Form Ct-941 (Drs/p) - Connecticut Reconciliation Of Withholding For Household Employers - 2008


Department of Revenue Services
Form CT-941 (DRS/P)
State of Connecticut
PO Box 2931
Connecticut Reconciliation of Withholding
Hartford CT 06104-2931
for Household Employers
(Rev. 04/08)
General Instructions
• See instructions on back.
Complete the return in blue or black ink only.
• Sign and date the return in the space provided.
All household employers registered for Connecticut income tax
• If payment is due, remit payment with this return.
withholding are required to file Form CT-941 (DRS/P), Connecticut
Reconciliation of Withholding for Household Employers, as long
• Make your check payable to: Commissioner of Revenue Services.
as they have an active withholding account with the Department
• DRS may submit your check to your bank electronically.
of Revenue Services (DRS) even if no tax is due.
• Write your Connecticut Tax Registration Number on your check.
Due Date: April 15, 2009. If the due date falls on a Saturday,
Where to File: Visit the Taxpayer Service Center (TSC) at the
Sunday, or legal holiday, the next business day is the due date.
DRS website to electronically file this return.
Mail your completed return and payment (if applicable) to:
Household employers who are registered to withhold
Connecticut income tax from wages of their household
Department of Revenue Services
employees are not to file Form CT-941 (DRS/P) for each calendar
State of Connecticut
quarter, but instead are required to file one Form CT-941 (DRS/P)
PO Box 2931
for the entire 2008 calendar year, the due date of which is
Hartford CT 06104-2931.
April 15, 2009. Payment of the Connecticut income tax withheld
For Further Information: Call DRS during business hours,
from wages of household employees during the entire calendar
Monday through Friday:
year is to accompany Form CT-941 (DRS/P). See Informational
• 1-800-382-9463 (Connecticut calls outside the Greater Hartford
Publication 2008(1), Connecticut Circular CT, Employer’s Tax Guide.
calling area only); or
Rounding Off to Whole Dollars: You must round off cents to
• 860-297-5962 (from anywhere).
the nearest whole dollar on your returns and schedules. Round
down to the next lowest dollar all amounts that include 1 through
TTY, TDD, and Text Telephone users only may transmit
49 cents. Round up to the next highest dollar all amounts that
inquiries anytime by calling 860-297-4911.
include 50 through 99 cents. If you do not round, DRS will disregard
Taxpayer Service Center (TSC): The TSC is an interactive tax
the cents.
organization tool that allows taxpayers to file, pay, and manage
Amended Return: To amend Form CT-941 (DRS/P), use Form
their state tax responsibilities electronically. Through our website
CT-941X, Amended Connecticut Reconciliation of Withholding.
at , the TSC offers a fast, easy, and secure
Forms and publications may be obtained by visiting the DRS
way to conduct business with DRS.
website at or by calling the DRS Forms Unit
at 860-297-4753 (from anywhere).
Separate here and mail coupon to DRS. Keep a copy for your records.
CT-941 (DRS/P)
Connecticut Reconciliation of Withholding for Household Employers
Connecticut Tax Registration Number
Federal Employer ID Number
Reporting Quarter
Due Date
Annual Filer (4)
April 15, 2009
Read instructions before completing.
Household Employer
1. Gross wages
Enter name and address below. Please print or type.
2. Gross Connecticut wages
3. Connecticut tax withheld
4. Credit from prior year
5. Payments made for this year
6. Total Payment: Add Line 4 and Line 5.
ZIP Code
7. Net tax due (or credit): Line 3 minus Line 6
8a. Penalty:
+ 8b. Interest:
= 8
9. Amount to be credited
Check if you no longer have household employees in
10. Amount to be refunded
Connecticut and enter date of last payroll ____________ .
11. Total amount due: Add Line 7 and Line 8.
Mail to:
Department of Revenue Services
I declare under penalty of law that I have examined this return (including any accompanying schedules
State of Connecticut
and statements) and, to the best of my knowledge and belief, it is true, complete, and correct.
PO Box 2931
Signature ________________________________________________________
Hartford CT 06104-2931
Title _______________________________________
Date _______________


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