Form De 3 Hw - Annual Payroll Tax Return For Employer Of Household Workers

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ANNUAL PAYROLL TAX RETURN FOR
EMPLOYER OF HOUSEHOLD WORKERS
APPROVED EXTENSION TO: _______________________
PLEASE TYPE ALL INFORMATION
DELINQUENT IF
YEAR
NOT POSTMARKED
YEAR ENDED ___________________ DUE ______________
OR RECEIVED BY ______________________
EMPLOYER ACCOUNT NO.
DO NOT ALTER THIS AREA
P1
P2
C
P
U
S
A
Mo. Day
Yr.
EFFECTIVE
=
=
=
DATE
NO WAGES THIS YEAR
CHECK BOX
DETAILED INSTRUCTIONS ARE
FINAL RETURN
IF:
LOCATED ON THE BACK
REVERT TO QUARTERLY REPORTING
A. TOTAL SUBJECT WAGES PAID THIS CALENDAR YEAR
WAGES
UI %
B. EMPLOYER’S UNEMPLOYMENT INSURANCE (UI) TAXES
(B1)
(B2)
(B3)
X
=
(Total Employee Wages up to $7,000 per employee per calendar year)
(multiplied by)
WAGES
ETT %
C. EMPLOYMENT TRAINING TAX (ETT)
(C1)
(C2)
(C3)
X
=
(Total Employee Wages up to $7,000 per employee per calendar year)
(multiplied by)
WAGES
SDI %
D. EMPLOYEE STATE DISABILITY INSURANCE (SDI) TAXES
(D1)
(D2)
(D3)
X
=
(Total Employee Wages up to $31,767 per employee per calendar year)
(multiplied by)
E. CALIFORNIA PERSONAL INCOME TAX (PIT) WITHHELD
(Total PIT withheld per forms W-2)
F. TOTAL TAXES DUE (Add Items B3, C3, D3, and E)
G. LESS VOLUNTARY PREPAYMENT OF TAXES MADE DURING THE YEAR
H. BALANCE OF TOTAL TAXES DUE
INCLUDE EMPLOYER ACCOUNT NUMBER ON YOUR CHECK. Do not staple check to return.
Make check payable to EMPLOYMENT DEVELOPMENT DEPARTMENT
HELP US IMPROVE THE QUALITY OF OUR EMPLOYMENT TAX SERVICES. PLEASE RATE OUR CURRENT SERVICES BY
ENTERING THE APPROPRIATE NUMBER IN THE BOX:
4 = EXCELLENT
3 = GOOD
2 = FAIR
1 = POOR
I. Be sure to sign this declaration: I declare that the information herein is true and correct to the best of my knowledge and belief.
(
)
Signature ________________________ Title ____________________________ Phone _________________ Date ___________
(Owner, Accountant, Preparer, etc.)
DE 3 HW Rev. 2 (10-96) (INTERNET) State of California / Employment Development Department / P.O. Box 826221 / Sacramento, CA 94230-6221
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