2022    FW-3                                                                                                               FW-3    
                                                  CITY OF FLINT
   EMPLOYER’S ANNUAL RECONCILIATION OF INCOME TAX WITHHELD
                                                                                                                           2022
1. EMPLOYER NAME AND ADDRESS                                             2. FEDERAL EMPLOYER IDENTIFICATION   NUMBER

                                                                         DUE ON OR BEFORE

                                                                                                        2 8/2 /2023

                                                  SUMMARY OF WITHHOLDING TAX PAID
                    MONTH/QUARTER                      TAX WITHHELD                                     WITHHOLDING TAX PAID
                     January
                     February
                       March
                FIRST QUARTER TOTAL
                       April
                       May
                       June
                SECOND QUARTER TOTAL
                       July
                       August
                     September
                THIRD QUARTER TOTAL
                     October
                     November
                     December
                FOURTH QUARTER TOTAL
                                                       TOTAL WITHHOLDING TAX PAID                    3.
                                                  NUMBER OF W-2 FORMS ATTACHED                       4.
                                                       TOTAL TAX WITHHELD PER W-2(S)                 5.
                                                                              BALANCE DUE            6.
                                                  OVERPAYMENT - ATTACH EXPLANATION*                  7.
                                                                         TOTAL PAYROLL               8.
                               *SUBMIT A LETTER EXPLAINING THE OVERPAYMENT AND REQUESTING A REFUND.
9. SIGNATURE                                      10. NAME AND TITLE (Please Print)                                        11. DATE

INSTRUCTIONS FOR EMPLOYER’S ANNUAL RECONCILIATION OF INCOME TAX WITHHELD
• Check identification information in Box 1 and Box 2.  If incorrect, make corrections and file Notice of Change or Discontinuance, Form F-6-IT.
• Enter tax withheld and tax payment information in the Summary of Withholding Tax Paid section.
• Enter the total withholding tax paid in Box 3.
• Enter the number of W-2 forms attached in Box 4.
• Enter the amount of tax withheld per the W-2 forms attached in Box 5.  Attach an adding machine tape totaling the W-2 forms or include copies of the
  computer generated summary W-2 forms.
• If the withholding tax paid (Box 3) is less than the tax withheld per the W-2 forms (Box 5), enter the balance due in Box 6.  The balance due must be paid in
  full with this FW-3 form.  Make remittance payable to:  FLINT CITY TREASURER
• If the withholding tax paid (Box 3) is greater than the tax withheld per the W-2 forms (Box 5), enter the overpayment in Box 7.  To receive a refund of any
  overpayment, submit a letter explaining the overpayment and requesting a refund.
• If the withholding tax paid (Box 3) equals the tax withheld per the W-2 forms (Box 5), enter a zero (0) in Boxes 6 and 7.
• Sign the return in box 9; Print your name and title in Box 10; and Enter the date signed in Box 11.
• Attach the required copies of the W-2 forms (or electronic media) and payment for any balance due to the completed FW-3 form and mail to:
  CITY OF FLINT INCOME TAX DEPARTMENT, WITHHOLDING TAX SECTION,                   PO BOX,            529
  EATON RAPIDS, MI  48827-0529 OR PAY ONLINE AT: WWW.CITYOFFLINT.COM
  *PLEASE VISIT www.cityofflint.com/IncomeTax/forms.asp FOR ELECTRONIC W2 FILING SPECIFICATIONS