What is the Application for Withholding Account?

It is a company application for a Village of Leipsic income tax withholding account. It collects company, payroll, contact, and withholding information.

Who completes this application?

A company seeking a Village of Leipsic withholding account completes the form, including its payroll information, withholding details, and the preparer's signature and date.

Do I need a notary for the Application for Withholding Account?

No. The application asks the preparer to sign and date it and does not identify a notarized or sworn attachment.

How do I submit the Application for Withholding Account?

Return it to the Income Tax Department at 142 E. Main St., Leipsic, OH 45856, or fax it to (419) 943-2010, as stated on the form.

Leipsic, OH · Putnam County

No notary required

Application for Withholding Account

Companies use this application to request a Village of Leipsic income tax withholding account and provide payroll, contact, and withholding details.

What this form is

Companies complete this application to request a Village of Leipsic income tax withholding account. It asks for company and federal ID information, payroll contacts, whether the company will pay the village income tax instead of withholding from employees, withholding locations, start date, filing frequency, and a signature. The form also states the tax rate and explains monthly and quarterly filing criteria.

Who needs it

A company seeking a Village of Leipsic income tax withholding account completes this application and provides its payroll and withholding information.

How to submit it

Return the completed application to the Income Tax Department at 142 E. Main St., Leipsic, OH 45856. The form says it may also be faxed to (419) 943-2010.

About notarization

This application is signed without a notary; the form asks the preparer to sign and date it, with no notarized or sworn attachment noted.

How to submit this form

1
Download The Application
Download the Application for Withholding Account PDF.
2
Complete The Company Details
Enter company, federal ID, contact, payroll, and withholding information requested on the form.
3
Sign And Date
The person preparing the application signs and dates it.
4
Return The Application
Return it to the Income Tax Department at 142 E. Main St., Leipsic, OH 45856, or fax it to (419) 943-2010.

Frequently asked questions

What is the Application for Withholding Account?: It is a company application for a Village of Leipsic income tax withholding account. It collects company, payroll, contact, and withholding information.
Who completes this application?: A company seeking a Village of Leipsic withholding account completes the form, including its payroll information, withholding details, and the preparer's signature and date.
Do I need a notary for the Application for Withholding Account?: No. The application asks the preparer to sign and date it and does not identify a notarized or sworn attachment.
How do I submit the Application for Withholding Account?: Return it to the Income Tax Department at 142 E. Main St., Leipsic, OH 45856, or fax it to (419) 943-2010, as stated on the form.

Need something notarized?

This Application for Withholding Account doesn’t need a notary — but if you have another Leipsic form that does, a commissioned online notary can help.