HP - 941 City of Highland Park- Income Tax Divison                                                                               1 M            2023
            Employer’s Return of Income Tax Withheld                                                      Tax withheld                   ____________________________________
                                                               Make remittance payable to:
If this is your first return, enter date this                  Treasurer, City of Highland Park           Adjustments                    ____________________________________
business was started _______________________________           Mail to:
If this is final return, or employer status has changed,       City of Highland Park Withholding Payments Net tax withheld               ____________________________________
see back of form for required information to be submitted.     P.O. Box 239                               Late payment penalty - 1%
I certify the tax withheld as shown on this return is correct. Eaton Rapids, MI 48827-0530                per month ($2.00 minimum)      ____________________________________
Signature _______________________________________________________  Date _________________                 Interest due 
                                                                                                          (contact city for daily rates) ____________________________________
Phone # ____________________________________________
                                                                                                          TOTAL DUE
                                                                                                          PAY THIS AMOUNT
                                                                                                          FEDERAL EMPLOYER ID #          ____________________________________
                                                                                                            TAX YEAR                     2023
                                                                                                           PAYROLL PERIOD  JANUARY 1M
                                                                                                            DUE DATE                     February 28, 2023
                                                                                                                                 
                                                                                                                               DO NOT WRITE BELOW THIS LINE

HP - 941 City of Highland Park - Income Tax Divison                                                                              2 M            2023
            Employer’s Return of Income Tax Withheld                                                      Tax withheld                   ____________________________________
                                                               Make remittance payable to:
If this is your first return, enter date this                  Treasurer, City of Highland Park           Adjustments                    ____________________________________
business was started _______________________________           Mail to:
If this is final return, or employer status has changed,       City of Highland Park Withholding Payments Net tax withheld               ____________________________________
see back of form for required information to be submitted.     P.O. Box 239                               Late payment penalty - 1%
I certify the tax withheld as shown on this return is correct. Eaton Rapids, MI 48827-0530                per month ($2.00 minimum)      ____________________________________
Signature _______________________________________________________  Date _________________                 Interest due 
                                                                                                          (contact city for daily rates) ____________________________________
Phone # ____________________________________________
                                                                                                          TOTAL DUE
                                                                                                          PAY THIS AMOUNT
                                                                                                          FEDERAL EMPLOYER ID #          ____________________________________
                                                                                                            TAX YEAR                     2023
                                                                                                           PAYROLL PERIOD  FEBRUARY 2M
                                                                                                            DUE DATE                     March 31, 2023
                                                                                                                                 
                                                                                                                               DO NOT WRITE BELOW THIS LINE

HP - 941 City of Highland Park - Income Tax Divison                                                                              3 M            2023
            Employer’s Return of Income Tax Withheld                                                      Tax withheld                   ____________________________________
                                                               Make remittance payable to:
If this is your first return, enter date this                  Treasurer, City of Highland Park           Adjustments                    ____________________________________
business was started _______________________________           Mail to:
If this is final return, or employer status has changed,       City of Highland Park Withholding Payments Net tax withheld               ____________________________________
see back of form for required information to be submitted.     P.O. Box 239                               Late payment penalty - 1%
I certify the tax withheld as shown on this return is correct. Eaton Rapids, MI 48827-0530                per month ($2.00 minimum)      ____________________________________
Signature _______________________________________________________  Date _________________                 Interest due 
                                                                                                          (contact city for daily rates) ____________________________________
Phone # ____________________________________________
                                                                                                          TOTAL DUE
                                                                                                          PAY THIS AMOUNT
                                                                                                          FEDERAL EMPLOYER ID #          ____________________________________
                                                                                                            TAX YEAR                     2023
                                                                                                           PAYROLL PERIOD  MARCH 3M
                                                                                                            DUE DATE                     April 30, 2023
                                                                                                                                 
                                                                                                                               DO NOT WRITE BELOW THIS LINE

                                                              4.                                                                                                                                 3.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        2.                                                                                                                                                              1. 
                                                              �                                                                                                                                  Your current address �                                                                                                                                                           �                                                                                                            �                                                                �                                                                                                   � applicable questions Check reason for “Final Return” and answer taxes were withheld_____________________                                                                             Last pay period on which Highland Park
______________________________ ______________________________ Other:                    Zip Code                State                      City                        Street                                         Moved out of Highland Park Zip Code               State                      City                       Street                    Name                      Business sold to (Date)                     Wages will be paid starting                   Still operating –                              (Date) Operations will be resumed on Business temporarily discontinued                                  Business permanently discontinued
                                                                                                                                           ___________________________                                                                                                                             ___________________________
                                                              _________________________                         __________________________                             _________________________                                                                        __________________________                            _________________________ _________________________                  __________________________                                                                    __________________________
                                                                                        _______________________                                                                                                                                  _______________________

                                                                                                                                                                                                                                                                                                                                                                                                                                                                            Ceased paying wages

                                                              4.                                                                                                                                 3.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        2.                                                                                                                        1. 
                                                              �                                                                                                                                  Your current address �                                                                                                                                                           �                                                                                                            �                                                                �                                                                                                   � applicable questions Check reason for “Final Return” and answer taxes were withheld_____________________                                       Last pay period on which Highland Park
______________________________ ______________________________ Other:                    Zip Code                State                      City                        Street                                         Moved out of Highland Park Zip Code               State                      City                       Street                    Name                      Business sold to (Date)                     Wages will be paid starting                   Still operating –                              (Date) Operations will be resumed on Business temporarily discontinued                                  Business permanently discontinued
                                                                                                                                           ___________________________                                                                                                                             ___________________________
                                                              _________________________                         __________________________                             _________________________                                                                        __________________________                            _________________________ _________________________                  __________________________                                                                    __________________________
                                                                                        _______________________                                                                                                                                  _______________________

                                                                                                                                                                                                                                                                                                                                                                                                                                                                            Ceased paying wages

                                                              4.                                                                                                                                 3.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        2.                                                                                                                                                              1. 
                                                              �                                                                                                                                  Your current address �                                                                                                                                                           �                                                                                                            �                                                                �                                                                                                   � applicable questions Check reason for “Final Return” and answer taxes were withheld_____________________                                                                             Last pay period on which Highland Park
______________________________ ______________________________ Other:                    Zip Code                State                      City                        Street                                         Moved out of Highland Park Zip Code               State                      City                       Street                    Name                      Business sold to (Date)                     Wages will be paid starting                   Still operating –                              (Date) Operations will be resumed on Business temporarily discontinued                                  Business permanently discontinued
                                                                                                                                           ___________________________                                                                                                                             ___________________________
                                                              _________________________                         __________________________                             _________________________                                                                        __________________________                            _________________________ _________________________                  __________________________                                                                    __________________________
                                                                                        _______________________                                                                                                                                  _______________________

                                                                                                                                                                                                                                                                                                                                                                                                                                                                            Ceased paying wages

HP - 941 City of Highland Park - Income Tax Divison                                                                              4 M            2023
            Employer’s Return of Income Tax Withheld                                                      Tax withheld                   ____________________________________
                                                               Make remittance payable to:
If this is your first return, enter date this                  Treasurer, City of Highland Park           Adjustments                    ____________________________________
business was started _______________________________           Mail to:
If this is final return, or employer status has changed,       City of Highland Park Withholding Payments Net tax withheld               ____________________________________
see back of form for required information to be submitted.     P.O. Box 239                               Late payment penalty - 1%
I certify the tax withheld as shown on this return is correct. Eaton Rapids, MI 48827-0530                per month ($2.00 minimum)      ____________________________________
Signature _______________________________________________________  Date _________________                 Interest due 
                                                                                                          (contact city for daily rates) ____________________________________
Phone # ____________________________________________
                                                                                                          TOTAL DUE
                                                                                                          PAY THIS AMOUNT
                                                                                                          FEDERAL EMPLOYER ID #          ____________________________________
                                                                                                            TAX YEAR                     2023
                                                                                                           PAYROLL PERIOD  APRIL 4M
                                                                                                            DUE DATE                     May 31, 2023
                                                                                                                                 
                                                                                                                               DO NOT WRITE BELOW THIS LINE

HP - 941 City of Highland Park - Income Tax Divison                                                                              5 M            2023
            Employer’s Return of Income Tax Withheld                                                      Tax withheld                   ____________________________________
                                                               Make remittance payable to:
If this is your first return, enter date this                  Treasurer, City of Highland Park           Adjustments                    ____________________________________
business was started _______________________________           Mail to:
If this is final return, or employer status has changed,       City of Highland Park Withholding Payments Net tax withheld               ____________________________________
see back of form for required information to be submitted.     P.O. Box 239                               Late payment penalty - 1%
I certify the tax withheld as shown on this return is correct. Eaton Rapids, MI 48827-0530                per month ($2.00 minimum)      ____________________________________
Signature _______________________________________________________  Date _________________                 Interest due 
                                                                                                          (contact city for daily rates) ____________________________________
Phone # ____________________________________________
                                                                                                          TOTAL DUE
                                                                                                          PAY THIS AMOUNT
                                                                                                          FEDERAL EMPLOYER ID #          ____________________________________
                                                                                                            TAX YEAR                     2023
                                                                                                           PAYROLL PERIOD  MAY 5M
                                                                                                            DUE DATE                     June 30, 2023
                                                                                                                                 
                                                                                                                               DO NOT WRITE BELOW THIS LINE

HP - 941 City of Highland Park - Income Tax Divison                                                                              6 M            2023
            Employer’s Return of Income Tax Withheld                                                      Tax withheld                   ____________________________________
                                                               Make remittance payable to:
If this is your first return, enter date this                  Treasurer, City of Highland Park           Adjustments                    ____________________________________
business was started _______________________________           Mail to:
If this is final return, or employer status has changed,       City of Highland Park Withholding Payments Net tax withheld               ____________________________________
see back of form for required information to be submitted.     P.O. Box 239                               Late payment penalty - 1%
I certify the tax withheld as shown on this return is correct. Eaton Rapids, MI 48827-0530                per month ($2.00 minimum)      ____________________________________
Signature _______________________________________________________  Date _________________                 Interest due 
                                                                                                          (contact city for daily rates) ____________________________________
Phone # ____________________________________________
                                                                                                          TOTAL DUE
                                                                                                          PAY THIS AMOUNT
                                                                                                          FEDERAL EMPLOYER ID #          ____________________________________
                                                                                                            TAX YEAR                     2023
                                                                                                           PAYROLL PERIOD  JUNE 6M
                                                                                                            DUE DATE                     July 31, 2023
                                                                                                                                 
                                                                                                                               DO NOT WRITE BELOW THIS LINE

                                                              4.                                                                                                                                 3.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        2.                                                                                                                                                              1. 
                                                              �                                                                                                                                  Your current address �                                                                                                                                                           �                                                                                                            �                                                                �                                                                                                   � applicable questions Check reason for “Final Return” and answer taxes were withheld_____________________                                                                             Last pay period on which Highland Park
______________________________ ______________________________ Other:                    Zip Code                State                      City                        Street                                         Moved out of Highland Park Zip Code               State                      City                       Street                    Name                      Business sold to (Date)                     Wages will be paid starting                   Still operating –                              (Date) Operations will be resumed on Business temporarily discontinued                                  Business permanently discontinued
                                                                                                                                           ___________________________                                                                                                                             ___________________________
                                                              _________________________                         __________________________                             _________________________                                                                        __________________________                            _________________________ _________________________                  __________________________                                                                    __________________________
                                                                                        _______________________                                                                                                                                  _______________________

                                                                                                                                                                                                                                                                                                                                                                                                                                                                            Ceased paying wages

                                                              4.                                                                                                                                 3.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        2.                                                                                                                        1. 
                                                              �                                                                                                                                  Your current address �                                                                                                                                                           �                                                                                                            �                                                                �                                                                                                   � applicable questions Check reason for “Final Return” and answer taxes were withheld_____________________                                       Last pay period on which Highland Park
______________________________ ______________________________ Other:                    Zip Code                State                      City                        Street                                         Moved out of Highland Park Zip Code               State                      City                       Street                    Name                      Business sold to (Date)                     Wages will be paid starting                   Still operating –                              (Date) Operations will be resumed on Business temporarily discontinued                                  Business permanently discontinued
                                                                                                                                           ___________________________                                                                                                                             ___________________________
                                                              _________________________                         __________________________                             _________________________                                                                        __________________________                            _________________________ _________________________                  __________________________                                                                    __________________________
                                                                                        _______________________                                                                                                                                  _______________________

                                                                                                                                                                                                                                                                                                                                                                                                                                                                            Ceased paying wages

                                                              4.                                                                                                                                 3.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        2.                                                                                                                                                              1. 
                                                              �                                                                                                                                  Your current address �                                                                                                                                                           �                                                                                                            �                                                                �                                                                                                   � applicable questions Check reason for “Final Return” and answer taxes were withheld_____________________                                                                             Last pay period on which Highland Park
______________________________ ______________________________ Other:                    Zip Code                State                      City                        Street                                         Moved out of Highland Park Zip Code               State                      City                       Street                    Name                      Business sold to (Date)                     Wages will be paid starting                   Still operating –                              (Date) Operations will be resumed on Business temporarily discontinued                                  Business permanently discontinued
                                                                                                                                           ___________________________                                                                                                                             ___________________________
                                                              _________________________                         __________________________                             _________________________                                                                        __________________________                            _________________________ _________________________                  __________________________                                                                    __________________________
                                                                                        _______________________                                                                                                                                  _______________________

                                                                                                                                                                                                                                                                                                                                                                                                                                                                            Ceased paying wages

HP - 941 City of Highland Park - Income Tax Divison                                                                              7 M            2023 
            Employer’s Return of Income Tax Withheld                                                      Tax withheld                   ____________________________________
                                                               Make remittance payable to:
If this is your first return, enter date this                  Treasurer, City of Highland Park           Adjustments                    ____________________________________
business was started _______________________________           Mail to:
If this is final return, or employer status has changed,       City of Highland Park Withholding Payments Net tax withheld               ____________________________________
see back of form for required information to be submitted.     P.O. Box 239                               Late payment penalty - 1%
I certify the tax withheld as shown on this return is correct. Eaton Rapids, MI 48827-0530                per month ($2.00 minimum)      ____________________________________
Signature _______________________________________________________  Date _________________                 Interest due 
                                                                                                          (contact city for daily rates) ____________________________________
Phone # ____________________________________________
                                                                                                          TOTAL DUE
                                                                                                          PAY THIS AMOUNT
                                                                                                          FEDERAL EMPLOYER ID #          ____________________________________
                                                                                                            TAX YEAR                     2023
                                                                                                           PAYROLL PERIOD  JULY 7M
                                                                                                            DUE DATE                     August 31, 2023
                                                                                                                                 
                                                                                                                               DO NOT WRITE BELOW THIS LINE

HP - 941 City of Highland Park - Income Tax Divison                                                                              8 M            2023
            Employer’s Return of Income Tax Withheld                                                      Tax withheld                   ____________________________________
                                                               Make remittance payable to:
If this is your first return, enter date this                  Treasurer, City of Highland Park           Adjustments                    ____________________________________
business was started _______________________________           Mail to:
If this is final return, or employer status has changed,       City of Highland Park Withholding Payments Net tax withheld               ____________________________________
see back of form for required information to be submitted.     P.O. Box 239                               Late payment penalty - 1%
I certify the tax withheld as shown on this return is correct. Eaton Rapids, MI 48827-0530                per month ($2.00 minimum)      ____________________________________
Signature _______________________________________________________  Date _________________                 Interest due 
                                                                                                          (contact city for daily rates) ____________________________________
Phone # ____________________________________________
                                                                                                          TOTAL DUE
                                                                                                          PAY THIS AMOUNT
                                                                                                          FEDERAL EMPLOYER ID #          ____________________________________
                                                                                                            TAX YEAR                     2023
                                                                                                           PAYROLL PERIOD  AUGUST 8M
                                                                                                            DUE DATE                     September 30, 2023
                                                                                                                                 
                                                                                                                               DO NOT WRITE BELOW THIS LINE

HP - 941 City of Highland Park - Income Tax Divison                                                                              9 M            2023
            Employer’s Return of Income Tax Withheld                                                      Tax withheld                   ____________________________________
                                                               Make remittance payable to:
If this is your first return, enter date this                  Treasurer, City of Highland Park           Adjustments                    ____________________________________
business was started _______________________________           Mail to:
If this is final return, or employer status has changed,       City of Highland Park Withholding Payments Net tax withheld               ____________________________________
see back of form for required information to be submitted.     P.O. Box 239                               Late payment penalty - 1%
I certify the tax withheld as shown on this return is correct. Eaton Rapids, MI 48827-0530                per month ($2.00 minimum)      ____________________________________
Signature _______________________________________________________  Date _________________                 Interest due 
                                                                                                          (contact city for daily rates) ____________________________________
Phone # ____________________________________________
                                                                                                          TOTAL DUE
                                                                                                          PAY THIS AMOUNT
                                                                                                          FEDERAL EMPLOYER ID #          ____________________________________
                                                                                                            TAX YEAR                     2023
                                                                                                           PAYROLL PERIOD  SEPTEMBER 9M
                                                                                                            DUE DATE                     October 31, 2023
                                                                                                                                 
                                                                                                                               DO NOT WRITE BELOW THIS LINE

                                                              4.                                                                                                                                 3.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        2.                                                                                                                                                              1. 
                                                              �                                                                                                                                  Your current address �                                                                                                                                                           �                                                                                                            �                                                                �                                                                                                   � applicable questions Check reason for “Final Return” and answer taxes were withheld_____________________                                                                             Last pay period on which Highland Park
______________________________ ______________________________ Other:                    Zip Code                State                      City                        Street                                         Moved out of Highland Park Zip Code               State                      City                       Street                    Name                      Business sold to (Date)                     Wages will be paid starting                   Still operating –                              (Date) Operations will be resumed on Business temporarily discontinued                                  Business permanently discontinued
                                                                                                                                           ___________________________                                                                                                                             ___________________________
                                                              _________________________                         __________________________                             _________________________                                                                        __________________________                            _________________________ _________________________                  __________________________                                                                    __________________________
                                                                                        _______________________                                                                                                                                  _______________________

                                                                                                                                                                                                                                                                                                                                                                                                                                                                            Ceased paying wages

                                                              4.                                                                                                                                 3.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        2.                                                                                                                        1. 
                                                              �                                                                                                                                  Your current address �                                                                                                                                                           �                                                                                                            �                                                                �                                                                                                   � applicable questions Check reason for “Final Return” and answer taxes were withheld_____________________                                       Last pay period on which Highland Park
______________________________ ______________________________ Other:                    Zip Code                State                      City                        Street                                         Moved out of Highland Park Zip Code               State                      City                       Street                    Name                      Business sold to (Date)                     Wages will be paid starting                   Still operating –                              (Date) Operations will be resumed on Business temporarily discontinued                                  Business permanently discontinued
                                                                                                                                           ___________________________                                                                                                                             ___________________________
                                                              _________________________                         __________________________                             _________________________                                                                        __________________________                            _________________________ _________________________                  __________________________                                                                    __________________________
                                                                                        _______________________                                                                                                                                  _______________________

                                                                                                                                                                                                                                                                                                                                                                                                                                                                            Ceased paying wages

                                                              4.                                                                                                                                 3.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        2.                                                                                                                                                              1. 
                                                              �                                                                                                                                  Your current address �                                                                                                                                                           �                                                                                                            �                                                                �                                                                                                   � applicable questions Check reason for “Final Return” and answer taxes were withheld_____________________                                                                             Last pay period on which Highland Park
______________________________ ______________________________ Other:                    Zip Code                State                      City                        Street                                         Moved out of Highland Park Zip Code               State                      City                       Street                    Name                      Business sold to (Date)                     Wages will be paid starting                   Still operating –                              (Date) Operations will be resumed on Business temporarily discontinued                                  Business permanently discontinued
                                                                                                                                           ___________________________                                                                                                                             ___________________________
                                                              _________________________                         __________________________                             _________________________                                                                        __________________________                            _________________________ _________________________                  __________________________                                                                    __________________________
                                                                                        _______________________                                                                                                                                  _______________________

                                                                                                                                                                                                                                                                                                                                                                                                                                                                            Ceased paying wages

HP - 941 City of Highland Park - Income Tax Divison                                                                                             10 M            2023
            Employer’s Return of Income Tax Withheld                                                                     Tax withheld                   ____________________________________
                                                               Make remittance payable to:
If this is your first return, enter date this                  Treasurer, City of Highland Park                          Adjustments                    ____________________________________
business was started _______________________________           Mail to:
If this is final return, or employer status has changed,       City of Highland Park Withholding Payments                Net tax withheld               ____________________________________
see back of form for required information to be submitted.     P.O. Box 239                                              Late payment penalty - 1%
I certify the tax withheld as shown on this return is correct. Eaton Rapids, MI 48827-0530                               per month ($2.00 minimum)      ____________________________________
Signature _______________________________________________________  Date _________________                                Interest due 
                                                                                                                         (contact city for daily rates) ____________________________________
Phone # ____________________________________________
                                                                                                                         TOTAL DUE
                                                                                                                         PAY THIS AMOUNT
                                                                                                                         FEDERAL EMPLOYER ID #          ____________________________________
                                                                                                                           TAX YEAR                     2023
                                                                                                                          PAYROLL PERIOD  OCTOBER 10M
                                                                                                                           DUE DATE                     November 30, 2023
                                                                                                                                                
                                                                                                                                              DO NOT WRITE BELOW THIS LINE

HP - 941 City of Highland Park - Income Tax Divison                                                                                             11 M            2023
            Employer’s Return of Income Tax Withheld                                                                     Tax withheld                   ____________________________________
                                                               Make remittance payable to:
If this is your first return, enter date this                  Treasurer, City of Highland Park                          Adjustments                    ____________________________________
business was started _______________________________           Mail to:
If this is final return, or employer status has changed,       City of Highland Park Withholding Payments                Net tax withheld               ____________________________________
see back of form for required information to be submitted.     P.O. Box 239                                              Late payment penalty - 1%
I certify the tax withheld as shown on this return is correct. Eaton Rapids, MI 48827-0530                               per month ($2.00 minimum)      ____________________________________
Signature _______________________________________________________  Date _________________                                Interest due 
                                                                                                                         (contact city for daily rates) ____________________________________
Phone # ____________________________________________
                                                                                                                         TOTAL DUE
                                                                                                                         PAY THIS AMOUNT
                                                                                                                         FEDERAL EMPLOYER ID #          ____________________________________
                                                                                                                           TAX YEAR                     2023
                                                                                                                          PAYROLL PERIOD  NOVEMBER 11M
                                                                                                                           DUE DATE                     Decenber 31, 2023
                                                                                                                                                
                                                                                                                                              DO NOT WRITE BELOW THIS LINE

HP - 941 City of Highland Park - Income Tax Divison                                                                                             12 M            2023
            Employer’s Return of Income Tax Withheld                                                                     Tax withheld                   ____________________________________
                                                               Make remittance payable to:
If this is your first return, enter date this                  Treasurer, City of Highland Park                          Adjustments                    ____________________________________
business was started _______________________________           Mail to:
If this is final return, or employer status has changed,       City of Highland Park Withholding Payments                Net tax withheld               ____________________________________
see back of form for required information to be submitted.     P.O. Box 239                                              Late payment penalty - 1%
I certify the tax withheld as shown on this return is correct. Eaton Rapids, MI 48827-0530                               per month ($2.00 minimum)      ____________________________________
Signature _______________________________________________________  Date _________________                                Interest due 
                                                                                                                         (contact city for daily rates) ____________________________________
Phone # ____________________________________________
                                                                                                                         TOTAL DUE
                                                                                                                         PAY THIS AMOUNT
                                                                                                                         FEDERAL EMPLOYER ID #          ____________________________________
                                                                                                                           TAX YEAR                     2023
                                                                                                                          PAYROLL PERIOD  DECEMBER 12M
                                                                                                                           DUE DATE                     January 31, 2024
                                                                                                                                                
                                                                                                                                              DO NOT WRITE BELOW THIS LINE

                                              CITY OF HIGHLAND PARK-INCOME TAX DIVISION
                                              RECONCILATION OF HIGHLAND PARK INCOME TAX WITHHELD                                                  Copies of W-2s must accompany this document.
2023                            1. TOTAL HIGHLAND PARK TAX WITHHELD DURING YEAR AS SHOWN ON FORMS HPW-2 OR W-2 ENCLOSED                         $           (A)                                                                                                             2023
HPW-3                           2. TOTAL NUMBER OF WITHHOLDING TAX STATEMENTS (FORMS HPW-2 OR W-2) TRANSMITTED HEREWITH                                                                                                                                                     HPW-3
                                                                                                                          QUARTER ENDED
IMPORTANT                       3. TOTAL HIGHLAND PARK TAX WITHHELD AS SHOWN ON FORMS HP-941                              MARCH 31              $                                                                                                                           DUE ON
                                            (use otherside if forms HP-941 were filed monthly)                            QUARTER ENDED
INFORMATION                                                                                                               JUNE 30                                                                                                                                           OR 
                               THE NAME ADDRESS AND INDENTIFICATION NUMBER ON THIS FORM MUST BE THE SAME AS USED ON       QUARTER ENDED                                                                                                                                     BEFORE
GROSS PAYROLL                                            FORMS HP-941 AND HPW-2 OR W-2.  IF NOT CORRECT , PLEASE CORRECT  SEPETMBER 30
USED TO CALCULATE                                                                       NAME AND ADDRESS                  QUARTER ENDED                                                                                                                                     2/28/2024
PAYROLL TAX                                                                                                               DECEMBER 31
                                                                                                                          TOTAL PAYMENT
                                                                                                                          TO HIGHLAND PARK      $           (B)
                                                                                                                          DIFFERENCE            $           (A-B)
$ ____________________________                                                                                            EMPLOYER IDENTIFICATION NO.

                                                                  SIGNATURE                                                      TITLE                                                                             DATE                                              PHONE #

                                                              4.                                                                                                                                                3.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         2.                                                                                                                                                              1. 
                                                              �                                                                                                                                                 Your current address �                                                                                                                                                           �                                                                                                            �                                                                                  �                                                                                                   �                   applicable questions                              Check reason for “Final Return” and answer taxes were withheld_____________________                                                                             Last pay period on which Highland Park
______________________________ ______________________________ Other:                    Zip Code                               State                      City                        Street                                         Moved out of Highland Park Zip Code               State                      City                       Street                    Name                      Business sold to (Date)                     Wages will be paid starting                   Still operating –                                                (Date) Operations will be resumed on Business temporarily discontinued                                  Business permanently discontinued
                                                                                                                                                          ___________________________                                                                                                                             ___________________________
                                                              _________________________                                        __________________________                             _________________________                                                                        __________________________                            _________________________ _________________________                  __________________________                                                                                      __________________________
                                                                                        _______________________                                                                                                                                                 _______________________

                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           Ceased paying wages

                                                              4.                                                                                                                                                3.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         2.                                                                                                                                                                                                    1. 
                                                              �                                                                                                                                                 Your current address �                                                                                                                                                           �                                                                                                            �                                                                                  �                                                                                                   �                   applicable questions                              Check reason for “Final Return” and answer taxes were withheld_____________________                                                                                                                   Last pay period on which Highland Park
______________________________ ______________________________ Other:                    Zip Code                               State                      City                        Street                                         Moved out of Highland Park Zip Code               State                      City                       Street                    Name                      Business sold to (Date)                     Wages will be paid starting                   Still operating –                                                (Date) Operations will be resumed on Business temporarily discontinued                                  Business permanently discontinued
                                                                                                                                                          ___________________________                                                                                                                             ___________________________
                                                              _________________________                                        __________________________                             _________________________                                                                        __________________________                            _________________________ _________________________                  __________________________                                                                                      __________________________
                                                                                        _______________________                                                                                                                                                 _______________________

                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           Ceased paying wages

                                                              4.                                                                                                                                                3.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         2.                                                                                                                        1. 
                                                              �                                                                                                                                                 Your current address �                                                                                                                                                           �                                                                                                            �                                                                                  �                                                                                                   �                   applicable questions                              Check reason for “Final Return” and answer taxes were withheld_____________________                                       Last pay period on which Highland Park
______________________________ ______________________________ Other:                    Zip Code                               State                      City                        Street                                         Moved out of Highland Park Zip Code               State                      City                       Street                    Name                      Business sold to (Date)                     Wages will be paid starting                   Still operating –                                                (Date) Operations will be resumed on Business temporarily discontinued                                  Business permanently discontinued
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                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           Ceased paying wages

                                                                                                                YEARLY TOTAL $                            4TH QUARTER TOTAL $         DECEMBER                  NOVEMBER             OCTOBER                    3RD QUARTER TOTAL $    SEPTEMBER                  AUGUST                     JULY                      2ND QUARTER TOTAL $       JUNE             MAY                        APRIL                                                            1ST QUARTER TOTAL $                           MARCH  FEBRUARY                      JANUARY                                                                                                                                      LIST PAYMENTS MADE WITH HP941
                                                                                                                                                                                                                                                                                                                                                                                                  
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       Eaton Rapids, MI 48827-0530
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       EMPLOYER’S RETURNS
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              Income Tax Division                      City of Highland Park
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      SUMMARY                                                                                                                                                                                                                     P.O. Box 239