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FILING FREQUENCY
FORM
DO NOT SEND PAYMENT WITH THIS FORM.
MISSOURI DEPT. OF REVENUE
MO W-3
IF YOU HAVE WITHHOLDING TAX DUE,
TRANSMITTAL OF
DUE ON OR BEFORE
USE FORM MO-941.
(REV. 08-2012)
TAX STATEMENTS
MO TAX I.D. NUMBER
TAX YEAR
1. Total
___ ___ ___ ___ ___ ___ ___ ___
___ ___ ___ ___
Missouri
Income Tax
FEIN
0 0
$
•
Withheld ......
___ ___ ___ ___ ___ ___ ___ ___ ___
NAME
2. Number of
Form W-2(s)/
1099-R(s)
STREET ADDRESS
*
Issued ..........
CITY, STATE, ZIP CODE
Submitting W-2 Cs only ....................................................................................
I have direct control, supervision, or responsibility for filing this report. Under penalties of
perjury, I declare it is a true, accurate, and complete report.
AUTHORIZED SIGNATURE
DATE (MM/DD/YYYY)
_ _ / _ _ / _ _ _ _
DOR USE ONLY
*
MAIL REPORT TO: Missouri Department of Revenue, P.O. Box 3330, Jefferson
City, Missouri 65105-3330.
For more information, visit
MO W-3 (08-2012)
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
INSTRUCTIONS FOR COMPLETING FORM MO W-3 TRANSMITTAL OF TAX STATEMENTS
The Transmittal of Tax Statements is due on or before the last day of February,
If you discover an error has occurred on a previously filed Employer’s
after all of your withholding tax returns have been filed. If the due date falls
Return of Income Tax Withheld (MO-941) you must correct it by remitting an
on a Saturday, Sunday, or legal holiday, the Form MO W-3 will be considered
Employer’s Withholding Tax Return Correction (MO-941C). This form must
timely if postmarked on the next business day. Copies of all Forms W-2(s)
be used to increase or decrease any previously reported tax amounts. This
and 1099-R(s) (Copy 1), the magnetic tape, the cartridge, or the diskette must
form can be located at
accompany the Form MO W-3, Transmittal of Tax Statements. A list, prefer-
ably an adding machine tape or a computer printout, of the total amount of
If after you have filed your Form W-2s and Form MO W-3, you discover an
the income tax withheld as shown on all “Copy 1s” of Form W-2 and Form
error and need to file a Form W-2C, you should attach a copy of the Form
1099-R must be included. (If you have 250 or more employees, you must
W-2C to Form MO W-3 and check the box indicated for submitting Form
use magnetic media reporting. Specifications for magnetic media reporting
W-2Cs. Enter the same amount on Line 1 and Line 2 that was originally
are provided in the Employer’s Tax Guide, which is provided on our web
entered unless as a result of the Form W-2Cs those amounts changed. If
site. To obtain an Employer’s Tax Guide, access
changed, enter the total new correct amount for all Form W-2Cs in both
or call (800) 877-6881.)
boxes.
Send Forms W-2(s) and 1099-R(s), the magnetic tape, the cartridge, or the
diskette to the Missouri Department of Revenue in convenient size pack-
ages. Each package must be identified with the name and account number
of the employer and the packages must be consecutively numbered. The
Department of Revenue will not provide notification when magnetic media
information is processed; nor will the Department return completed magnetic
media to the employer.
Do not include the fourth quarter or 12th month return or payment with the
Forms W-2(s) or 1099-R(s), the magnetic tape, the cartridge, or the diskette.
The last remittance must be sent separately with Form MO-941, Employer’s
Return of Income Taxes Withheld.