Form Ct-1096 (Drs) - Connecticut Annual Summary And Transmittal Of Information Returns - 2007

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Department of Revenue Services
2007
Form CT-1096 (DRS)
PO Box 5081
Hartford, CT 06102-5081
Connecticut Annual Summary and Transmittal of Information Returns
(Rev. 12/06)
Please read instructions on back before completing this return.
General Instructions
Round down to the next lowest dollar all amounts that include
1 through 49 cents. Round up to the next highest dollar all
Complete the return in blue or black ink only.
amounts that include 50 through 99 cents. However, if you
Form CT-1096 (DRS), Connecticut Annual Summary and
need to add two or more amounts to compute the amount to
Transmittal of Information Returns, may be used by new payers
enter on a line, include cents and round off only the total.
or payers who have not received the Withholding Remittance
Example: Add two amounts ($1.29 + $3.21) to compute the
Coupon Book for Payers of Nonpayroll Amounts for 2007. If
total ($4.50) to enter on a line. $4.50 is rounded to $5.00 and
you are not required to file federal Form 1096, you are not
entered on the line.
required to file Form CT-1096.
If you do not round, the Department of Revenue Services (DRS)
Annual Summary: Form CT-1096 must be filed by certain
will disregard the cents.
payers who are required to file federal Form 1096. Form
• Group the forms by form number and send each group
CT-1096 is due the last day of February, 2008. No payment
with a separate Form CT-1096.
is to be made with this return.
• Mail your completed return to: Department of Revenue
Rounding Off to Whole Dollars: You must round off cents
Services, PO Box 5081, Hartford CT 06102-5081.
to the nearest whole dollar on your returns and schedules.
• Miscellaneous payments made to resident individuals, or,
Line Instructions
where the payments relate to services performed wholly or
Line 1
partly within Connecticut, to nonresident individuals, as
Enter the total amount of income tax withheld from Connecticut
reported on federal Form 1099-MISC, whether or not
nonpayroll amounts subject to Connecticut income tax
Connecticut income tax was withheld;
withholding during the calendar year. (This should equal the
• Distributions from pensions, annuities, retirement, or
Total line on the back of this return.) Nonpayroll amounts
profit-sharing plans, as reported on federal Form 1099-R,
subject to Connecticut income tax withholding are the amounts
but only if Connecticut income tax was withheld;
required to be reported on Line 2.
• Proceeds from real estate transactions, as reported on Form
Line 2
1099-S, but only real estate transactions in Connecticut; and
• Unemployment compensation payments, as reported on
Enter the total amount of:
federal Form 1099-G, but only if Connecticut income tax
• Connecticut Lottery winnings paid to resident and nonresident
was withheld.
individuals, as reported on federal Form W-2G, whether or
Group the forms by form number and send each group with a
not Connecticut income tax was withheld;
separate Form CT-1096.
• Other gambling winnings paid to resident individuals, as
Line 3
reported on federal Form W-2G, whether or not Connecticut
income tax was withheld;
Indicate the number of 1098, 1099, or W-2G forms submitted
with this return. Be sure to complete all required information
• Property taxes paid to a Connecticut municipality on real
on the back of this return.
estate, as reported on federal Form 1098, box 4;
RESET FORM
Separate Here and Mail Coupon to DRS. Make a Copy for Your Records.
CT-1096 (DRS) Connecticut Annual Summary and Transmittal of Information Return
2007
Connecticut Tax Registration Number
Federal Employer ID Number
Due Date
February 28, 2008
1. Connecticut income tax withheld from
00
Enter name and address below. Please print or type.
Connecticut nonpayroll amounts
1.
2. Total nonpayroll amounts reported with
00
Form CT-1096
2.
1 2 3 4 5 6 7 8 9 0 1 2 3
1 2 3 4 5 6 7 8 9 0 1 2 3
1 2 3 4 5 6 7 8 9 0 1 2 3
1 2 3 4 5 6 7 8 9 0 1 2 3
3. Number of 1098s, 1099s, or W-2Gs
1 2 3 4 5 6 7 8 9 0 1 2 3
1 2 3 4 5 6 7 8 9 0 1 2 3
1 2 3 4 5 6 7 8 9 0 1 2 3
1 2 3 4 5 6 7 8 9 0 1 2 3
1 2 3 4 5 6 7 8 9 0 1 2 3
1 2 3 4 5 6 7 8 9 0 1 2 3
submitted
3.
1 2 3 4 5 6 7 8 9 0 1 2 3
1 2 3 4 5 6 7 8 9 0 1 2 3
1 2 3 4 5 6 7 8 9 0 1 2 3
1 2 3 4 5 6 7 8 9 0 1 2 3
1 2 3 4 5 6 7 8 9 0 1 2 3
1 2 3 4 5 6 7 8 9 0 1 2 3
Note: Do not send a payment with this return.
Mail to:
Department of Revenue Services
PO Box 5081
Hartford CT 06102-5081
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. I understand the penalty for willfully delivering a false return or document to
DRS is a fine of not more than $5,000, or imprisonment for not more than five years, or both.
Signature __________________________________________________________
Title ______________________________________ Date __________________

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