Form Ct-W3 (Drs) - Connecticut Annual Reconciliation Of Withholding - 1999
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2STATE OF CONNECTICUT
DEPARTMENT OF REVENUE SERVICES
The attached Annual Reconciliation of Withholding may be used by new employers and employers who have not received the Employer’s Withholding Coupon Book for 1999.
Form CT-W3 (DRS), Connecticut Annual Reconciliation of Withholding, is due the last day of February. No payment is to be made with this form.
Employers must file every “state copy” of federal Form W-2 with the annual reconciliation, even if no Connecticut income tax was withheld.
Line 1:
Enter the total amount of Connecticut income tax withheld from wages for the entire calendar year. This should equal the Total Line on the back of this form.
Line 2:
Enter the gross Connecticut wages paid during the calendar year.
Line 3:
Indicate the number of W-2 forms submitted with this return.
Be sure to complete all requested information on the back of this form. Sign and date the return in the space provided.
Do not make payment with this form. All payments must be made using Forms CT-WH and CT-941.
Send with Form CT-W3 every “state copy” of federal Form W-2 reporting Connecticut wages paid during the calendar year (copy 1 of the optional six-part federal Form W-2
or equivalent). If you are required by the IRS to file copies of federal Form W-2 on magnetic media, you must file these forms on magnetic media with DRS. However, if you file
24 or fewer Forms W-2 with DRS, you may be excused from the magnetic media filing requirements without obtaining a waiver. For new information regarding magnetic media
reporting requirements, contact DRS at: 1-800-382-9463 (in-state) or 860-297-5962 (anywhere). Telecommunications Device for the Deaf (TDD/TT) users only, call 860-297-
4911.
: If a household employer is
registered with DRS for Connecticut income tax withholding purposes, the employer should enter the words
“HOUSEHOLD EMPLOYER” in the space reserved for the Connecticut tax registration number on this form.
If an agricultural employer is
registered with DRS for Connecticut income tax withholding purposes, the employer should write the words
“AGRICULTURAL EMPLOYER” in the space reserved for the Connecticut tax registration number on this form.
Mail your completed return to: Department of Revenue Services, PO Box 2930, Hartford CT 06104-2930.
CONNECTICUT TAX REGISTRATION NUMBER
FEDERAL EMPLOYER ID NUMBER
DUE DATE
1. Connecticut tax withheld from wages
Enter name and address below. Please print or type.
(See Instructions)
1.
2. Total Connecticut wages reported
2.
1 2 3 4 5
1 2 3 4 5
1 2 3 4 5
1 2 3 4 5
3. Number of W-2s submitted
3.
1 2 3 4 5
1 2 3 4 5
NOTE: DO NOT MAKE PAYMENT WITH THIS FORM.
DEPARTMENT OF REVENUE SERVICES
PO BOX 2930
HARTFORD CT 06104-2930
Check if you are a household employer and
I declare under the penalties of false statement that I have examined this return
you withhold Connecticut income tax from the
and, to the best of my knowledge and belief, it is true, complete and correct.
wages of household employees.
Signature __________________________________________________________
Check if you are a household employer and
you do not withhold Connecticut income tax
Title ______________________________________ Date __________________
from the wages of household employees.
SEPARATE HERE AND MAIL COUPON TO DEPARTMENT OF REVENUE SERVICES. RETAIN TOP PORTION FOR YOUR RECORDS.
CONNECTICUT TAX REGISTRATION NUMBER
FEDERAL EMPLOYER ID NUMBER
DUE DATE
1. Connecticut tax withheld from wages
Enter name and address below. Please print or type.
(See Instructions)
1.
2. Total Connecticut wages reported
2.
1 2 3 4 5
1 2 3 4 5
1 2 3 4 5
1 2 3 4 5
3. Number of W-2s submitted
3.
1 2 3 4 5
NOTE: DO NOT MAKE PAYMENT WITH THIS FORM.
DEPARTMENT OF REVENUE SERVICES
P O BOX 2930
Check if you are a household employer and
HARTFORD CT 06104-2930
you withhold Connecticut income tax from the
I declare under the penalties of false statement that I have examined this return
wages of household employees.
and, to the best of my knowledge and belief, it is true, complete and correct.
Check if you are a household employer and
you do not withhold Connecticut income tax
Signature __________________________________________________________
from the wages of household employees.
Title ______________________________________ Date __________________
CT-W3 (DRS) (Rev.10/98)
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