoke an existing appointment. Part II. Employer or Payer Information: Complete this part if you want to appoint an agent or revoke an appointment 1. Employer's or payor's name

2.Federal employer identification number

3. Trade name (if any) 4. Address (Street number, street name and suite or room number) 5. City 8. Foreign country name 11.

6. State 9. Foreign province/county

Forms for which you want to appoint an agent or revoke an agent's appointment to file, Form GR-501 (Employer's Monthly Deposit of Income Tax Withheld) Form GR-941 (Employers Quarterly Return of Income Tax Withheld) Form GRW-3 (Employer's Annual Reconciliation of Income Tax Withheld) Form W-2 (Wage and Tax Statement, city copy (via paper or magnetic media)

7. ZIP code 10. Foreign postal code

For SOME For ALL employees/ employees/ payees/payments payees/payments 11a. 11b. 11c. 11d. 11e. 11 f. 11g. 11h.

I am authorizing the income tax department of the above named city to disclose otherwise confidential tax information to the agent relating to the authority granted under this appointment, including disclosures required to process Form GR-2678. The agent may contract with a third party, such as a reporting agent or certified public accountant, to prepare or file the returns covered by this appointment, or to make any required deposits and payments. Such contract may authorize the income tax department of the above named city to disclose confidential tax information of the employer/payer and agent to such third party. If a third party fails to file the returns or make the deposits and payments, the agent and employer/payer remain liable.

12. Sign your name here

13. Print your title here

14. Print your name here

15. Date (MM/DD/YYYY)

16. Best daytime phone number

After completing and signing Part I and Part II of this form, give this form to the agent to complete Pat III.

Employer's or payor's name (form Part II, line 1)

FEIN (from Part II, line 2) Form GR-2678, Page 2

Part III. Agent Information: If you will be An agent for an employer or payor, or want to revoke an appointment, complete this part. 1. Agent's name

2.Agent's federal employer identification number

3. Agent's trade name (if any) 4. Agent's address (Street number, street name and suite or room number) 5. City 8. Foreign country name

6. State 9. Foreign province/county

7. ZIP code 10. Foreign postal code

Under penalties of perjury, I declare that I have examined this form and any attachments, and to the best of my knowledge and belief, it is true, correct, and complete. 11. Sign your name here

12. Print your title here

13. Print your name here

14. Date (MM/DD/YYYY)

15. Best daytime phone number

INSTRUCTIONS FOR FORM GR-2678 Revised 10/15/2015

Purpose of Form Use Form GR-2678 if you want to: 1. Request approval to have an agent file returns and make deposits or payments of Grand Rapids income tax withholding; or 2. Revoke an existing appointment.

How to Complete the Form Part I: Why You Are Filing This Form In Part 1, you will check a box to indicate why you are filing Form GR-2678.

If you are an employer or payer and you are requesting authorization to appoint an agent, sign and date Form GR-2678 in Part 2. Then give the form to the agent to complete and sign Part 3. If you are an employer or payer and you want to revoke an existing appointment, sign and date Form GR-2678 in Part 2. Complete Part 3. Then send the form to Grand Rapids Income Tax Department, PO Box 347, Grand Rapids, MI 49501-0347.

Part III: Agent Information

If you are an employer or payer and you want to appoint an agent, check the box that says, “You want to appoint an agent for tax reporting, depositing, and paying.”

If you are an employer or payer and you are requesting authorization to appoint an agent, have the agent complete and sign Part 3.

If you are an employer, payer, or agent and you want to revoke an existing appointment, check the box that says, “You want to revoke an existing appointment.”

If you are an employer or payer and you want to revoke an existing appointment, complete Part 3. The agent's signature is not required. Then send the form to Grand Rapids Income Tax Department, PO Box 347, Grand Rapids, MI 49501-0347.

Part II: Employer or Payer Information If you are an employer or payer, enter your name, employer identification number (FEIN), trade name, and address. If you are an agent revoking an existing appointment, enter the FEIN, name, trade name, and address of the employer or payer for whom you have been authorized to act. The employer's or payer's signature is not required. On line 11, check the boxes for all forms for which you want to: 1. Request approval to appoint an agent to file on your behalf, or 2. Revoke an agent's existing appointment. If you are only appointing an agent for all employees, payees, or payments, check the box under For ALL employees/payees/payments. If you are only appointing an agent for some employees, payees, or payments, check the box under For SOME employees/payees/payments. Example 1. You are an employer. You appoint an agent to file returns and deposit city income tax withholding related to biweekly wage payments that you paid your employees. However, you make bonus wage payments directly to your employees, not through the agent. You should report the bonus payments on a return filed using your FEIN. Example 2. You are an employer. You appoint an agent to file returns and city income tax withholding for biweekly wage payments that you paid to your employees. However, you make biweekly wage payments directly to your company's executives. You should report the wage payments to the executives on a return filed using your FEIN.

If you want to accept an appointment as an agent or you are an agent who wants to revoke an existing appointment, complete Part 3 with your information. Then sign and date the form where indicated. Send the form to Grand Rapids Income Tax Department, PO Box 347, Grand Rapids, MI 49501-0347. Note. If an agent is a corporate officer, partner, or tax matters partner, the agent must have the authority to execute this appointment of agent.

Filing Form GR-2678 Send Form GR-2678 to Grand Rapids Income Tax Department, PO Box 347, Grand Rapids, MI 495010347. We will send a letter to the employer or payer and to the agent after we have approved the request. The authorization to act as an agent is effective on the date shown in the letter. Until we approve the request, the agent is not liable for filing any tax returns or making any deposits or payments. Only one signature is required to revoke an agent's appointment. If an existing appointment is revoked, the city income tax department cannot disclose confidential tax information to anyone other than the employer or payer for periods after the appointment is revoked. If an agent's appointment is revoked, we will send both the employer or payer and the agent a letter confirming the revocation. The revocation is effective on the date shown in the letter.

Form

GR-8655

City of Grand Rapids

Form

INCOME TAX DEPARTMENT Reporting Agent Authorization

GR-8655

Revised 09/28/2015

Taxpayer 1. Name of taxpayer( as distinguished from trade name

2.Federal employer identification number

3. Trade name (if any) 4. Address (Street number, street name and suite or room number)

5.Other identification number

6. City

7. State

9. Contact person

10. Daytime telephone number

8. ZIP code

11. Fax number

Reporting Agent 12. Name (enter company name or name of business

13.Federal employer identification number

14. Address (Street number, street name and suite or room number) 15. City

16. State

18. Contact person

19. Daytime telephone number

17. ZIP code

20. Fax number

Authorization of Reporting Agent to Sign and File Returns (Caution: See Authorization Agreement) 21.

Use the entry lines below to indicate the tax return(s) to be filed by the reporting agent. Enter the beginning year of annual tax returns or beginning quarter of quarterly tax returns. See the instructions for how to enter the quarter and year. Once this authority is granted, it is effective until revoked by the taxpayer or reporting agent. GR-941

GRW-3

Forms W-2

Authorization of Reporting Agent to Make Deposits and Payments (Caution: See Authorization Agreement) 22.

Use the entry lines below to enter the starting date (the first month and year) of any tax return(s) for which the reporting agent is authorized to make deposits or payments. See the instructions for how to enter the month and year. Once this authority is granted, it is effective until revoked by the taxpayer or reporting agent GR-501

GR-941

GRW-3

Disclosure of information to Reporting Agents 23a. Check here to authorize the reporting agent to receive or request copies of tax information and other communications from the income tax department of the above named city related to the authorization granted on lines 21, 22, and/or line 24 ................................................................ 23b. Check here if the reporting agent also wants to receive copies of notices from the city income tax department ....……........................................

Disclosure Authorization 24.

The reporting agent is authorized to receive otherwise confidential taxpayer information from the income tax department of the city named above to assist in responding to certain notices relating to the Form W-2 series information returns. This authority is effective for calendar year forms beginning

Authorization Agreement I understand that this agreement does not relieve me, as the taxpayer, of the responsibility to ensure that all tax returns are filed and that all deposits and payments are made. If line 21 is completed, the reporting agent named above is authorized to sign and file the return indicated, beginning with the quarter or year indicated. If any starting dates on line 22 are completed, the reporting agent named above is authorized to make deposits and payments beginning with the period indicated. Any authorization granted remains in effect until it is revoked by the taxpayer or reporting agent. I am authorizing the income tax department of the above names city to disclose otherwise confidential tax information to the reporting agent relating to the authority granted on line 21 and/or line 22, including disclosures required to process Form GR-8655. Disclosure authority is effective upon signature of taxpayer and receipt of Form 8655 by the income tax department of the above named city. The authority granted on Form 8655 will not revoke any Power of Attorney (Form GR-2848) in effect.

Sign Here

I certify I have the authority to execute this form and authorize disclosure of otherwise confidential information on behalf of the taxpayer. 12. Sign your name here 13. Print your title here 14. Print your name here

15. Date (MM/DD/YYYY)

16. Best daytime phone number

INSTRUCTIONS FOR FORM GR-8655 Revised 09/29/2015

General Instructions Purpose of Form Use Form GR-8655 to authorize a reporting agent to: 1. 2. 3.

4.

Sign and file certain returns. Make deposits and payments for certain returns; Receive duplicate copies of tax information, notices, and other written and/or electronic communication regarding any authority granted; and Provide city income tax department with information to aid in penalty relief determinations related to the authority granted on Form GR-8655.

Note. An authorization does not relieve the taxpayer of the responsibility or the liability for failing to ensure that all tax returns are filed timely and that all withholding tax deposits and payments are made timely. Employers who enroll to make withholding tax payments using the city’s tax tool can view deposits and payments made on their behalf under their federal employer identification number (FEIN).

Authority Granted Once Form GR-8655 is signed, any authority granted is effective beginning with the period indicated on lines 21 or 22 and continues indefinitely unless revoked by the taxpayer or reporting agent. A new authorization must be submitted to the city for any increase or decrease in the authority of a reporting agent to act for its client. The preceding authorization remains in effect except as modified by the new one. No authorization or authority is granted for periods prior to the period(s) indicated on Form GR-8655. Where authority is granted for any form, it is also effective for related forms such as the corresponding amended return or payment voucher. Disclosure authority granted on line 23a is effective on the date Form GR-8655 is signed by the taxpayer. Any authority granted on Form GR-8655 does not revoke and has no effect on any authority granted on Form GR-2848 or any third-party designee checkbox authority.

Where To File Send Form GR-8655 to: Grand Rapids Income Tax Department PO Box 347, Grand Rapids, MI 49501-0347 You can fax Form GR-8655 to: (616) 456-4540

Revoking an Authorization If you have a valid Form GR-8655 on file with the city, the filing of a new Form GR-8655 revokes the authority of the prior reporting agent beginning with the period indicated on the new Form GR-8655. However, the prior reporting agent is still an authorized reporting agent and retains any previously granted disclosure authority for the periods prior to the beginning period of the new reporting agent’s authorization unless specifically revoked. If the taxpayer wants to revoke an existing authorization, send a copy of the previously executed Form GR-8655 to city at the address listed under Where To File, above. Re-sign the copy of the Form 8655 under the original signature. Write “REVOKE” across the top of the form. If you do not have a

copy of the authorization you want to revoke, send a statement to the city. The statement of revocation must indicate that the authority of the reporting agent is revoked and must be signed by the taxpayer. Also, list the name and address of each reporting agent whose authority is revoked.

Withdrawing from reporting authority. A reporting agent can withdraw from authority by filing a statement with the city on paper. The statement must be signed by the reporting agent and identify the name and address of the taxpayer and authorization(s) from which the reporting agent is withdrawing.

Specific Instructions Line 15 Use the “YYYY” format for annual tax returns. Use the “MM/YYYY” format for quarterly tax returns, where “MM” is the ending month of the quarter the named reporting agent is authorized to sign and file tax returns for the taxpayer. For example, enter “09/2016” on the line for “GR-941” to indicate you are authorizing the named reporting agent to sign and file Form GR-941 for the July–September quarter of 2016 and subsequent quarters. Line 16 Use the “MM/YYYY” format to enter the starting date, where “MM” is the first month the named reporting agent is authorized to make deposits or payments for the taxpayer. For example, enter “08/2016” on the line for “GR-501” to indicate you are authorizing the named reporting agent to make deposits or payments for Form GR-501 starting in August 2016 and all subsequent months.

Who Must Sign Sole proprietorship. The individual owning the business. Corporation (including a limited liability company (LLC) treated as a corporation). Generally, Form GR-8655 can be signed by: (a) an officer having legal authority to bind the corporation, (b) any person designated by the board of directors or other governing body, (c) any officer or employee on written request by any principal officer, and (d) any other person authorized to access information under section 6103(e) of the Internal Revenue Code. Partnership (including an LLC treated as a partnership) or an unincorporated organization. Generally, Form GR-8655 can be signed by any person who was a member of the partnership during any part of the tax period covered by Form GR-8655.

Single member LLC treated as a disregarded entity. The owner of the LLC. Trust or estate. The fiduciary.

Form CF-W-4 — EMPLOYEE’S WITHHOLDING CERTIFICATE FOR MICHIGAN CITIES LEVYING AN INCOME TAX (See list below)

Revised 12/02/2014

1. Print your full name

Social Security No.

2. Address, Number and Street

EMPLOYEE: File this form with your employer. Otherwise your employer must withhold tax for the cities without any allowance for exemptions.

Apartment

Employee Identification No

City, Township or Village where you reside

State

EMPLOYER: Keep this certificate with your records. If the YOUR WITHHOLDING EXEMPTIONS information submitted by the employee is not believed to be true, 4. Exemptions for yourself (See cities below) correct and complete, the City Income Tax Department must be advised. 5. Exemptions for spouse (See cities below)

CHECK BOX IF CHECK BOX YOU ARE A MICHIGAN CITIES IF YOU ARE A NONRESIDENT LEVYING AN INCOME RESIDENT OF AND WORK TAX AND THE VALUE A LISTED FOR OF ONE EXEMPTION CITY EMPLOYER IN A LISTED CITY

CHECK THE BOX THAT INDICATES THE APPROXIMATE AMOUNT OF TIME WORKING FOR EMPLOYER IN THE CHECKED NONRESIDENT CITY UNDER 25%

25% TO 40%

41% TO 60%

61% TO 80%

81% TO 100%

6. Exemptions for your dependent children

Nonresident City Exemptions

4 5 6 7

8. Total number of exemptions claimed

8

Exemptions allowed by city for taxpayer and spouse, if married. Regular exemption

4. Taxpayer 5. Spouse

Battle Creek $750

4. Taxpayer 5. Spouse

Big Rapids $600

4. Taxpayer 5. Spouse

Detroit $600

4. Taxpayer 5. Spouse

Flint $600

4. Taxpayer 5. Spouse

Grand Rapids $600

4. Taxpayer 5. Spouse

Grayling $3,000

4. Taxpayer 5. Spouse

Hamtramck $600

4. Taxpayer 5. Spouse

Highland Park $600

4. Taxpayer 5. Spouse

Hudson $1,000

4. Taxpayer 5. Spouse

Ionia $700

4. Taxpayer 5. Spouse

Jackson $600

4. Taxpayer 5. Spouse

Lansing $600

4. Taxpayer 5. Spouse

Lapeer $600

4. Taxpayer 5. Spouse

Muskegon $600

4. Taxpayer 5. Spouse

Muskegon Heights $600

4. Taxpayer 5. Spouse

Pontiac $600

4. Taxpayer 5. Spouse

Port Huron $600

4. Taxpayer 5. Spouse

Portland $1,000

4. Taxpayer 5. Spouse

Saginaw $750

4. Taxpayer 5. Spouse

Springfield $750

4. Taxpayer 5. Spouse

Walker $600

4. Taxpayer 5. Spouse 9. Date

Postal Code

Resident City Exemptions

7. Exemptions for your other dependents

Albion $600

I am not a resident of any listed city I do not expect to work in any city listed

Office, Plant, Dept.

10. Signature

65 or over at end of year

Blind

Deaf

Permanently Disabled

CF-2848

CITY OF {CITY NAME} INCOME TAX DEPARTMENT

Power of Attorney Authorization Issued under Authority of the Uniform City Income Tax Ordinance (MCL 141.601 et seq.) Filing is voluntary. Complete this form if you wish to appoint someone to represent you to the Income Tax Department on income tax matters, or if you wish to revoke or change your current power of attorney authorization. Read the instructions on page 2 before completing this form. Revised: 08/11/2015

PART 1: TAXPAYER INFORMATION Taxpayer's (first name, initial, last name or business name)

Taxpayer SSN/FEIN

If joint return spouse's first name, initial, last name

Spouse SSN

Current address (number and street)

Apt./Ste. no.

If a business, enter DBA, trade or assumed name

Address line 2

Telephone number

City, town or post office

State

Zip code

Fax number

E-mail address

Foreign country name, province/county, postal code

PART 2: REPRESENTATIVE INFORMATION AND AUTHORIZATION DATES Representative's name

Contact's name (if applicable)

Contact's name (if applicable)

Firm name

E-mail address

E-mail address

Telephone number

Telephone number

Fax number

Fax number

Beginning authorization date (MM/DD/YY)

Ending authorization date (MM/DD/YY)*

Address (number and street)

Apt./Ste. no.

Address line 2

City, town or post office

State

Zip code

Foreign country name, province/county, postal code

PART 3: TYPE OF AUTHORIZATION GENERAL AUTHORIZATION Authorizes my representative to: (1) inspect or receive confidential information; (2) represent me and make oral or written presentations of fact and argument; (3) sign returns; (4) enter into agreements; (5) receive mail including forms, billings and payment notices. This authorization applies to all tax matters for all tax years or periods. Only as All Tax LIMITED AUTHORIZATION Specified Matters Below Select the type of authorization by checking the appropriate boxes. 1. Inspect or receive confidential information 2. Represent me and make oral or written presentations of fact and argument 3. Sign returns 4. Enter into agreements 5. Receive mail (includes forms, billings and payment notices) Type of Income Tax

Tax Form or Assessment Number

Tax Year(s) or Period(s)

PART 4: CHANGE IN POWER OF ATTORNEY REPRESENTATION OR REVOCATION CHANGE IN POWER OF ATTORNEY REPRESENTATION: This form replaces all earlier powers of attorney, except those attached, on file for the same tax matters and years or periods covered by this Power of Attorney. REVOKE PREVIOUS AUTHORIZATION: I revoke all Powers of Attorney submitted and will represent myself in all tax matters. Attach copies of all Powers of Attorney that remain in effect concurrent with this new authorization.

PART 5: TAXPAYER SIGNATURE(S) If signed by a corporate officer, partner or fiduciary on behalf of the taxpayer, I certify that I have the authority to execute this Power of Attorney. Signature

Name or title typed or printed

Date

Spouse's signature

Name or title typed or printed

Date

* If no Ending Authorization date is provided, the above-named representative will be authorized to represent you until you notify the Income Tax Department in writing that this Power of Attorney is revoked.

Revised 11/03/2014

City of {City Name} Income Tax Department

INSTRUCTIONS FOR POWER OF ATTORNEY AUTHORIZATION Complete and file a Power of Attorney Authorization if you wish to appoint an individual, firm or organization as your representative in income tax matters before the Income Tax Department of the city noted above. Failure to complete this form will prohibit the Income Tax Department from discussing or releasing your tax return and/or tax return information with or to another person including your spouse. PART 1: TAXPAYER INFORMATION Enter the taxpayer’s name, address, telephone number, fax number and e-mail address (if applicable). If the taxpayer is a business operating under another name, enter the DBA, trade or assumed name. Enter the Social Security number(s), federal employer identification number (FEIN) or other account number, whichever applies. If spouses are designating the same representative, enter the spouse’s name, address (if different) and Social Security number. PART 2: REPRESENTATIVE INFORMATION AND AUTHORIZATION DATES You must send a separate Power of Attorney form for each different representative. Enter the authorized representative’s name firm’s name, address, telephone number, fax number, and e-mail address (if applicable). If your representative is not an individual, designate a contact person. Indicate the beginning and ending dates of authorization. PART 3: TYPE OF AUTHORIZATION Check the General Authorization box to allow your representative to act on your behalf to do all of the following: 1. Inspect and receive confidential information; 2. Represent you and make oral or written presentations of fact and argument; 3. Sign returns; 4. Enter into agreements; and 5. Receive all mail including forms, billings and payment notices. This authorization applies to all income tax matters for all years and tax periods. You may restrict your representative’s authorization to act on your behalf by checking the Limited Authorization box, and checking the appropriate boxes. To limit the authorization to specific income tax matters, check the appropriate “Only as Specified Below” boxes, and indicate the type of income tax, type of income tax form, and tax years or periods for which you are granting authorization in the space provided. 1. Check this box if your representative is authorized to inspect or receive confidential information. 2. Check this box if your representative is authorized to represent you and make oral or written presentation of fact and argument.

3. 4. 5.

Check this box if your representative is authorized to sign tax returns. Check this box if your representative is authorized to enter into agreements (such as payment plans). Check this box if your representative is authorized to receive mail.

PART 4: CHANGE IN POWER OF ATTORNEY REPRESENTATION OR REVOCATION Unless otherwise specified, this Power of Attorney Authorization replaces and revokes any previous power of attorney authorizations on file with the Income Tax Department of the city noted above for the same tax matters identified on this form. You must identify any previous authorizations that are to remain in effect, and attach a copy of the authorizations to this form when filed. PART 5: TAXPAYER SIGNATURE You, and if a joint return, your spouse must sign and date the form. FILING Mail this form to: {Address listed in Appendix F for city named at top of this page}

GRAND RAPIDS INCOME TAX WITHHOLDING SPECIFICATIONS Revised: 09/14/2015

`

APPENDIX A

Exemption Amounts and Tax Rates for Tax Year 2016 CITIES ACCEPTING COMMON INCOME TAX WITHHOLDING FORMS City Name

GRAND RAPIDS

Effective Date of Ordinance

2016 Exemption Amount

7/1/1967

$600

2016 Withholding Tax Rates Resident

Non-Resident

1.50%

0.75%  

  Revised: 09/14/2015

APPENDIX B Personal Exemptions Allowed City Name

GRAND RAPIDS

Regular

65 & over

Blind

X

X

X

Deaf

Permanently Disabled

An employee or spouse who is 65 years of age or older may not claim the exemption for being permanently disabled. Albion, Big Rapids, Highland Park and Pontiac do not allow a taxpayer to claim a personal exemption if the taxpayer is claimed as an exemption by another taxpayer on that city's income tax return.

   

APPENDIX C

Revised: 09/29/2015

Withholding Deposit Requirements Monthly and quarterly deposits are required for cities electing alternative Sections 60 and 61 (MCL 141.760 and MCL 141.761). Employers whose total withholding for the first or second month of a quarter exceeds $100 are required to make a monthly deposit of the tax withheld for the month and are required to make a quarterly deposit of income tax withheld for the quarter not previously deposited for the first or second month of the quarter CITIES ACCEPTING COMMON INCOME TAX WITHHOLDING FORMS

City Name

GRAND RAPIDS

Quarterly Deposits Required

Monthly and Quarterly Deposits Required (See above)

Monthly Reporting Optional

XX  

 

 

GRAND RAPIDS INCOME TAX WITHHOLDING SPECIFICATIONS Revised 09/14/2015

APPENDIX D Authorized City Name Abbreviation to Use for Completing Form W-2, Box 20, Locality Name and Related RS Record Data for EFW2 Transmittals MICHIGAN CITIES LEVYING AN INCOME TAX COLUMN A CITY NAME

GRAND RAPIDS

AUTHORIZED LOCALITY NAME ABBREVIATIONS FOR USE IN FORM W-2, BOX 20 (LOCALITY NAME) AND EFW2 RS RECORD LOCATIONS 298-307 COLUMN B 5 CHARACTER ABBREVIATION FOR PRINTED FORM W-2 FOR MIICHIGAN CITIES

COLUMN C 6 CHARACTER ABBREVIATION FOR PRINTED FORM W-2 FOR MIICHIGAN CITIES

COLUMN D EFW2 RS RECORD DATA LOCATIONS 298-307 (n=BLANK) "MI{CN}nnnnn"

MI-GRR

MIGRRnnnnn

MIGRR

    Revised: 09/14/2015

APPENDIX E Three Character City Name Abbreviation

City Name

GRAND RAPIDS

3 Character City Name {CN} Abbreviation GRR  

  Revised: 09/29/2015

APPENDIX F

Cities Accepting ACH Debit or Credit Withholding Deposits in leiu of Paper Returns; and Cities Accepting Forms W-2 Using Common Form CD-ROM format (See Appendix F for the city's website address and go to the website for Instructions and File Specifications)

City Name

GRAND RAPIDS

Accepting ACH Credit Payments

Accepting ACH Debit Payments

Accepting Forms W-2 Using CD-ROM Format

Yes

Yes

Yes  

   

  GRAND RAPIDS INCOME TAX WITHHOLDING SPECIFICATIONS

Revised: 09/14/2015

APPENDIX G

Mailing Addresses for Mailing Returns to Cities Accepting the Withholding Tax Common Form USE MAILING ADDRESS FOR WITHHOLDING TAX FORMS OR PAYMENTS CITY

Grand Rapids

MAILING ADDRESS

Grand Rapids Income Tax Dept PO Box 347 Grand Rapids MI 49501-0347

Form CF-501

Form CF-941

XX

XX

Prior Year Form CF-W-3 Form CF-W-3 Form CF-IT-6, Prior Year Amended Power of Notice of and Forms and Forms Forms Withholding Attorney Change or W-2 with W-2 without CF-501 or Tax Return Authorization Discontinuance CF-941 Payment Payment Forms

XX

XX

XX

XX

XX

XX

   

APPENDIX H Withholding Tax Contacts for Michigan Cities Levying a City Income Tax City Name

GRAND RAPIDS

Telephone Number (616) 456-3415 Ext. 4

Withholding Tax Website Address for City Fax Number (616) 456-4540

www.grcity.us/incometax

     

GRAND RAPIDS INCOME TAX WITHHOLDING SPECIFICATIONS

Revised: 09/04/2015

APPENDIX I OCR Scan Line Specifications for Withholding Tax Return Forms, CF-501, CF-941 or CF-W-3 CITY SSN/FEIN (TAX ID) 123

SSN/FEIN INDICATOR

CHECK DIGIT *

TAX YEAR

TAX CODE PLUS TYPE

PAYMENT AMOUNT

1

1

1234

123456

12,345,678.90

W

2

123456789

PAYMENT DATE

ROUTINGANK ACCOUN TYPE OF NUMBER NUMBER ACCOUNT MMDDYYYY ######## 4567891234 1

EXAMPLE

GRR 123456789

SSN/FEIN INDICATOR

W

2016 94101M 1234567890

TAX CODE

* FOR CHECK DIGIT SPECIFICATIONS SEE APPENDIX J

THE SCAN LINE DATA STREAM MAY BE IN 10 OR 12 POINT "OCR A" FONT

######## 4567891234

C

TAX CODE TAX CODE (PAYMENT CODE)

941

EMPLOYER FEIN

04012015

941 941 941 941 941 941 941 941 941 941 941 941

WITHHOLDING TAX PAYMENT TAX TYPE TAX TYPE (PAYMENT TYPE)

01M 02M 01Q 04M 05M 02Q 07M 08M 03Q 10M 11M 04Q

JANUARY WITHHOLDING TAX PAYMENT FEBRUARY WITHHOLDING TAX PAYMENT 1ST QTR (MARCH) WITHHOLDING TAX PAYMENT APRIL WITHHOLDING TAX PAYMENT MAY WITHHOLDING TAX PAYMENT 2ND QTR (JUNE) WITHHOLDING TAX PAYMENT JULY WITHHOLDING TAX PAYMENT AUGUST WITHHOLDING TAX PAYMENT 3RD QTR (SEPTEMBER) WITHHOLDING TAX PAYMENT OCTOBER WITHHOLDING TAX PAYMENT NOVEMBER WITHHOLDING TAX PAYMENT 4TH QTR (DECEMBER) WITHHOLDING TAX PAYMENT

ACTUAL DATA STREAMS FOR A MONTHLY WITHHOLDING TAX PAYMENT USING FORM CF-501 WITH AND WITHOUT PAYMENT AMOUNT

GRR123456789W2201694101M1234567890 GRR123456789W2201694101M ACTUAL DATA STREAMS FOR A QUARTERLY WITHHOLDING TAX PAYMENT USING FORM CF-941 WITH AND WITHOUT PAYMENT AMOUNT

GRR123456789W2201694101Q1234567890 GRR123456789W2201694101Q DATA STREAM CHARACTERS CHARACTER 1 THROUGH 3 4 THROUGH 12 13 14 15 THROUGH 18 19 THROUGH 24 25 THROUGH 34 35 THROUGH 42 43 THROUGH 51 52 THROUGH 68 69

EXPLANATION 3 CHARACTER CITY NAME (CN) ABBREVIATION FROM APPENDIX H NINE DIGIT SSN/FEIN (TAXPAYER IDENTIFICATION NUMBER) ONE CHARACTER SSN/FEIN INDICATOR CHECK DIGIT FOUR DIGIT TAX YEAR SIX CHARACTER TAX CODE AND TAX TYPE (Three character Tax Code plus three character Tax Type) PAYMENT AMOUNT (Right justified; Zero filled on left; Last two digits are cents; No decimal point) PAYMENT DATE (Reserved for future development) ROUTING NUMBER (Reserved for future development) BANK ACCOUNT NUMBER (Right justified; Zero filled on left) (Reserved for future development) BANK ACCOUNT TYPE (Reserved for future development)

GRAND RAPIDS INCOME TAX WITHHOLDING SPECIFICATIONS

Revised 09/04/2015

APPENDIX J TAX ID CHECK DIGIT SPECIFICATIONS CHARACTERS 1 TO 9

10 11

DESCRIPTION

EXPLANATION SSN (Social Security Number), ITIN (Individual Taxpayer Identification Number) or FEIN (Federal Employer Identification Number) POSSIBLE CHARACTERS ARE 0, C, T & W (0 = SSN OR ITIN, C = Corporation or Partnership FEIN, T = Estate or Trust FEIN & W = Employer Withholding Tax FEIN) AS COMPUTED IN EXAMPLES BELOW

9 DIGIT TAX ID TAX ID TYPE INDICATOR FOR AN SSN, ITIN OR FEIN CHECK DIGIT

CHARACTER TRANSLATION SCHEME 0 1 2 3 0 1 2 3

E 5

F 6

G 7

H 8

I 9

J K 10 11

L M N O P Q R S T U V W X Y Z 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26

0

# 0

$ 0

* 0

& 0

INPUT VALUE TRANSLATION VALUE INPUT VALUE TRANSLATION VALUE

4 4

5 5

6 6

7 7

8 8

9 9

A 1

B 2

C 3

D 4

/ 0

WEIGHTS: 3, 5, 7, 9 REPEATED THROUGHOUT FOR NUMBER OF CHARACTERS EXAMPLE OF CHECK DIGIT CALCULATION FOR SSN OR ITIN CHARACTER PLACE 1 2 3 4 5 6 7 CHARACTER VALUE 3 2 1 6 5 4 7 CHARACTER WEIGHT 3 5 7 9 3 5 7

EXAMPLE OF CHECK DIGIT CALCULATION FOR TRUST FEIN CHARACTER PLACE 1 2 3 4 5 6 7 CHARACTER VALUE 1 2 3 4 5 6 7 CHARACTER WEIGHT 3 5 7 9 3 5 7

VALUE x WEIGHT

VALUE x WEIGHT

9

10

7

8 9 10 8 9 0 9 3 5 54 15 20 49 72 27 0

SUM OF VALUE x WEIGHT

263

MODULUS 10

263 / 10 = 26 REMAINDER 3 10 - 3 = 7 (REMAINDER OF 0 MAKES CHECK DIGIT = 0)

REMAINDER FROM 10 CHECK DIGIT

7

3

8 9 10 8 9 20 9 3 5 10 21 36 15 30 49 72 27 100 363

SUM OF VALUE x WEIGHT MODULUS

363 / 10 = 36 REMAINDER 3 10 - 3 = 7 (REMAINDER OF 0 MAKES CHECK DIGIT = 0)

REMAINDER FROM 10 CHECK DIGIT

7

EXAMPLE OF CHECK DIGIT CALCULATION FOR CORPORATION FEIN CHARACTER PLACE 1 2 3 4 5 6 7 8 9 CHARACTER VALUE 3 2 1 6 5 4 7 8 9 CHARACTER WEIGHT 3 5 7 9 3 5 7 9 3

EXAMPLE CHECK DIGIT CALCULATION FOR WITHHOLDING TAX FEIN CHARACTER PLACE 1 2 3 4 5 6 7 8 9 CHARACTER VALUE 3 2 1 6 5 4 7 8 9 CHARACTER WEIGHT 3 5 7 9 3 5 7 9 3

VALUE x WEIGHT

VALUE x WEIGHT

SUM OF VALUE x WEIGHT MODULUS 10 REMAINDER FROM 10 CHECK DIGIT

9

10

7

10 3 5 54 15 20 49 72 27 15

278 278 / 10 = 27 REMAINDER 8 10 - 8 = 2 (REMAINDER OF 0 MAKES CHECK DIGIT = 0)

2

SUM OF VALUE x WEIGHT MODULUS 10 REMAINDER FROM 10 CHECK DIGIT

9

10

7

10 23

5 54 15 20 49 72 27 115

378 378 / 10 = 37 REMAINDER 8 10 - 8 = 2 (REMAINDER OF 0 MAKES CHECK DIGIT = 0)

2

GRAND RAPIDS INCOME TAX DEPARTMENT WITHHOLDING SPECIFICATIONS APPENDIX K Revised: October 28, 2015

SPECIFICATIONS FOR ELECTRONIC MEDIA FILING OF W-2 FORMS Acceptable standards for electronic media filing of Forms W-2: 1. The Social Security Administration, Specifications for Filing Forms W-2 Electronically (EFW2) For Tax Year 2015, Publication Number 42-007 (number 1 below); or 2. The CityTax Proprietary Format (number 2 below). How to Report Wages and Income Tax Withheld 1. Federal EFW2 Format (EFW2 Tax Year 2015): a. Data is to be submitted via CD-ROM and the file must be: (Transmission of data via any other media is strictly prohibited unless an alternative method is approved by the City.) 1) In a fixed length MS-DOS ASCII file format; 2) Named “W2REPORT” with no file extension; and 3) In the root directory. b. Records Specifications are found on Page 15 of the EFW2 for tax year 2015. The specifications for electronic media filing of local Forms W-2 are the same as specifications published by the Social Security Administration except for fields in the RS record (State Wage Record) defined by the State/local agency. c. Transmitters of W-2 information for multiple employers can avoid creating a separate file for each employer by using the EFW2 for tax year 2015 specifications. Review Appendix C, example 10, page 82, to see how multiple employers can be combined into one file. d. Data rules can be found on page 15 of EFW2 for tax year 2015. e. Required and Optional Records: Include the RA, RE, RW, RO, RS, RT, RU and RF records when using the EFW2 format. The employer records should include only records pertaining to the City of Grand Rapids income tax. The RS records should include only local tax information for Grand Rapids. RA − Submitter Record (Required) This record should be the same as the record submitted to the Social Security Administration. RE − Employer Record (Required) This record should be the same as the record submitted to the Social Security Administration. RW − Employee Wage Record (Required) This record should be the same as the record submitted to the Social Security Administration. Include RW records for all employees who worked and/or conducted business on behalf of their employer in Grand Rapids. RO − Employee Wage Record (Optional) Page 1 of 5

1. Federal EFW2 Format: (Continued) RS − State Record (Required) a. This record should be the same as the record submitted to the Social Security Administration. Include RS records for: 1) All employees from whom tax was withheld for the City of Grand Rapids; 2) All employees who are residents of Grand Rapids regardless of where they worked for the employer; and 3) All employees who are nonresidents of Grand Rapids and worked or conducted business on behalf of the employer in Grand Rapids. b. Specifications for RS record fields defined by State/local agency, The City of Grand Rapids: RS FIELD NAME POSITION 5-9 Taxing Entity Code

LENGTH

FIELD SPECIFICATIONS

5

To be defined by State/Local agency. Left Justified and blank filled. Identify the City of Grand Rapids using the abbreviation “MIGRR”. Applies to income tax reporting. To be defined by State/Local agency. Left Justified and blank filled. Identify the City of Grand Rapids using the abbreviation “MIGRR” followed by 5 blank characters. Applies to income tax reporting.

298-307

Other state data Locality Name (Form W-2, box 20)

10

309-319

Local taxable wages (Form W-2, box 18)

11

To be defined by State/Local agency. Right justified and zero filled Applies to income tax reporting.

320-330

Local income tax withheld (Form W-2, box 19)

11

To be defined by State/Local agency Right justified and zero filled. Include only income tax withheld for the City of Grand Rapids, Michigan. Applies to income tax reporting.

The code used by your accounting system to identify the particular city as the locality for which tax was withheld is meaningless to the city. RT − Total Record (Required) This record should be the same as the record submitted to the Social Security Administration except include totals for only the RS records for all employees who were residents of Grand Rapids or worked (and/or conducted business) for their employer in Grand Rapids. RU − Total Record (Optional) RF − Final Record (Required) RV – State Total Record (Optional)

Page 2 of 5

2. CityTax Proprietary Format (CTP): (This is a comma-delimited format. See instructions for creating this file in Microsoft Excel under section e below.) a. Data is to be submitted via CD-ROM and the file must be: 1) In comma delimited MS-DOS ASCII file format; 2) Named “W2REPORT” with a “.CSV” file extension; and 3) In the root directory. b. First row: Employer Record Specifications Column A B C D E F G H I J

Data CTE Employer EIN of Tax ID Tax year Employer name C or blank Employer street address Employer city Employer state Employer Zip Code Employer Zip Plus 4

Explanation Text exactly as shown. Identifies as employer record. 9 digits no spaces or punctuation 4 digits C if corporation, blank otherwise No punctuation or commas in address 2 character state abbreviation 5 digits (6 characters if foreign address) 4 digits

c. Employee rows: Employee Record Specifications (One row per employee) Column A

Data CTW

B C D E F

Employee SSN Employee Last Name Employee First name Employee Middle Initial Employee Street Address

G H I J K

Employee City Employee State Employee Zip Code Employee Zip Plus 4 Employee total wages

L

Local Entity Code

Explanation Text exactly as shown. Identifies as employee record. 9 digits no spaces or punctuation

No punctuation or commas in address 2 character state abbreviation 5 digits (6 characters if foreign address) 4 digits Same as Form W-2, box 1. Format as number with two decimal places; do not use 1000 Separator (,). If no wages zero fill field. Same as Form W-2, box 20. Identify the City of Grand Rapids using the abbreviation MIGRR followed by 5 blank characters. Page 3 of 5

2. CityTax Proprietary Format (CTP): (Continued) Column L

M

Data Local Entity Code

Grand Rapids Income Tax Withheld

Explanation Same as Form W-2, box 20. Identify the City of Grand Rapids using the abbreviation MIGRR followed by 5 blank characters. Same as Form W-2, box 19. Format as number with two decimal places; do not use 1000 Separator (,). If no withholding zero fill.

d. End of data marker. In row after the last row of employee data, enter in column A ‘ZZZ’ as the end of data marker. e. How to Create CTP formatted file using Microsoft Excel. 1) Open a new spreadsheet. 2) All entries are to be made in upper case letters. 3) In the first row, enter the employer data as specified above. Enter one value per column. Skip a column if blank. Start by entering ‘CTE’ on the first line in column A. Enter the remaining employer data items one per column. 4) In the second row and each subsequent employee row necessary thereafter, enter the employee data as specified above. Enter ‘CTW’ in column A. Enter the remaining employee data items one item per column. If a data item is blank, skip the corresponding column. The employee records should include only local tax information for: i. All employees from whom tax was withheld for the City of Grand Rapids; ii. All employees who are residents of Grand Rapids regardless of where they worked for the employer; and iii. All employees who are nonresidents of Grand Rapids and who worked or conducted business on behalf of the employer in Grand Rapids regardless of whether or not Grand Rapids withholding was deducted. 5) On the row after the last line of employee data, enter in column A ‘ZZZ’ as an end of data marker. 6) When done entering employee data, click on the Save button (or select Save from the file menu). At the bottom of the save window is a drop down box titled, Save as type. Click on this drop-down and select, ‘CSV (Comma delimited)(*.csv). Enter the file name, ‘W2REPORT’ and then click on the save button. 3. Marking of CR-ROM’s: Mark all CD-ROM’s submitted with the name of the taxpayer, the taxpayer’s tax ID, the tax year of the Forms W-2, and the sequential number if more than one CD-ROM is submitted.

Page 4 of 5

4. Filing of Form GRW-3, Employer’s Annual Reconciliation of Income Tax Withheld An employer filing W-2’s on CD-ROM must submit Form GRW-3, Employer’s Annual Reconciliation of Income Tax Withheld, with the electronic media. a. Tax due upon reconciliation, as reported on Form GRW-3, line 6, must be paid when the reconciliation and CD-ROM are submitted. b. Refund of an overpayment of tax withheld, as reported on Form GRW-3, line 7, will be made only upon the employer’s submission of a letter requesting a refund of the overpayment and providing a detailed explanation of the cause of the overpayment. The request for refund should be attached to the Form GRW-3 submitted to the city. 5. Mail the CD-ROM with Form GRW-3 to: Grand Rapids Income Tax Department PO Box 347 Grand Rapids MI 49501-0347 6. Questions: All questions about electronic media filing of Forms W-2 with Grand Rapids must be directed via e-mail to [email protected] or phone to (616) 456-4083.

Page 5 of 5

COMMON INCOME TAX WITHHOLDING APPENDIX L

Revised 09/11/2015

WITHHOLDING TAX SECTIONS OF THE MICHIGAN UNIFORM CITY INCOME TAX ORDINANCE (MCL 141.601 et seq) AND THE REGULATIONS ADOPTED BY MOST MICHIGAN CITIES 141.605 Doing business; definition; solicitation of orders and storage excepted Sec. 5. "Doing business" means the conduct of any activity with the object of gain or benefit, except that it does not include: (a) The solicitation of orders by a person or his representative in the city for sales of tangible personal property, which orders are sent outside the city for approval or rejection and, if approved, are filled by shipment or delivery from a point outside the city. (b) The solicitation of orders by a person or his representative in the city in the name of or for the benefit of a prospective customer of a person, if orders by the customer to such person to enable the customer to fill orders resulting from the solicitation are orders described in paragraph (a). (c) The mere storage of personal property in the city in a warehouse neither owned nor leased by the taxpayer. Reg. 5.1. A person shall not be considered to be doing business in the city, in the absence of maintaining an establishment in the city or engaging in other activity in the city, merely by engaging in one or more of the following acts: (a) maintenance, by a corporation, of a resident agent in the city; (b) installing, servicing, or instructing in the use of equipment or other goods sold when performed by an employee-salesman of such person and where such activities are incidental to the employeesalesman's primary selling activities; (c) occasional credit investigations or collections by an employee-salesman of such person where such activities are incidental to the employee-salesman's primary selling activities; (d) exhibiting goods for a short time, in leased space, at a convention, exhibition or trade show; (e) mere ownership of real or tangible personal property in the city which is not used in or related to business activity in the city and which does not produce gross income in the city. 141.608 Definitions; predominant place of employment Sec. 8. (3) "Predominant place of employment" means that city imposing a tax under a uniform city income tax ordinance other than the city of residence, in which the employee estimates he will earn the greatest percentage of his compensation from the employer, which percentage is 25% or more. MCL 141.651 Tax withheld; rates for residents and nonresidents; employer as trustee; liability for taxes, penalties, interest Sec. 51. (1) An employer doing business or maintaining an establishment within the city shall withhold from each payment to the employer's employees on and after the effective date of this

ordinance the tax on their compensation subject to the tax, after giving effect to exemptions, as follows: (a) Residents. (i) At a rate equal to the rate set by ordinance to be levied against resident individuals under this ordinance, but not to exceed 3% of all compensation paid to the employee who is a resident of the city, if the employee is not subject to withholding in any other city levying the tax. (ii) At a rate equal to the difference in the percentage rate of tax on resident individuals as set by ordinance to be levied under this ordinance less the percentage rate of tax levied by any other city in which the employee works, on all compensation earned by the resident in another city. (b) Nonresidents. At a rate equal to the rate set by ordinance to be levied under this ordinance on nonresidents but not to exceed 50% of the percentage rate imposed on resident individuals of the compensation paid to the employee for work done or services performed in the city designated by the employee as the employee's predominant place of employment. The withholding rate shall be applied to the percentage of the employee's total compensation equal to the employee's estimated percentage of work to be done or services to be performed in the city for that employer, but no withholding shall be required if the estimated percentage of work is less than 25%. (2) An employer withholding the tax is deemed to hold the tax as a trustee for the city. (3) An employer who is required to withhold and who fails or refuses to deduct and withhold is liable for the payment of the amount required to be withheld. The liability shall be discharged upon payment of the tax by the employee but the employer is not relieved of penalties and interest provided in this ordinance for this failure or refusal. (Amended by Act 60 of 1981, effective June 5, 1981; Amended by Act 124 of 1982, effective April 19, 1982.) Reg. 51.1 In determining whether the tax shall be withheld from musicians, entertainers, athletes and other such individuals the definition of employee in Sec. 6(1) of the ordinance shall be controlling. ("Employee" means a person from whom an employer is required to withhold for either federal income or federal social security taxes.) Reg. 51.2 An employer, whether or not an individual, and whether or not a resident of the city, who maintains a business establishment or business establishments in the city and a business establishment or business establishments outside the city must withhold the tax from all residents working at such employer's out-of-city establishment or establishments. Reg. 51.3 Compensation subject to withholding shall include wage and salary advances, and advances on commissions. MCL 141.652 Same; payments excepted Sec. 52. Employers shall not withhold any tax from the following payments or persons: (a) Compensation paid to domestic help. (b) Compensation paid to a person who is not an employee, including an independent contractor. (c) An amount allowed and paid to an employee as reimbursement for expenses necessarily and actually incurred by the employee in the actual performance of his or her services, and deductible by the employer. (d) A qualified taxpayer. "Qualified taxpayer" means that term as defined in section 35(12)(c)(i).

(Amended by Act 442 of 1996, effective Dec. 19, 1996) Reg. 52.1 An employer who directly makes wage continuation payments for personal injuries, sickness or disability may elect to withhold or not withhold the tax on the exempt portion of such payments. In either case the amount of exempt income shall be included in the total amount of compensation reported on the annual information return required of all employers under Section 61(2) of this ordinance, either as part of total wages paid or as a separate figure. MCL 141.653 Same; payment by employee or employer Sec. 53. If the tax is not withheld, an employee is not excused from filing a return and paying the tax on his compensation. If the tax is withheld but an employer fails to pay the tax to the city, the employee is not liable for the tax so withheld. MCL 141.654 Same; exemptions claimed; percentage of work done at predominant place of employment; qualified taxpayer within renaissance zone Sec. 54. An employee with compensation subject to tax shall file with his or her employer a form on which the employee states the number of exemptions claimed, the city of residence, the predominant place of employment, whether or not the employee claims status as a qualified taxpayer of a renaissance zone, and the percentage of work done or services performed in the predominant place of employment. The percentage shall be expressed as "less than 25%", "40%", "60%". "80%" or "100%". The employer shall retain the form, rely on the information on the form for withholding purposes unless directed by the city to withhold on another basis, and, if the employee claims status as a qualified taxpayer based on residency in a renaissance zone, the employer shall forward a copy of the form to the city. If information submitted by the employee is not believed to be true, correct and complete, the city shall be so advised. As used in this section, "Renaissance zone" means that term as defined in section 35. (Amended by Act No. 442 of 1996, effective Dec. 19, 1996) MCL 141.655 Same; revised form, time for filing; qualified taxpayer within renaissance zone Sec. 55. (1) Except as provided in subsection (2), an employee shall file with his or her employer a revised form within 10 days after the number of exemptions decreases when a change in residence from or to a taxing city occurs. The employee may file a revised form when the number of exemptions increases. An employee shall file a revised form by December 1 of each year, if his or her predominant place of employment, estimate of the percentage of work done or services to be rendered in the city, or status as a qualified taxpayer of a renaissance zone will change for the ensuing year. Revised withholding certificates shall not be given retroactive effect. (2) An employee shall file a revised form with his or her employer within 10 days after the employee completes the residency requirements under section 35(12), and when a change of status occurs from resident of a renaissance zone to nonresident of a renaissance zone. The employer shall forward a copy of a revised form filed under this subsection to the city. (3) As used in this section, "renaissance zone" means that term as defined in section 35. (Amended by Act 442 of 1996, effective Dec. 19, 1996)

MCL 141.656 Same; refusal to furnish withholding certificate, rate of tax Sec. 56. If an employee refuses to furnish a withholding certificate upon the request of his or her employer, the employer shall withhold a percentage of the employee's total compensation equal to the percentage rate of tax on resident individuals as set by ordinance to be levied under this ordinance, and report and pay the withholding on the basis of the best information in the possession of the employer. (Amended by Act 60 of 1981, effective June 5, 1981; Amended by Act 124 of 1982, effective April 19, 1982.) MCL 141.657 Same; withholding tables; first compensation taxable Sec. 57. (1) The city shall provide withholding tables establishing the amounts to be withheld for various tax rates, wage brackets, numbers of exemptions and pay periods. An employer who uses the tables fully discharges his duty to withhold. An employer may elect not to use the tables, in which case to discharge fully his duty to withhold he shall withhold the applicable per cent of taxable compensation after provision for exemptions. (2) The first compensation paid an employee on or after the effective date of the tax levy is subject to withholding on either of the following bases at the option of the employer: (a) On the full amount of compensation paid. (b) On the proportion of compensation paid for work done or services performed on or after the effective date of the levy. MCL 141.658 Same; overwithheld tax, refund Sec. 58. If an employer withholds more than the apparent tax liability of an employee due to an increase in the number of exemptions claimed during the year, or due to the actual percentage of work performed in the city by a nonresident being less than the estimated percentage, or due to a change of residence during the year to or from a taxing city, or due to any reason other than the employer's error, the employer shall neither refund the excess to the employee nor offset the excess by under-withholding in a subsequent period. The employee shall claim his refund from the city on his annual return. MCL 141.659 Same; correction of error, refund Sec. 59. Correction of an over or an under-withholding as a result of an employer's error shall be made as follows: (a) If the error is discovered in the same quarter in which it is made, the employer shall make the necessary adjustment on a subsequent pay and include only the corrected amount on the quarterly return. (b) If the error is discovered in a subsequent quarter of the same calendar year, the employer shall make the necessary adjustment on a subsequent pay and report it as an adjustment on the quarterly return. (c) If the error is discovered in the following calendar year, or if the employer-employee relationship has terminated, the procedure shall be as follows: (i) The employee or former employee shall apply to the city for a refund in case of an overwithholding. Upon proper verification the city shall refund to him the amount of the over-withholding. (ii) If a deficiency is discovered, the employer shall notify the city and the employee or former employee, who shall pay the city the additional tax due in his annual return.

MCL 141.660 Tax withheld; payment by employer; return; electronic funds transfer. Sec. 60. (1) Except as provided in subsection (2), an employer shall file a return, furnished by or obtainable on request from the city, and pay to the city the full amount of the tax withheld on or before the last day of the month following the close of each calendar quarter. (2) For tax years after the 1996 tax year and for which a city has entered into an agreement pursuant to section 9 of chapter 1, an employer shall file a return and pay the tax withheld for each calendar month on or before the fifteenth day of the month following the close of each calendar month to the department by means of an electronic funds transfer method approved by the state commissioner of revenue. (Amended by Act 478 of 1996, effective Jan. 1, 1997) MCL 141.760 Alternate Section 60. Sec. 60. (1) Except as provided in subsection (2), an employer shall file a return, furnished by or obtainable on request from the city, and pay to the city the full amount of the tax withheld on or before the last day of the month following the close of each calendar quarter, except that if during any calendar month other than the last month of a calendar quarter the amount withheld exceeds $100.00, the employer shall deposit the amount withheld with the city treasurer before the end of the next calendar month. (2) For tax years after the 1996 tax year and for which a city has entered into an agreement pursuant to section 9 of chapter 1, and employer shall file a return and pay the tax withheld for each calendar month on or before the fifteenth day of the month following the close of each calendar month to the department by means of an electronic funds transfer method approved by the state commissioner of revenue. (Amended by Act 478 of 1996, effective Jan. 1, 1997) 141.661 Tax withheld; employer's reconciliation of quarterly returns; deficiency; refund; information return; cessation of business. Sec. 61. (1) An employer shall file with the city or the department a reconciliation of quarterly returns on or before the last day of February following each calendar year in which the employer has withheld from an employee's compensation. A deficiency is due when the reconciliation is filed. If the employer made quarterly payments in excess of the amount withheld from an employee's compensation, the city or the department upon proper verification shall refund the excess to the employer. (2) In addition to the reconciliation, the employer shall file with the city or the department an information return for each employee from whom the city income tax has been withheld and each employee subject to withholding under this ordinance, setting forth his or her name, address, and social security number, the total amount of compensation paid him or her during the year, and the amount of city income tax withheld. The information return shall be on a copy of the federal W-2 form or on a form furnished or approved by the city or the department. A copy of the information return shall be furnished to the employee. (3) Except as provided in subsection (4), if an employer goes out of business or otherwise ceases to be an employer, reconciliation forms and the information return forms shall be filed with the city by the date the final withholding return and payment are due.

(4) For tax years after the 1996 tax year and for which a city has entered into an agreement pursuant to section 9 of chapter 1, if an employer goes out of business or otherwise ceases to be an employer, reconciliation forms and the information return forms shall be filed with the department within 30 days after the employer goes out of business or ceases to be an employer. (Amended by Act 478 of 1996, effective Jan. 1, 1997) MCL 141.761 Alternate Section 61. Sec. 61. (1) An employer shall file with the city or department a reconciliation of quarterly returns on or before the last day of February following each calendar year in which the employer has withheld from an employee's compensation. A deficiency is due when the reconciliation is filed. If the employer made monthly or quarterly or both, payments in excess of the amount withheld from an employee's compensation, the city or the department upon proper verification shall refund the excess to the employer. (2) In addition to the reconciliation the employer shall file with the city or the department an information return for each employee from whom the city income tax has been withheld and each employee subject to withholding under this ordinance, setting forth his or her name, address, and social security number, the total amount of compensation paid him or her during the year, and the amount of city income tax withheld. The information return shall be on a copy of the federal W-2 form or on a form furnished or approved by the city or the department. A copy of the information return shall be furnished to the employee. (3) Except as provided in subsection (4), if an employer goes out of business or otherwise ceases to be an employer, reconciliation forms and the information return forms shall be filed with the city by the date the final withholding return and payment are due. (4) For tax years after the 1996 tax year and for which a city has entered into an agreement pursuant to section 9 of chapter 1, if an employer goes out of business or otherwise ceases to be an employer, reconciliation forms and the information return forms shall be filed with the department within 30 days after the employer goes out of business or ceases to be an employer. (Amended by Act 478 of 1996, effective Jan. 1, 1997)