Department of Revenue Services
2009
Form CT-941 (DRS)
PO Box 2931
Hartford, CT 06104-2931
Connecticut Quarterly Reconciliation of Withholding
(Rev. 12/08)
General Instructions
entire calendar year instead of fi ling Form CT-941 (DRS) for each
calendar quarter. See IP 2009(1).
Complete the return in blue or black ink only.
Rounding Off to Whole Dollars: You must round off cents to the
Form CT-941 (DRS), Connecticut Quarterly Reconciliation of
nearest whole dollar on your returns and schedules. If you do not
Withholding, may be used by new employers who have not received
round, DRS will disregard the cents.
the Employer’s Withholding Remittance Coupon Book for calendar
year 2009. Use Form CT-941 (DRS) to reconcile your quarterly
Round down to the next lowest dollar all amounts that include
Connecticut income tax withholding payments from wages only.
1 through 49 cents. Round up to the next highest dollar all amounts
Payers of nonpayroll amounts must use Form CT-945 (DRS),
that include 50 through 99 cents. However, if you need to add two
Connecticut Annual Reconciliation of Withholding for Nonpayroll
or more amounts to compute the amount to enter on a line, include
Amounts, to reconcile Connecticut income tax withholding.
cents and round off only the total.
All employers who are registered for Connecticut income tax
Example: Add two amounts ($1.29 + $3.21) to compute the total
withholding purposes (other than household employers, agricultural
($4.50) to enter on a line. $4.50 is rounded to $5.00 and entered
employers granted annual fi ler status, and seasonal fi lers) are
on the line.
required to fi le Form CT-941 (DRS) for each calendar quarter as
Reminders:
long as they have an active withholding account with the Department
See instructions on back.
of Revenue Services (DRS) even if no tax is due or if no tax was
Be sure to complete all requested information on the back of
required to be withheld for that quarter.
this return.
Due Dates: First quarter, April 30, 2009; second quarter, July 31, 2009;
Sign and date the return in the space provided.
third quarter, October 31, 2009; and fourth quarter, January 31, 2010.
If payment is due, remit payment with this return.
An employer who made timely deposits of Connecticut withholding tax
Make your check payable to: Commissioner of Revenue
in full payment of such taxes due for the quarter may fi le the return
Services.
on or before the tenth day of the second calendar month following
the end of the quarter. If the due date falls on a Saturday, Sunday, or
DRS may submit your check to your bank electronically.
legal holiday, the next business day is the due date.
Write your Connecticut Tax Registration Number and calendar
quarter to which the payment applies on check.
Household employers who are registered to withhold Connecticut
income tax from wages of their household employees are not to
Where to File: Visit the Taxpayer Service Center (TSC) at the
fi le Form CT-941 (DRS) for each calendar quarter, but instead
DRS website at to electronically fi le this return.
are required to file one Form CT-941 (DRS/P), Connecticut
The TSC for Business Taxes (TSC-BUS) allows taxpayers to
Reconciliation of Withholding for Household Employers, for the
electronically fi le, pay, and manage state tax responsibilities.
entire calendar year, the due date of which is April 15, 2010.
Mail your completed return and payment (if applicable) to:
Payment of the Connecticut income tax withheld from wages
Department of Revenue Services, PO Box 2931, Hartford CT
of household employees during the entire calendar year is to
06104-2931.
accompany Form CT-941 (DRS/P). See Informational Publication
Amended Return: Use Form CT-941X, Amended Connecticut
2009(1), Connecticut Circular CT, Employer’s Tax Guide.
Reconciliation of Withholding, to amend Form CT-941 (DRS).
Seasonal filers may request permission from DRS to file
Forms and Publications: Forms and publications may be obtained
Form CT-941 (DRS) only for the calendar quarters in which they pay
by visiting the DRS website at or by calling the
Connecticut wages to employees. Certain agricultural employers
DRS Forms Unit at 860-297-4753.
may request permission to fi le one Form CT-941 (DRS) for the
Separate Here and Mail Coupon to DRS. Make a Copy for Your Records.
2009
CT-941 (DRS)
Connecticut Quarterly Reconciliation of Withholding
Connecticut Tax Registration Number
Federal Employer ID Number
Enter Reporting Quarter (1, 2, 3, or 4)
Due Date
READ INSTRUCTIONS BEFORE COMPLETING
Enter name and address below. Please print or type.
Name
00
1. Gross wages
1
00
2. Gross Connecticut wages
2
Address
00
3. Connecticut tax withheld
3
00
4. Credit from prior quarter
4
City
State
ZIP Code
00
5. Payments made for this quarter
5
00
6. Total payments: Add Line 4 and Line 5.
6
00
7. Net tax due (or credit): Line 3 minus Line 6.
7
Check if you no longer have employees in Connecticut and
00
8a. Penalty:
+ 8b. Interest:
= 8
enter date of last payroll: _______________________ .
00
9. Amount to be credited
9
00
10. Amount to be refunded
10
Mail to:
Department of Revenue Services
00
11. Total amount due: Add Line 7 and Line 8.
11
PO Box 2931
Hartford CT 06104-2931
I declare under penalty of law that I have examined this return (including any accompanying schedules and
statements) and, to the best of my knowledge and belief, it is true, complete, and correct.
Signature ____________________________________________________________
Title _______________________________________ Date ____________________