Employment Roster – Form

May 16, 2017

Pursuant to Sections 181.13(A) and 182.133(B) of the Middlefield Tax Code, in order to verify that all persons who are working in the Village of Middlefield are complying with Chapter 182 of the Codified Ordinances, it is necessary for me to obtain from each Middlefield employer a roster of all (1) current employee names, (2) names of all persons employed during 2016.  In this context, “employees” includes not only employees paid as “W-2 employees”, but all individuals working in the Village for your business as independent contractors, 1099 employees, etc., including any people who work for your business through an employment agency which is paid by your business and which itself pays those people.

All such records produced will be retained by the Village Tax Administrator as confidential tax records pursuant to Section 182.14 of the Codified Ordinances and Chapter 718 of the Ohio Revised Code.  As such, all such records will be shielded from public disclosure and are, by definition, not public records.

The Village appreciates your anticipated prompt response to this request.  However, if voluntary compliance is not forthcoming, the Village has directed me to exercise my authority to issue orders and subpoenas for the production of books, accounts, papers, records, documents, etc.  We trust that this will not be necessary.

Very truly yours,

Latisha Stupka

Tax Administrator