Form Nj-927-H - New Jersey Gross Income Tax And Other Employer Payments Worksheet - 2006 Page 2

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Business Paperless Telefiling System
FOR PHONE
FOR PHONE
Worksheet
FILING ONLY
FILING ONLY
New Jersey Gross Income Tax and Other Employer Payments
(Form NJ-927-H Domestic Employer’s Annual Return)
Fill in the Worksheet. Call the New Jersey Business Paperless Telefiling System 24 hours a day at 1-877-829-2866. Choose “2” from the menu for
Gross Income Tax and Other Employer Payments. Complete the filing, enter your Confirmation Number on the Worksheet, and keep a copy of the
Worksheet for your business records.
IDENTIFICATION
New Jersey Taxpayer
/
–
–
Identification Number
PIN/Taxpayer Name
Tax Preparer’s Identification
Contact
–
–
Number (if applicable)
Phone Number
RETURN INFORMATION
Provided by Filer
Provided by Phone System
1. Tax year covered by return ...............................................
2. Total of all wages paid subject to UI, DI, WF & HC ........ $
.
00
3. Taxable wage base (per employee) ........................................................................................................ $
.
4. Total wages in excess of taxable wage base .................. $
.
5. Taxable wages subject to UI, WF & HC ................................................................................................. $
.
6. Taxable wages subject to DI (Combination Plan) .......... $
.
7. Taxable wages subject to DI ................................................................................................................... $
.
0.
8. UI, WF & HC rate (see instructions) .......................................................................................................
9. Total UI, WF & HC contributions due ...................................................................................................... $
.
0.
10. DI rate (see instructions) .........................................................................................................................
11. Total DI contributions due ........................................................................................................................ $
.
12. Total gross income tax withheld for the year ................... $
.
13. Total liability .............................................................................................................................................. $
.
14. Total payments and credits ............................................... $
.
............................................................................ $
.
15. Overpayment amount
Credit
Refund
16. Balance due ............................................................................................................................................. $
.
17. Average number of workers employed for each quarter (see instructions)
1st
2nd
3rd
4th
PAYMENT INFORMATION
Complete this section if paying by e-check or EFT debit. If using EFT debit, enter only account type and debit date.
Bank Routing Number
Account Number
1 – Checking
/
/
Type of Account
Payment Debit Date
2 – Savings
SIGNATURE AND CONFIRMATION
You will be required to agree with the following declaration and provide a voice signature: “Subject to the penalties of perjury,
I hereby certify that this return, to the best of my knowledge and belief, is a true and correct statement.”
DO NOT HANG UP! You will be assigned a Confirmation Number. Enter this number and the date in the boxes below.
/
/
Date
Signed by: ________________________________________
Do not mail this worksheet – Keep it for your records
WORKSHEET MAY BE REPRODUCED
NJ-927-H (9/06)
(Also available at: )

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