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HomeMy WebLinkAboutBerkley Risk Audit MINNESOTA REVENUE OAK PARK HEIGHTS CITY OF Withholding Tax 14168 OAK PARK BLVD MN ID: 7201583 STILLWATER, MN 550826476 Filing Period: 31-Mar-2013 Return Received: 30-Apr-2013 Deposits and Credits: $16,741.53 Tax Inputs: Wages: $345,152.40 Employees: 30 Tax Withheld: $16,741.53 2% Contractor Withholding Included in Tax $0.00 Withheld: Summary: Tax Withheld: $16,741.53 Deposits and Credits: $16,741.53 Projected Penalty: $0.00 Projected Interest: $0.00 Projected Amount Due: $0.00 Payroll Schedule Payroll Date Amount Withheld 1/8/2013 $197.10 1/8/2013 $95.87 1/15/2013 $3,031.90 1/16/2013 $21.89 1/22/2013 $5.66 1/31/2013 $2,535.81 2/1/2013 $37.09 2/12/2013 $95.87 Income Tax and Withholding Division /'• Mail Station 6501 Tel:(651)282-9999 or 1-800-657-3594 St.Paul,MN 55146-6501 Fax:(651)556-5152 An equal opportunity employer TTY:(651)556-3030 or www.revenue.state.mn.us Call 711 for the Minnesota Relay State Application Page 1 of 1 Itc 11% • tinempiornerginsurance innesataTuesday,April 30,2013 41/44y0 * Indicates Required Employer Self-Service Log Off Field My Home Wage Detail Submission Process FAQ/Contact Us " " " COMPLETE Select Submit Confirm Process and Account Maintenance Filing Wage Submission Calculate Benefits Paid Charge Activities Method Information Correspondence Correspondence Preferences Employer Information Determinations and Issue Summary Employer Account Number: 07983042 Employer Name: CITY OF OAK Legal Business Changes PARK Payment Information HEIGHTS Tax and Wage Detail Reporting Adjustment k Forecast Tax Calculator Wage Detail Submission Confirmation k Submit Wage Detail • You have successfully submitted a Wage Detail Report for k View History Quarter 1 of Year 2013. k View Submission History • Your confirmation Number is 7983042_043013094118. For Tax Appeals future reference this number is viewable in View Submission User Maintenance History. • Any future adjustments to this report may result in an Change Password Administrative Service Fee or UI Program Review. Log Off • If you would like to make a payment for amounts due select 'Make Payment' at the bottom of this page. • If you are closing your business and this is your final Wage Detail Report select'Account Maintenance', then 'Terminate Account' from the left navigation and proceed with the prompts. Make Payment Employer Feedback? Accessibility I Privacy Statement I Viewing Tips I Questions or Inquiries https://wwwl.uimn.org/ui_employer/employer/wagedetail/wageDetailMain.do 4/30/2013 State Application Page 1 of 1 11 tiner►tpbymenS Insurence n � � e�r Monday,July 29,2013 J Employer Self-Service Log Off " Indicates Required Field My Home Wage Detail Submission Process FAQ/Contact Us a > COMPLETE Select Submit Confirm Process and Account Maintenance Filing Wage Submission Calculate Benefits Paid Charge Activities Method Information Correspondence Correspondence Preferences Employer Information Determinations and Issue Summay Employer er Account Number: 07983042 Employer Name: CITY OF Legal Business Changes OAK Payment Information PARK Tax and Wage Detail Reporting HEIGHTS ■ Adjustment Forecast Tax Calculator Wage Detail Submission Confirmation • Submit Wage Detail • You have successfully submitted a Wage Detail Report for View History Quarter 2 of Year 2013. View Submission History • Your confirmation Number is 7983042_072913093813. For Tax Appeals future reference this number is viewable in View Submission User Maintenance History. • Any future adjustments to this report may result in an Change Password Administrative Service Fee or UI Program Review. Log Off • If you would like to make a payment for amounts due select 'Make Payment' at the bottom of this page. • If you are closing your business and this is your final Wage Detail Report select'Account Maintenance', then 'Terminate Account' from the left navigation and proceed with the prompts. Make Payment Feedback? Accessibility I Privacy Statement I Viewing Tips I Questions or Inquiries /`• https://www 1.uimn.org/ui_employer/employer/wagedetail/wageDetailMain.do 7/29/2013 MINNESOTA REVENUE OAK PARK HEIGHTS CITY OF Withholding Tax 14168 OAK PARK BLVD MN ID: 7201583 STILLWATER, MN 550826476 Filing Period: 30-Jun-2013 Return Received: 29-Jul-2013 Deposits and Credits: $16,067.73 Tax Inputs: Wages: $339,038.85 Employees: 31 Tax Withheld: $16,067.73 2% Contractor Withholding Included in Tax $0.00 Withheld: Summary: Tax Withheld: $16,067.73 Deposits and Credits: $16,067.73 Projected Penalty: $0.00 Projected Interest: $0.00 Projected Amount Due: $0.00 Payroll Schedule Payroll Date Amount Withheld 4/9/2013 $185.93 4/15/2013 $2,575.26 4/30/2013 $2,557.46 5/14/2013 $110.13 5/15/2013 $2,618.43 5/31/2013 $2,615.93 6/3/2013 $14.98 6/11/2013 $189.35 Income Tax and Withholding Division Mail Station 6501 Tel:(651)282-9999 or 1-800-657-3594 St.Paul,MN 55146-6501 Fax:(651)556-5152 An equal opportunity employer TTY:Call 711 for Minnesota Relay www.revenue.state.mn.us Call 711 for the Minnesota Relay MINNESOTA REVENUE Withholding Tax MN ID: 7201583 Page: 2 Payroll Schedule(continued) Payroll Date Amount Withheld 6/14/2013 $2,615.93 6/17/2013 $57.76 6/28/2013 $2,526.57 Income Tax and Withholding Division /"••■ Mail Station 6501 Tel:(651)282-9999 or 1-800-657-3594 St.Paul,MN 55146-6501 Fax:(651)556-5152 An equal opportunity employer TTY:Call 711 for Minnesota Relay www.revenue.state.mn.us Call 711 for the Minnesota Relay Form 941 for 2013: Employer's QUARTERLY Federal Tax Return 950113 (Rev.January 2013) Department of the Treasury—Internal Revenue Service OMB No.1545-0029 ■••1 Employer identification number(Flit) 4 1 — 0 9 4 1 6 8 1 Report for this Quarter of 2013 (Check one.) Name(not your trade name) CITY OF OAK PARK HEIGHTS ❑ 1:January,February,March Trade name Of any) © 2:April,May,June ❑3:July,August,September Address 14168 OAK PARK BLVD NO,P.O.BOX 2007 ❑ 4:October,November,December Number Street Suite or room number Instructions and prior year forms are OAK PARK HEIGHTS MN 55082 available at www.irs.gov/form941. City State ZIP code Read the separate instructions before you complete Form 941.Type or print within the boxes. Part 1: Answer these questions for this quarter. 1 Number of employees who received wages,tips,or other compensation for the pay period including:Mar.12(Quarter 1),June 12(Quarter 2),Sept.12(Quarter 3),or Dec.12(Quarter 4) 1 31 2 Wages,tips,and other compensation 2 339038 • 85 3 Income tax withheld from wages,tips,and other compensation 3 37924 • 83 4 If no wages,tips,and other compensation are subject to social security or Medicare tax ❑Check and go to line 6. Column 1 Column 2 5a Taxable social security wages . . 210585 • 28 x.124= 26112 • 57 5b Taxable social security tips . . . x.124= • 5c Taxable Medicare wages&tips. . 386094 • 11 x .029= 11254 • 71 sI Taxable wages&tips subject to Additional Medicare Tax withholding • x.009= • 5e Add Column 2 from lines 5a,5b,5c,and 5d 5e 37367 • 28 5f Section 3121(q)Notice and Demand—Tax due on unreported tips(see instructions) . 5f • 6 Total taxes before adjustments(add lines 3,5e,and 5f) 6 75292 • 11 7 Current quarter's adjustment for fractions of cents 7 . 8 Current quarter's adjustment for sick pay 8 9 Current quarter's adjustments for tips and group-term life insurance 9 • 10 Total taxes after adjustments.Combine lines 6 through 9 10 75292 • 11 11 Total deposits for this quarter,including overpayment applied from a prior quarter and overpayment applied from Form 941-X or Form 944-X filed in the current quarter . . 11 12a COBRA premium assistance payments(see instructions) 12a • 12b Number of individuals provided COBRA premium assistance . . 13 Add lines 11 and 12a 13 • 14 Balance due.If line 10 is more than line 13,enter the difference and see instructions . . 14 75292 . 11 15 Overpayment.If line 13 is more than line 10,enter the difference Check one: ❑Apply to next return. ❑ Send a refund. ■You MUST complete both pages of Form 941 and SIGN it Next For Privacy Act and Paperwork Reduction Act Notice,see the back of the Payment Voucher. Cat.No.17001Z Form 941(Rev.1-2013) 950213 Name(not your trade name) Employer identification number(EIN) CITY OF OAK PARK HEIGHTS 41-0941681 Part 2: Tell us about your deposit schedule and tax liability for this quarter. If you are unsure about whether you are a monthly schedule depositor or a semiweekly schedule depositor,see Pub.15 (Circular E),section 11. 16 Check one: ❑ line 10 on this return is less than$2,500 or line 10 on the return for the prior quarter was less than$2,500,and you did not incur a $100,000 next-day deposit obligation during the current quarter.If line 10 for the prior quarter was less than$2,500 but line 10 on this return is$100,000 or more,you must provide a record of your federal tax liability.If you are a monthly schedule depositor,complete the deposit schedule below;if you are a semiweekly schedule depositor,attach Schedule 8(Form 941).Go to Part 3. ❑ You were a monthly schedule depositor for the entire quarter.Enter your tax liability for each month and total liability for the quarter,then go to Part 3. Tax liability: Month 1 • Month 2 • Month 3 • Total liability for quarter • Total must equal line 10. I] You were a semiweekly schedule depositor for any part of this quarter.Complete Schedule B(Form 941), Report of Tax Liability for Semiweekly Schedule Depositors,and attach it to Form 941. Part 3: Tell us about your business.If a question does NOT apply to your business,leave it blank. 17 If your business has closed or you stopped paying wages ❑ Check here,and enter the final date you paid wages / / . 18 If you are a seasonal employer and you do not have to file a return for every quarter of the year . . ❑ Check here. Part 4: May we speak with your third-party designee? Do you want to allow an employee,a paid tax preparer,or another person to discuss this return with the IRS?See the instructions for details. ❑ Yes. Designee's name and phone number Select a 5-digit Personal Identification Number(PIN)to use when talking to the IRS. ❑ No. Part 5: Sign here.You MUST complete both pages of Form 941 and SIGN it. Under penalties of perjury,I declare that I have examined this return,including accompanying schedules and statements,and to the best of my knowledge and belief,it is true,correct,and complete.Declaration of preparer(other than taxpayer)is based on all Information of which preparer has any knowledge. X Print your Sign your name here BETTY CARUSO name here Print your title here FINANCE DIRECTOR Date 7 /3// /3 Best daytime phone 651-439-4439 Paid Preparer Use Only Check if you are self-employed . . . ❑ Preparer's name PTIN Preparer's signature Date / / Firm's name(or yours if self-employed) EIN Address Phone City State ZIP code Page 2 Form 941(Rev.1-2013) Schedule B (Form 941): 960311 Report of Tax Liability for Semiweekly Schedule Depositors OMB No.1545-0029 (Rev.June 2011) Department of the Treasury—Internal Revenue Service Report for this Quarter... (EIN) 4 1 — 0 9 4 1 6 8 1 (Check one.) ` Employer identification number Name(not your trade name) CITY OF OAK PARK HEIGHTS ❑ 1;January,',February,March © 2:April May June Calendar year 2 0 1 3 (Also check quarter) E] 3• :'July,August September ❑ 4• :October,November,December Use this schedule to show your TAX LIABILITY for the quarter;DO NOT use it to show your deposits.When you file this form with Form 941 or Form 941-SS,DO NOT change your tax liability by adjustments reported on any Forms 941-X.You must fill out this form and attach it to Form 941 or Form 941-SS if you are a semiweekly schedule depositor or became one because your accumulated tax liability on any day was $100,000 or more.Write your daily tax liability on the numbered space that corresponds to the date wages were paid. See Section 11 in Pub.15(Circular E),Employer's Tax Guide,for details. Month 1 1 • g 948 ■ 44 17' ■ 25 ■ Tax liability for Month 1 2 10 • 18 26 24491 ■ 57 3, • 11 • 19 • 27' ■ 4 • 12 ■ 20 ■ 28 • 5 ▪ 13 21 29 • 6 14 11834 ■ 93 7 ■ 15 11708 . 20 • 3 ■ /� s ▪ 16 24 • Month 2 1 • 9 ■ 17< ■ 25 • Tax liability for Month 2 2 • 10' 19 26 25058 ■ 90 3 ■ 11 ■ 19 ■ 27 ■ 4 ■ 12 ■ 20 l 28 ■ 5 ■ 13" ■ 21' ■ 29 • 6 14, 751 ■ 56 22 • 3p' • 7 • 15; 12160 . 98 23 ■ 31 12146 ■ 36 8 16 24 ■ Month 3 1 ■ 9 ■ 17 416 ■ 62 25 •■ Tax liability for Month 3 2 10 18 25 25741 ■ 64 3 162 . 63 11 977 . 87 19 27 • 4 • 12 • 20 • 20 11988 ■ 16 5 ■ 13? ■ 21 • 29? • 6; 14 12196 . 36 22 30 7 I ■,, 15, • 23 ■ 31 ■ 8 ▪ 16< ■ 24 ■ �� Total liability for the quarter Fill in your total liability for the quarter(Month 1 +Month 2+Month 3)■ Total must equal line 10 on Form 941 or Form 941-SS. 75292 ■ 11 For Paperwork Reduction Act Notice,see separate instructions. Cat.No.119670 Schedule B(Form 941)(Rev.6-2011) Form 941 for 2013: Employer's QUARTERLY Federal Tax Return 950113 (Rev.January 2013) Department of the Treasury—Internal Revenue Service OMB No.1545-0029 Report for this Quarter of 2013 Employer identification number(EIN) 4 1 0 9 4 1 6 8 1 (Check one.) Name(not your trade name) CITY OF OAK PARK HEIGHTS © 1:January,February,March Trade name(if any) ❑ 2:April,May,June ❑ 3:July,August,September Address 14168 OAK PARK BLVD.NO.,P.O.BOX 2007 ❑ 4:October,November,December Number Street Suite or room number Instructions and prior year forms are OAK PARK HEIGHTS MN 55082 available at www.irs.gov/form941. City State ZIP code Read the separate instructions before you complete Form 941.Type or print within the boxes. Part 1: Answer these questions for this quarter. 1 Number of employees who received wages,tips,or other compensation for the pay period including:Mar.12(Quarter 1),June 12(Quarter 2),Sept.12(Quarter 3),or Dec. 12(Quarter 4) 1 30 2 wages,tips,and other compensation 2 345152 • 40 3 Income tax withheld from wages,tips,and other compensation 3 38946 • 58 4 If no wages,tips,and other compensation are subject to social security or Medicare tax ❑ Check and go to line 6. Column 1 Column 2 5a Taxable social security wages . . 214559 • 06 x.124= 26605 • 38 5b Taxable social security tips . . . x.124= • 5c Taxable Medicare wages&tips. . 391405 • 51 x.029= 11350 • 76 5d Taxable wages&tips subject to Additional Medicare Tax withholding • x.009= • 5e Add Column 2 from lines 5a,5b,5c,and 5d 5e 37956 • 14 5f Section 3121(q)Notice and Demand—Tax due on unreported tips(see instructions) . 5f 6 Total taxes before adjustments(add lines 3,5e,and 5f) 6 76902 . 72 7 Current quarter's adjustment for fractions of cents 7 • 8 Current quarter's adjustment for sick pay 8 ■ 9 Current quarter's adjustments for tips and group-term life insurance 9 • 10 Total taxes after adjustments.Combine lines 6 through 9 10 76902 • 72 11 Total deposits for this quarter, including overpayment applied from a prior quarter and overpayment applied from Form 941-X or Form 944-X filed in the current quarter . . 11 76902 • 72 12a COBRA premium assistance payments(see instructions) 12a • 12b Number of individuals provided COBRA premium assistance . . 13 Add lines 11 and 12a 13 0 . 00 14 Balance due.If line 10 is more than line 13,enter the difference and see instructions . . 14 0 • 00 15 Overpayment.If line 13 is more than line 10,enter the difference • Check one: ❑Apply to next return. ❑ Send a refund. ►You MUST complete both pages of Form 941 and SIGN It Next■ i For Privacy Act and Paperwork Reduction Act Notice,see the back of the Payment Voucher. Cat.No.17001Z Form 941 (Rev.1-2013) 950213 Name(not your trade name) Employer identification number(EIN) , N CITY OF OAK PARK HEIGHTS 41-0941681 Part 2: Tell us about your deposit schedule and tax liability for this quarter. If you are unsure about whether you are a monthly schedule depositor or a semiweekly schedule depositor,see Pub.15 (Circular E),section 11. 16 Check one: n Line 10 on this return is less than$2,500 or line 10 on the return for the prior quarter was less than$2,500,and you did not incur a $100,000 next-day deposit obligation during the current quarter.If line 10 for the prior quarter was less than$2,500 but line 10 on this return is$100,000 or more, you must provide a record of your federal tax liability.If you are a monthly schedule depositor,complete the deposit schedule below;if you are a semiweekly schedule depositor,attach Schedule B(Form 941).Go to Part 3. E You were a monthly schedule depositor for the entire quarter. Enter your tax liability for each month and total liability for the quarter,then go to Part 3. Tax liability: Month 1 • Month 2 . Month 3 . Total liability for quarter - Total must equal line 10. F] You were a semiweekly schedule depositor for any part of this quarter.Complete Schedule B(Form 941), Report of Tax Liability for Semiweekly Schedule Depositors,and attach it to Form 941. Part 3: Tell us about your business.If a question does NOT apply to your business,leave it blank. 17 If your business has closed or you stopped paying wages 0 Check here,and enter the final date you paid wages / / . 18 If you are a seasonal employer and you do not have to file a return for every quarter of the year . . 0 Check here. ,--..., Part 4: May we speak with your third-party designee? Do you want to allow an employee,a paid tax preparer,or another person to discuss this return with the IRS?See the instructions for details. El Yes. Designee's name and phone number Select a 5-digit Personal Identification Number(PIN)to use when talking to the IRS. El No. Part 5: Sign here.You MUST complete both pages of Form 941 and SIGN it. Under penalties of perjury,I declare that I have examined this return,including accompanying schedules and statements,and to the best of my knowledge and belief,it is true,correct,and complete.Declaration of preparer(other than taxpayer)is based on all information of which preparer has any knowledge. Print your Sign your X name here BETTY CARUSO name here Nf...66..ectA...4,....,—, Print your title here FINANCE DIRECTOR Date 4/ 130/ (3 Best daytime phone 651-439-4439 Paid Preparer Use Only Check if you are self-employed . . . 0 Preparer's name PTIN Preparer's signature Date / / Firm's name(or yours if self-employed) EIN Address Phone „......., City State ZIP code Page 2 Form 941 (Rev.1-2013) Schedule B (Form 941): 960311 .- . Report of Tax Liability for Semiweekly Schedule Depositors OMB No.1545-0029 (Rev.June 2011) Department of the Treasury—Internal Revenue Service Report for this Quarter... (BIN) 4 1 — 0 9 4 1 6 8 1 (Check one.) fi. Employer identification number 6 CITY OF OAK PARK HEIGHTS © 1:January,February,March Name(not your trade name) '';; ❑ 2:April,May,June Calendar year 2 0 1 3 (Also check quarter) ❑ 3:July,August,September ❑ 4:October,November,December Use this schedule to show your TAX LIABILITY for the quarter;DO NOT use it to show your deposits.When you file this form with Form 941 or Form 941-SS,DO NOT change your tax liability by adjustments reported on any Forms 941-X.You must fill out this form and attach it to Form 941 or Form 941-SS if you are a semiweekly schedule depositor or became one because your accumulated tax liability on any day was $100,000 or more. Write your daily tax liability on the numbered space that corresponds to the date wages were paid. See Section 11 in Pub.15(Circular E),Employer's Tax Guide,for details. Month 1 1 ■ 9 ■ 17 • 25 ■ Tax liability for Month 1 2 10 18 26 •■ 26264 . 22 3 ■ 11 • 19 •■ 27 ■ 4 • 12 ■ 2p ■ 28 • 5 6 1413' 2221' 65 . 66 3029 ■■ 7 • 15' 13079 . 75 23 • 31 11559 . 36 6, 1378 . 14 16 181 . 31 24 • Month 2 1 484 . 70 9 ■ 17 • 25 . Tax liability for Month 2 2 ▪ 10 1$ • 26 25293 • 13 3 • 11 19 344 . 87 27 4 • 12 1223 82 20 28 11602 • 50 5 ■ 13 ■ 21 ■ 29 • 67 14 • 22 ■ 30 ■ ▪ 15', 11637 • 24 23 • 31 ■ 8 • 16 • 24 • Month 3 1 ■ 9 • 17 • 25 • Tax liability for Month 3 2 • 10 • 18 26 • 25345 ■ 37 3 11' 19 27 • 4 12 1068 . 84 20; • 28 • 5 937 . 49 is 21 29 11744 . 52 6 • 14 • 22 • 30 • 7 ▪ 15'' 11594 ■ 52 23 • 31 • 8 • 16` • 24 • "'"'"\ Total liability for the quarter Fill in your total liability for the quarter(Month 1+Month 2+Month 3)■ Total must equal line 10 on Form 941 or Form 941-SS. 76902 ■ 72 For Paperwork Reduction Act Notice,see separate instructions. Cat.No.119670 Schedule B(Form 941)(Rev.6-2011) MINNESOTA REVENUE Withholding Tax MN ID: 7201583 Page: 2 Payroll Schedule(continued) Payroll Date Amount Withheld 2/12/2013 $118.42 2/15/2013 $2,560.45 2/19/2013 $20.37 2/28/2013 $2,551.66 3/5/2013 $95.87 3/5/2013 $52.03 3/12/2013 $197.22 3/15/2013 $2,549.66 3/29/2013 $2,574.66 Income Tax and Withholding Division /"••■ Mail Station 6501 Tel:(651)282-9999 or 1-800-657-3594 St.Paul,MN 55146-6501 Fax:(651)556-5152 An equal opportunity employer TTY:(651)556-3030 or www.revenue.state.mn.us Call 711 for the Minnesota Relay