Gallipolis, OH · Gallia County

No notary required

Withholding Questionnaire

Businesses use this questionnaire to provide Gallipolis with information about their operations, employees, and income tax withholding.

What this form is

The Gallipolis Income Tax Department uses this questionnaire to collect business details and information about employee withholding. The form says to answer all questions and return it within ten days. It asks for the business name and address, ownership type, date employees were first hired in Gallipolis, withholding frequency, correspondence address, federal ID number, and a signature and date.

Who needs it

A business that employed individuals in Gallipolis should complete the questionnaire and return it to the Income Tax Department.

How to submit it

Return the completed form within ten days to the Income Tax Department, PO Box 339, Gallipolis, Ohio 45631.

About notarization

This document is signed without a notary; the signer certifies the information and dates the form.

How to submit this form

  1. 1

    Download The Questionnaire

    Download the Gallipolis Withholding Questionnaire PDF.

  2. 2

    Complete All Questions

    Type or print plainly and provide the requested business, ownership, withholding, and correspondence details.

  3. 3

    Sign And Date The Form

    Certify that the information is true and correct to the best of your knowledge, then sign and date the form.

  4. 4

    Return The Form

    Return it within ten days to the Income Tax Department, PO Box 339, Gallipolis, Ohio 45631.

Frequently asked questions

Who should complete the Withholding Questionnaire?
Businesses that employed individuals in Gallipolis should answer the questionnaire and return it to the Gallipolis Income Tax Department.
What information does the questionnaire ask for?
It asks for business and ownership details, when the business first employed individuals in Gallipolis, withholding frequency, correspondence information, a federal ID number, and a signature and date.
How do I submit the Withholding Questionnaire?
Return the completed form within ten days to the Income Tax Department, PO Box 339, Gallipolis, Ohio 45631.
Do I need a notary for the Withholding Questionnaire?
No. The form is signed and dated without a notary; the signer certifies that the information is true and correct to the best of their knowledge.

Need something notarized?

This Withholding Questionnaire doesn’t need a notary — but if you have another Gallipolis form that does, a commissioned online notary can help.