P- 941                            CITY OF                          PORTLAND INCOME TAX DIVISION                                                                      P- 941 
                                  EMPLOYER’S MONTHLY DEPOSIT OF INCOME TAX WITHHELD 

                       2023   941  1M
                1. IDENTIFICATION NUMBER            2. DEPOSIT PERIOD                    3. DUE ON OR BEFORE        4. WITHHOLDING TAX DEPOSIT
                                                          JANUARY 2023                        02/28/202 3
        TAXPAYER NAME AND ADDRESS 

                                                                                                                                              IMPORTANT 
                                                                                                                    5. IF DEPOSIT IS FOR A                    MONTH    YEAR 
                                                                                                                            PERIOD OTHER THAN
                                                                                                                            BOX 2, ENTER THE 
                                                                                                                            CORRECT PERIOD. 
                                                                                                                                    MAKE REMITTANCE PAYABLE TO: 
                                                                                                                                    CITY OF          PORTLAND 
SIGNATURE                                           TITLE                                              DATE                         MAIL THIS FORM AND PAYMENT TO: 
                                                                                                                    CITY OF PORTLAND INCOME TAX 
                                                                                                                                           259 KENT ST. 
PRINTED NAME OF SIGNER                   PHONE NUMBER                                                                               PORTLAND, MI 488          75
                                                                   Cut on the dotted line
-------------------------------------------------------------------------------------------------------------------------------------------
                                  CITY OF PORTLAND INCOME TAX DIVISION
P- 941                                                                                                                                                               P- 941 
                                  EMPLOYER’S MONTHLY DEPOSIT OF INCOME TAX WITHHELD

                       2023   941  2M
                1. IDENTIFICATION NUMBER            2. DEPOSIT PERIOD                    3.  DUE ON OR BEFORE       4. WITHHOLDING TAX DEPOSIT
            
 SPACE BELOW                                              FEBRUARY 2023          03/31/2023
        TAXPAYER NAME AND ADDRESS 

                                                                                                                    5. IF DEPOSIT IS FORIMPORTANTA            MONTH    YEAR 
                                                                                                                            PERIOD OTHER THAN
                                                                                                                            BOX 2, ENTER THE 
                                                                                                                            CORRECT PERIOD. 
                                                                                                                                    MAKE REMITTANCE PAYABLE TO: 
                                                                                                                                    CITY OF PORTLAND 
SIGNATURE                                           TITLE                                              DATE                         MAIL THIS FORM AND PAYMENT TO: 
                                                                                                                    CITY OF PORTLAND INCOME TAX                              
                                                                                                                                           259 KENT ST. 
PRINTED NAME OF SIGNER                   PHONE NUMBER                                                                               PORTLAND, MI 488                 75
-----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------Cut on the dotted line
P-941                                               EMPLOYER’SCITY OFQUARTERLYPORTLANDDEPOSIT INCOMEOF INCOMETAXTAXDIVISION WITHHELD                                 P-941 

                       2023   941  3M/1Q
   DO NOT       1. IDENTIFICATION NUMBER            2. DEPOSIT PERIOD                    3. DUE ON OR BEFORE        4. TAX WITHHELD THIS QUARTER
   WRITE IN                                                                                   04/30/2023
 SPACE BELOW                                        MARCH/1st QTR 2023    
                                                                                                                    5. ADJUSTMENTS
        TAXPAYER NAME AND ADDRESS
                                                                                                                    6. ADJUSTED TAX WITHHELD

                                                                                                                    7a. TAX PAID FIRST MONTH OF QUARTER 

                                                                                                                    7b. TAX PAID SECOND MONTH OF QUARTER 

                                                                                                                    8. AMOUNT DUE (Line 6 less line 7a and 7b)
                                                                                                                       PAY THIS AMOUNT ➧
SIGNATURE                                           TITLE                                              DATE         PAY TO:         CITY OF PORTLAND 
                                                                                                                    MAIL TO: 
                                                                                                                                    259CITYKENTOF PORTLANDST. INCOME TAX DIVISION 
PRINTED NAME OF SIGNER                              PHONE NUMBER                                                                    PORTLAND, MI  48875

P- 941                            CITY OF                          PORTLAND INCOME TAX DIVISION                                                                      P- 941 
                                  EMPLOYER’S MONTHLY DEPOSIT OF INCOME TAX WITHHELD 

                       2023   941  4M
                1. IDENTIFICATION NUMBER            2. DEPOSIT PERIOD                  3. DUE ON OR BEFORE          4. WITHHOLDING TAX DEPOSIT
                                                          APRIL 2023                          05/31/   2023
        TAXPAYER NAME AND ADDRESS 

                                                                                                                                              IMPORTANT 
                                                                                                                    5. IF DEPOSIT IS FOR A                    MONTH    YEAR 
                                                                                                                            PERIOD OTHER THAN
                                                                                                                            BOX 2, ENTER THE 
                                                                                                                            CORRECT PERIOD. 
                                                                                                                                    MAKE REMITTANCE PAYABLE TO: 
                                                                                                                                    CITY OF          PORTLAND 
SIGNATURE                                           TITLE                                              DATE                         MAIL THIS FORM AND PAYMENT TO: 
                                                                                                                    CITY OF PORTLAND INCOME TAX 
                                                                                                                                           259 KENT ST. 
PRINTED NAME OF SIGNER                   PHONE NUMBER                                                                               PORTLAND, MI 488          75
                                                          Cut on the dotted line
-------------------------------------------------------------------------------------------------------------------------------------------
                                  CITY OF PORTLAND INCOME TAX DIVISION
P- 941                                                                                                                                                               P- 941 
                                  EMPLOYER’S MONTHLY DEPOSIT OF INCOME TAX WITHHELD

                       2023   941  5M
                1. IDENTIFICATION NUMBER            2. DEPOSIT PERIOD                  3.  DUE ON OR BEFORE         4. WITHHOLDING TAX DEPOSIT
                                                          MAY 2023                            06/30/2023
        TAXPAYER NAME AND ADDRESS 

                                                                                                                    5. IF DEPOSIT IS FORIMPORTANTA            MONTH    YEAR 
                                                                                                                            PERIOD OTHER THAN
                                                                                                                            BOX 2, ENTER THE 
                                                                                                                            CORRECT PERIOD. 
                                                                                                                                    MAKE REMITTANCE PAYABLE TO: 
                                                                                                                                    CITY OF PORTLAND 
SIGNATURE                                           TITLE                                              DATE                         MAIL THIS FORM AND PAYMENT TO: 
                                                                                                                    CITY OF PORTLAND INCOME TAX                              
                                                                                                                                           259 KENT ST. 
PRINTED NAME OF SIGNER                   PHONE NUMBER                                                                               PORTLAND, MI 488                 75
-----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------Cut on the dotted line
P-941                                               EMPLOYER’SCITY OFQUARTERLYPORTLANDDEPOSIT INCOMEOF INCOMETAXTAXDIVISION WITHHELD                                 P-941 

                       2023   941  6M/2Q
                1. IDENTIFICATION NUMBER            2. DEPOSIT PERIOD                  3. DUE ON OR BEFORE          4. TAX WITHHELD THIS QUARTER
                                                    JUNE/2nd QTR 2023                          07/31/2023
                                                                                                                    5. ADJUSTMENTS
        TAXPAYER NAME AND ADDRESS
                                                                                                                    6. ADJUSTED TAX WITHHELD

                                                                                                                    7a. TAX PAID FIRST MONTH OF QUARTER 

                                                                                                                    7b. TAX PAID SECOND MONTH OF QUARTER 

                                                                                                                    8. AMOUNT DUE (Line 6 less line 7a and 7b)
                                                                                                                       PAY THIS AMOUNT ➧
SIGNATURE                                           TITLE                                              DATE         PAY TO:         CITY OF PORTLAND 
                                                                                                                    MAIL TO: 
                                                                                                                                    259CITYKENTOF PORTLANDST. INCOME TAX DIVISION 
PRINTED NAME OF SIGNER                              PHONE NUMBER                                                                    PORTLAND, MI  48875

P- 941                            CITY OF                          PORTLAND INCOME TAX DIVISION                                                                      P- 941 
                                  EMPLOYER’S MONTHLY DEPOSIT OF INCOME TAX WITHHELD 

                       2023   941  7M
                1. IDENTIFICATION NUMBER            2. DEPOSIT PERIOD                  3. DUE ON OR BEFORE          4. WITHHOLDING TAX DEPOSIT
                                                          JULY 2023                           08/31/   2023
        TAXPAYER NAME AND ADDRESS 

                                                                                                                                              IMPORTANT 
                                                                                                                    5. IF DEPOSIT IS FOR A                    MONTH    YEAR 
                                                                                                                            PERIOD OTHER THAN
                                                                                                                            BOX 2, ENTER THE 
                                                                                                                            CORRECT PERIOD. 
                                                                                                                                    MAKE REMITTANCE PAYABLE TO: 
                                                                                                                                    CITY OF          PORTLAND 
SIGNATURE                                           TITLE                                              DATE                         MAIL THIS FORM AND PAYMENT TO: 
                                                                                                                    CITY OF PORTLAND INCOME TAX 
                                                                                                                                           259 KENT ST. 
PRINTED NAME OF SIGNER                   PHONE NUMBER                                                                               PORTLAND, MI 488          75
                                                                      Cut on the dotted line
-------------------------------------------------------------------------------------------------------------------------------------------
                                  CITY OF PORTLAND INCOME TAX DIVISION
P- 941                                                                                                                                                               P- 941 
                                  EMPLOYER’S MONTHLY DEPOSIT OF INCOME TAX WITHHELD

                       2023   941  8M
                1. IDENTIFICATION NUMBER            2. DEPOSIT PERIOD                  3.  DUE ON OR BEFORE         4. WITHHOLDING TAX DEPOSIT
                                                          AUGUST 2023                         09/30/2023
        TAXPAYER NAME AND ADDRESS 

                                                                                                                    5. IF DEPOSIT IS FORIMPORTANTA            MONTH    YEAR 
                                                                                                                            PERIOD OTHER THAN
                                                                                                                            BOX 2, ENTER THE 
                                                                                                                            CORRECT PERIOD. 
                                                                                                                                    MAKE REMITTANCE PAYABLE TO: 
                                                                                                                                    CITY OF PORTLAND 
SIGNATURE                                           TITLE                                              DATE                         MAIL THIS FORM AND PAYMENT TO: 
                                                                                                                    CITY OF PORTLAND INCOME TAX                                                             
                                                                                                                                           259 KENT ST. 
PRINTED NAME OF SIGNER                   PHONE NUMBER                                                                               PORTLAND, MI 488                 75
                                                                      Cut on the dotted line
-----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
P-941                                               EMPLOYER’SCITY OFQUARTERLYPORTLANDDEPOSIT INCOMEOF INCOMETAXTAXDIVISION WITHHELD                                 P-941 

                       2023   941  9M/3Q
                1. IDENTIFICATION NUMBER            2. DEPOSIT PERIOD                  3. DUE ON OR BEFORE          4. TAX WITHHELD THIS QUARTER
                                                    SEPT/3rd QTR 2023                         10 /31/2023
                                                                                                                    5. ADJUSTMENTS
        TAXPAYER NAME AND ADDRESS
                                                                                                                    6. ADJUSTED TAX WITHHELD

                                                                                                                    7a. TAX PAID FIRST MONTH OF QUARTER 

                                                                                                                    7b. TAX PAID SECOND MONTH OF QUARTER 

                                                                                                                    8. AMOUNT DUE (Line 6 less line 7a and 7b)
                                                                                                                       PAY THIS AMOUNT ➧
SIGNATURE                                           TITLE                                              DATE         PAY TO:         CITY OF PORTLAND 
                                                                                                                    MAIL TO: 
                                                                                                                                    259CITYKENTOF PORTLANDST. INCOME TAX DIVISION 
PRINTED NAME OF SIGNER                              PHONE NUMBER                                                                    PORTLAND, MI  48875

                       Cut on the dotted line

P- 941                            CITY OF                          PORTLAND INCOME TAX DIVISION                                                                       P- 941 
                                  EMPLOYER’S MONTHLY DEPOSIT OF INCOME TAX WITHHELD 

                       2023   941  10M

                1. IDENTIFICATION NUMBER            2. DEPOSIT PERIOD                  3. DUE ON OR BEFORE          4. WITHHOLDING TAX DEPOSIT
                                                          OCTOBER 2023                        11/30/   2023
        TAXPAYER NAME AND ADDRESS 

                                                                                                                                               IMPORTANT 
                                                                                                                    5. IF DEPOSIT IS FOR A                     MONTH    YEAR 
                                                                                                                            PERIOD OTHER THAN
                                                                                                                            BOX 2, ENTER THE 
                                                                                                                            CORRECT PERIOD. 
                                                                                                                                     MAKE REMITTANCE PAYABLE TO: 
                                                                                                                                     CITY OF PORTLAND 
SIGNATURE                                           TITLE                                              DATE                         MAIL THIS FORM AND PAYMENT TO: 
                                                                                                                    CITY OF                 PORTLAND INCOME TAX 
                                                                                                                                            259 KENT ST. 
PRINTED NAME OF SIGNER                       PHONE NUMBER                                                                            PORTLAND, MI 488           75
                                                                     Cut on the dotted line
-------------------------------------------------------------------------------------------------------------------------------------------
                                  CITY OF PORTLAND INCOME TAX DIVISION
P- 941                                                                                                                                                                P- 941 
                                  EMPLOYER’S MONTHLY DEPOSIT OF INCOME TAX WITHHELD

                       2023   941  11M
                1. IDENTIFICATION NUMBER            2. DEPOSIT PERIOD                  3.  DUE ON OR BEFORE         4. WITHHOLDING TAX DEPOSIT
                                                          NOVEMBER 2023           12 /31/2023
        TAXPAYER NAME AND ADDRESS 

                                                                                                                    5. IF DEPOSIT IS FORIMPORTANTA             MONTH    YEAR 
                                                                                                                            PERIOD OTHER THAN
                                                                                                                            BOX 2, ENTER THE 
                                                                                                                            CORRECT PERIOD. 
                                                                                                                                     MAKE REMITTANCE PAYABLE TO: 
                                                                                                                                     CITY OF PORTLAND 
SIGNATURE                                           TITLE                                              DATE                         MAIL THIS FORM AND PAYMENT TO: 
                                                                                                                    CITY OF          PORTLAND INCOME TAX                      
                                                                                                                                            259 KENT ST. 
PRINTED NAME OF SIGNER                       PHONE NUMBER                                                                            PORTLAND          , MI 488       75
-----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------Cut on the dotted line
P-941                                               EMPLOYER’SCITY OFQUARTERLYPORTLANDDEPOSIT INCOMEOF INCOMETAXTAXDIVISION WITHHELD                                  P-941 

                       2023   941  12M/4Q
                1. IDENTIFICATION NUMBER            2. DEPOSIT PERIOD                  3. DUE ON OR BEFORE          4. TAX WITHHELD THIS QUARTER
                                                      DEC/4th QTR 2023                        01/31/2024
                                                                                                                    5. ADJUSTMENTS
        TAXPAYER NAME AND ADDRESS
                                                                                                                    6. ADJUSTED TAX WITHHELD

                                                                                                                    7a. TAX PAID FIRST MONTH OF QUARTER 

                                                                                                                    7b. TAX PAID SECOND MONTH OF QUARTER 

                                                                                                                    8. AMOUNT DUE (Line 6 less line 7a and 7b)
                                                                                                                       PAY THIS AMOUNT ➧
SIGNATURE                                           TITLE                                              DATE         PAY TO:          CITY OF PORTLAND 
                                                                                                                    MAIL TO:         
                                                                                                                                     259CITYKENTOF PORTLANDST. INCOME TAX DIVISION 
PRINTED NAME OF SIGNER                              PHONE NUMBER                                                                     PORTLAND, MI  48875

2023   PW-3                                                                                                                       2023   PW-3
                                                                                                                                                                
                                                       CITY OF PORTLAND 

               EMPLOYER’S ANNUAL RECONCILIATION OF INCOME TAX WITHHELD
 1. EMPLOYER                                                              2. FEDERAL EMPLOYER IDENTIFICATION NUMBER

                                                                          DUE ON OR BEFORE                                 CONTACT PHONE NUMBER 

TOTAL GROSS WAGES (W-2 BOX 1)                                             February 28,              2024 
                                                  SUMMARY OF WITHHOLDING TAX PAID 

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

INSTRUCTIONS FOR EMPLOYER’S ANNUAL RECONCILIATION OF INCOME TAX WITHHELD 
• Check identification information in Box 1 and Box 2.
• Enter tax withheld and tax payment information in the Summary of Withholding Tax Paid section.
•  Enter the total withholding tax paid in Box 3.
• Enter the number of W-2 forms attached in Box 4.
• Enter the amount of tax withheld per the W-2 forms attached in Box 5.  Include copies of the computer generated summary W-2 forms.
                               
• If the withholding tax paid (Box 3) is less than the tax withheld per the W-2 forms (Box 5), enter the balance due in Box 6.  The balance due must be paid in
  full with this PW-3 form.  Make remittance payable to:  CITY OF PORTLAND
• If the withholding tax paid (Box 3) is greater than the tax withheld per the W-2 forms (Box 5), enter the overpayment in Box 7. To receive a refund of 
  any overpayment, submit a letter explaining the overpayment and requesting a refund.
• If the withholding tax paid (Box 3) equals the tax withheld per the W-2 forms (Box 5), enter a zero (0) in Boxes 6 and 7.
• Sign the return in Box 8; Print your name and title in Box 9; and Enter the date signed in Box 10.
•   Attach the required copies of the W-2 forms or a CD with W-2’s in federal format and payment for any balance due to the completed PW-3 form and mail 
  to: PORTLAND INCOME TAX DIVISION                259 KENT ST., PORTLAND,.           MI  48875