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Department of Revenue Services

Form CT-W3 HHE

2011

State of Connecticut

Connecticut Annual Reconciliation of Withholding for

PO Box 2930

Hartford CT 06104-2930

Household Employers

(Rev. 12/11)

Round down to the next lowest dollar all amounts that include 1

General Instructions

through 49 cents. Round up to the next highest dollar all amounts

Complete this return in blue or black ink only.

that include 50 through 99 cents. However, if you need to add two

Form CT-W3 HHE is used by household employers only. Do not

or more amounts to compute the amount to enter on a line, include

make a payment with this return.

cents and round off only the total.

A household employer not registered with the Department of

Example: Add two amounts ($1.29 + $3.21) to compute the total

Revenue Services (DRS) for Connecticut income tax withholding

($4.50) to enter on a line. $4.50 is rounded to $5.00 and entered

purposes should enter the words “HOUSEHOLD EMPLOYER” in

on the line.

the space reserved for the Connecticut Tax Registration Number

Line Instructions

on this return.

Line 1

When to File

Enter total Connecticut income tax withheld from wages during

If ﬁ ling electronically, you will ﬁ le a Form CT-W3, which is due

calendar year 2011. This should equal the Total line on the back

the last day of March 2012 and will be completed as part of the

of this return.

electronic filing process when you upload Copy 1 of federal

Line 2

Forms W-2, Wage and Tax Statement. If ﬁ ling electronically do not

Enter total Connecticut wages reported during calendar year

mail Form CT-W3 HHE. If ﬁ ling by paper, Form CT-W3 HHE is due

2011. Connecticut wages are all wages paid to employees who

the last day of February 2012.

are residents of Connecticut, even if those wages are paid for work

If the due date falls on a Saturday, Sunday, or legal holiday, the next

performed outside Connecticut by those resident employees, and

business day is the due date.

wages paid to employees who are nonresidents of Connecticut if

Employers must file every Copy 1 of federal Form W-2 with

those wages are paid for work performed in Connecticut by those

Form CT-W3 HHE even if Connecticut income tax was not withheld.

nonresident employees.

Where to File

Line 3

Use the Taxpayer Service Center (TSC)

Enter the number of W-2 forms submitted with this return.

to electronically file this return. You must

Reminders

have a Connecticut household employer Tax

Complete all requested information on the front and back of this

Registration Number to ﬁ le through the TSC.

return.

See TSC on back. If filing by paper, mail

Do not send a payment with this return. Payments are

completed return including Forms W-2 to the address on the return.

made using Form CT-941 HHE, Connecticut Reconciliation

Rounding Off to Whole Dollars

of Withholding for Household Employers or Form CT-941X,

Amended Connecticut Reconciliation of Withholding.

You must round off cents to the nearest whole dollar on your returns

Sign and date the return in the space provided.

and schedules. If you do not round, DRS will disregard the cents.



Separate here and mail return to DRS. Make a copy for your records.



2011

CT-W3 HHE

Connecticut Annual Reconciliation of Withholding for Household Employers

Connecticut Tax Registration Number

Federal Employer ID Number

Due date



February 29, 2012

Enter name and address below. Please print or type.



1. Connecticut tax withheld from wages

Name



2. Total Connecticut wages reported

Address



Number of W-2s submitted

Do not send payment with this return.

City

State

ZIP code

Mail to:

Department of Revenue Services

State of Connecticut

PO Box 2930

Hartford CT 06104-2930



I declare under penalty of law that I have examined this return (including any accompanying

Check if you are a household employer and you

schedules and statements) and, to the best of my knowledge and belief, it is true, complete,

withhold Connecticut income tax from the wages

and correct. I understand the penalty for willfully delivering a false return or document to

of household employees.

DRS is a ﬁ ne of not more than $5,000, or imprisonment for not more than ﬁ ve years, or both.



Check if you are a household employer and you

Signature ______________________________________________________

do not withhold Connecticut income tax from the

wages of household employees.

Title ____________________________________ Date _________________

Form Ct-W3 Hhe - Connecticut Annual Reconciliation Of Withholding For Household Employers - 2011

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