Form Ct-941 (Drs) - Connecticut Quarterly Reconciliation Of Withholding - 2004
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FORM CT-941 (DRS)
State of Connecticut
Department of Revenue Services
CONNECTICUT QUARTERLY RECONCILIATION OF WITHHOLDING
(Rev. 12/03)
GENERAL INSTRUCTIONS
Rounding Off to Whole Dollars: You must round off cents to
the nearest whole dollar on your returns and schedules. Round
Purpose: The attached Form CT-941 (DRS), Connecticut
down to the next lowest dollar all amounts that include 1 through
Quarterly Reconciliation of Withholding, may be used by new
49 cents. Round up to the next highest dollar all amounts that
employers who have not received the Employer’s Withholding
include 50 through 99 cents. However, if you need to add two or
Remittance Coupon Book for 2004.
more amounts to compute the amount to enter on a line, include
All employers registered for Connecticut income tax withholding
cents and round off only the total.
are required to file Form CT-941. You must file a quarterly
Example: Add two amounts ($1.29 + $3.21) to compute the
reconciliation as long as you have an active withholding account
total ($4.50) to enter on a line. $4.50 is rounded to $5.00 and
with the Department of Revenue Services (DRS), even if no tax
entered on the line.
is due, or if no tax was required to be withheld for that quarter. In
general, Form CT-941 must be filed even if you are not required to
Reminders:
file federal Form 941 (for example: household employers,
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See instructions on back.
agricultural employers, and intermittent filers).
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Be sure to complete all requested information on the back of
this return.
Due Dates: First quarter, April 30, 2004; second quarter,
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Sign and date the return in the space provided.
July 31, 2004; third quarter, October 31, 2004; and fourth quarter,
January 31, 2005. An employer who made timely deposits of
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If payment is due, remit payment with this return.
Connecticut withholdng tax in full payment of such taxes due for
Make your check payable to “Commissioner of Revenue
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the quarter may file the return by the tenth day of the second
Services.”
calendar month following the end of the quarter. If you are a
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Write your Connecticut Tax Registration Number, and the
household employer and permitted by DRS to file one return
calendar quarter to which the payment applies, on your check.
annually, the due date of Form CT-941 is April 15, 2005.
Where to File: Mail your completed return and payment
If the due date falls on a Saturday, Sunday, or legal holiday,
(if applicable) to: Department of Revenue Services, PO Box 2931,
the next business day is the due date.
Hartford CT 06104-2931.
Seasonal filers must obtain permission from DRS to file for only
Amended Return: To amend Form CT-941, use Form CT-941X,
the quarters in which they are active. Household employers who
Amended Connecticut Reconciliation of Withholding.
voluntarily register with DRS and agricultural employers may
request annual filing. See Informational Publication 2000 (11),
Forms and Publications: Forms and publications may be
Connecticut Circular CT - Employer’s Tax Guide, for detailed
obtained by visiting the DRS Web site at or by
information on how to obtain permission to become a seasonal or
calling the DRS Forms Unit at 860-297-4753.
annual filer.
Use Form CT-941 to reconcile your quarterly Connecticut income tax withholding payments from wages only. Payers of
nonpayroll amounts must use Form CT-945, Connecticut Annual Reconciliation of Withholding For Nonpayroll Amounts , to
reconcile Connecticut income tax withholding.
SEPARATE HERE AND MAIL COUPON TO DEPARTMENT OF REVENUE SERVICES. KEEP A COPY FOR YOUR RECORDS.
CT-941 (DRS)
CONNECTICUT QUARTERLY RECONCILIATION OF WITHHOLDING
2004
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CONNECTICUT TAX REGISTRATION NUMBER
FEDERAL EMPLOYER ID NUMBER
ENTER REPORTING QUARTER (1, 2, 3, OR 4) DUE DATE
!
!
*
READ NEW INSTRUCTIONS BEFORE COMPLETING
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1. GROSS WAGES
1
ENTER NAME AND ADDRESS BELOW. PLEASE PRINT OR TYPE.
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2. GROSS CONNECTICUT WAGES
2
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3. CONNECTICUT TAX WITHHELD
3
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4. CREDIT FROM PRIOR QUARTER
4
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5. PAYMENTS MADE FOR THIS QUARTER
5
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6. TOTAL PAYMENTS (Add Line 4 and Line 5)
6
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7. NET TAX DUE (OR CREDIT) (Line 3 minus Line 6)
7
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8a. PENALTY:
+ 8b. INTEREST:
= 8
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9. AMOUNT TO BE CREDITED
9
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Check if you are a household employer.
*
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10. AMOUNT TO BE REFUNDED
10
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Check if you no longer have employees in Connecticut
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11. TOTAL AMOUNT DUE (Add Line 7 and Line 8)
11
and enter date of last payroll: _____________________ .
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 ________________________________________________________
Mail to:
DEPARTMENT OF REVENUE SERVICES
PO BOX 2931
HARTFORD CT 06104-2931
Title _______________________________________
Date _______________
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