F   -501                                                                          FLINT INCOME TAX DEPARTMENT                                                                                                                           F-501
                                                                                                   EMPLOYER'S MONTHLY DEPOSIT OF INCOME TAX WITHHELD 

                                                               1. IDENTIFICATION NUMBER                        2. DEPOSIT PERIOD                               3. DUE ON OR BEFORE                       4.  WITHHOLDING TAX DEPOSIT

                           TAXPAYER NAME AND ADDRESS                                                         PAYABLE ONLINE AT WWW.CITYOFFLINT.COM                                                       MONTHLY DEPOSIT OF INCOME TAX 
                                                                                                                                                                                                         IS REQUIRED IF TAX WITHHELD IN FIRST 
                                                                                                                                                                                                         OR SECOND MONTH OF A QUARTER 
                                                                                                                                                                                                         EXCEEDS $100. 
                                                                                                                                                                                                                                      IMPORTANT 
                                                                                                                                                                                                           5.      IF DEPOSIT IS FOR A                      MONTH                    YEAR 
                                                                                                                                                                                                                   PERIOD OTHER THAN 
                                                                                                                                                                                                                   BOX 2, ENTER THE
                                                                                                                                                                                                                   CORRECT PERIOD.
                                                                                                                                                                                                                 MAKE REMITTANCE PAYABLE 
                                                                                                                                                                                                               TO: TREASURER, CITY OF FLINT   
                                 SIGNATURE                                                                   TITLE                                                             DATE              MAIL TO: CITY OF FLINT INCOME TAX DEPT 
                                                                                                                                                                                                             ATTN: WITHHOLDING SECTION
                                  PRINTED NAME OF SIGNER                                                                                                                                                                                   BOX 529
 - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -EATON- - - - - - -RAPIDS- - - - - - -,-MI - - -4-8827- - - --0-529- - - - - - - - - -  - -  
CUT ON DOTTED LINE

                                 F   -501                                                                          FLINT INCOME TAX DEPARTMENT                                                                                                                           F-501
                                                                                                   EMPLOYER'S MONTHLY DEPOSIT OF INCOME TAX WITHHELD 

                                                               1.      IDENTIFICATION NUMBER                   2. DEPOSIT PERIOD                               3. DUE ON OR BEFORE                       4.  WITHHOLDING TAX DEPOSIT

                                 TAXPAYER NAME AND ADDRESS                                                   PAYABLE ONLINE AT WWW.CITYOFFLINT.COM                                                       MONTHLY DEPOSIT OF INCOME TAX 
                                                                                                                                                                                                         IS REQUIRED IF TAX WITHHELD IN FIRST 
                                                                                                                                                                                                         OR SECOND MONTH OF A QUARTER 
                                                                                                                                                                                                         EXCEEDS $100. 
                                                                                                                                                                                                                                      IMPORTANT 
                                                                                                                                                                                                           5.      IF DEPOSIT IS FOR A                       MONTH                   YEAR 
                                                                                                                                                                                                                   PERIOD OTHER THAN 
                                                                                                                                                                                                                   BOX 2, ENTER THE
                                                                                                                                                                                                                   CORRECT PERIOD.
                                                                                                                                                                                                                 MAKE REMITTANCE PAYABLE 
                                                                                                                                                                                                               TO: TREASURER, CITY OF FLINT
                                 SIGNATURE                                                                   TITLE                                                             DATE              MAIL TO: CITY OF FLINT INCOME TAX DEPT
                                                                                                                                                                                                            ATTN: WITHHOLDING SECTION
                                 PRINTED NAME OF SIGNER                                                                                                                                                                                   BOX 529
                                                                                                                                                                                                                 EATON RAPIDS, MI  48827-0529
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -  
CUT ON DOTTED LINE

                                 F-941                                                                             FLINT INCOME TAX DEPARTMENT                                                                                                                           F-941
                                                                                                 EMPLOYER'S QUARTERLY RETURN OF INCOME TAX WITHHELD 

                                                             1. IDENTIFICATION NUMBER                        2. RETURN PERIOD                              3. DUE ON OR BEFORE                       4. TAX WITHHELD THIS QUARTER

                                                                                                                                                                                                     5. ADJUSTMENTS
                                 TAXPAYER NAME AND ADDRESS                                                   PAYABLE ONLINE AT WWW.CITYOFFLINT.COM
                                                                                                                                                                                                     6. ADJUSTED TAX WITHHELD

                                                                                                                                                                                                     7a. TAX PAID FIRST 
                                                                                                                                                                                                           MONTH OF QUARTER 
                                                                                                                                                                                                     7b. TAX PAID SECOND 
                                                                                                                                                                                                            MONTH OF QUARTER 
                                                                                                                                                                                                     8. AMOUNT DUE 
                                                                                                                                                                                                       (Line 6 less lines 7a and 7b)
                                                                                                                                                                                                       PAY THIS AMOUNT 
                                 SIGNATURE                                                                    TITLE                                                      DATE                          PAY TO:          TREASURER, CITY OF FLINT FLINT 
                                                                                                                        If final return, check here and                                               MAIL TO:         CITY OF FLINT INCOME TAX DEPT. 
                                 PRINTED NAME OF SIGNER                                                                  complete Notice of Change or                                                                   ATTN: WITHHOLDING SECTION                                   
                                                                                                                         Discontinuance in return booklet.                                                              PO BOX 529
                                                                                                                                                                                                                        EATON RAPIDS, MI  48827-0529