Form Ct-1096 - Connecticut Annual Summary And Transmittal Of Information Returns - 2015


Department of Revenue Services
PO Box 5081
Form CT-1096
Hartford, CT 06102-5081
Connecticut Annual Summary and Transmittal of Information Returns
(Rev. 08/15)
Complete this return in blue or black ink only.
General Instructions
Waiver of Electronic Filing Requirement
If you are not required to fi le federal Form 1096, you are
To request a waiver from the informational return electronic
not required to fi le Form CT-1096. Special rules apply to
fi ling requirement complete Form CT-8508, Request for
designated withholding agents. See Policy Statement
Waiver from Filing Informational Returns Electronically, at
2011(2), Income Tax Withholding for Athletes or Entertainers.
least 30 days before the due date.
Form CT-1096 must be fi led electronically. Do not send
If a waiver is granted your informational returns must be
this paper return to the Department of Revenue Services
submitted to DRS on compact disk by the last day of February.
(DRS), unless you have been granted a waiver from electronic
See Form CT-4804, Transmittal of Informational Returns
fi ling of informational returns. See Waiver of Electronic Filing
Reported on Compact Disc (CD) for Forms W-2G, 1099-R,
and 1099-MISC.
See Informational Publication 2015(8), Connecticut Tax
Who Must File Form CT-1096
Guide for Payers of Nonpayroll Amounts.
If you are required to fi le federal Form 1096, you must fi le
Do not make a payment with this return.
Form CT-1096 with DRS even if you are not required to be
When to File
registered with DRS, and submit every state copy of:
Form CT-1096 is due the last day of March 2016. Do not mail
• Federal Form W-2G for (1) Connecticut Lottery winnings
Form CT-1096.
paid to resident and nonresident individuals even if no
Connecticut income tax was withheld; and (2) other
If the due date falls on a Saturday, Sunday, or legal holiday,
gambling winnings paid to resident individuals even if no
the return will be considered timely if fi led by the next business
Connecticut income tax was withheld;
• Federal Form 1099-MISC for payments made to resident
Electronic Filing Requirement
individuals or to nonresident individuals if the payments
Taxpayers are required to fi le Form CT-1096 and Forms
relate to services performed wholly or partly in Connecticut
1099-MISC, 1099-R, or W-2G electronically.
even if no Connecticut income tax was withheld; and
Use the Taxpayer Service Center (TSC) to
• Federal Form 1099-R reporting distributions from pensions,
electronically fi le this return.
annuities, retirement, or profi t sharing plans, but only if
Connecticut income tax was withheld.
See Taxpayer Service Center (TSC), on back.
Electronic reporting requirements are available at
and Informational Publication
2015(10), Form 1099-R, 1099-MISC and W-2G Electronic
Filing Requirements for Tax Year 2015.
Separate here and mail
to DRS. Make a copy for your records.
Do not mail this form if fi ling electronically.
Connecticut Annual Summary and Transmittal of Information Returns
Connecticut Tax Registration Number
Federal Employer ID Number
Calendar year ending
Due date
Enter name and address below. Please print or type.
1. Connecticut income tax withheld from
Connecticut nonpayroll amounts
This return MUST be fi led electronically!
2. Total nonpayroll amounts reported
with Form CT-1096
3. Number of 1099-MISC, 1099-R, or
DO NOT MAIL paper return to DRS.
W-2Gs submitted
ZIP code
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 fi ne of not more than $5,000,
imprisonment for not more than fi ve years, or both.
Do not send payment with this return.
This return MUST be fi led electronically!
Signature _____________________________________________________________
DO NOT MAIL paper return to DRS.


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