STATE OF NEW JERSEY
DIVISION OF TAXATION
Monthly Return of Withholding from Unregistered Unincorporated Contractors
(Required Pursuant to N.J.S.A. 54A:7-1.2 effective January 1, 2007)
New Jersey Taxpayer ID
Mailing Address (number and street)
This return and payment is due by the
15th day of the month following the
month of withholding.
Number of Unregistered Unincorporated Contractors Reported
Gross Amount Paid Subject to Withholding (from Schedule A below)
Total Amount Withheld (Multiply Line 2 by .07)
Make Check Payable and
State of New Jersey, Gross Income Tax
Mail Return with Payment to:
PO Box 629
Trenton, NJ 08646-0629
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.
SCHEDULE A - Summary of Unregistered Unincorporated Contractors Subject to Withholding (MUST BE COMPLETED)
Unregistered Unincorporated Contractor
Contractor Name (Last, First, MI)
Gross Amount Paid
Social Security Number or FEIN
(Please Print )
Total Gross Amount Paid
Enter total here and on Line 2. Gross Amount Paid Subject to Withholding above. . . . . .
Total Amount Withheld
Enter total here. Amount must agree with Line 3 Total Amount Withheld, calculated above.
SEE INSTRUCTIONS ON REVERSE SIDE