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

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Department of Revenue Services
2009
Form CT-1096 ATHEN
State of Connecticut
PO Box 5081
Connecticut Annual Summary and
Hartford, CT 06102-5081
Transmittal of Information Returns
(Rev. 01/09)
General Instructions
Line Instructions
Line 1
Complete this return in blue or black ink only.
Enter the total amount of Connecticut income tax withheld
Form CT-1096 ATHEN may be used by new payers or
from payments made to athletes or entertainers during
payers who have not received the Designated Withholding
the 2009 calendar year. This amount should equal
Agent’s Withholding Remittance Coupon Package for
the sum of quarterly amounts listed on the back of
Income Tax Withholding for Athletes and Entertainers for
Form CT-1096 ATHEN.
2009. Except as otherwise provided in Special Rules for
Line 2
Payments Made to Nonresident Aliens, you must complete
Form CT-1096 ATHEN and fi le it along with a duplicate
Enter the total amount of payments made to athletes or
of all federal Forms 1099-MISC, Miscellaneous Income,
entertainers during the 2009 calendar year. This amount
reporting Connecticut income tax withholding information
should equal the sum of payments subject to Connecticut
in Boxes 16 and 18.
income tax withholding reported in Box 18 on each federal
Due date: February 28, 2010, if fi ling on paper; or March 31,
Form 1099-MISC.
2010, if fi ling electronically. Form CT-1096 ATHEN must
Line 3
be fi led by certain payers who are required to fi le federal
Indicate the number of federal Forms 1099-MISC
Form 1096, Annual Summary and Transmittal of U.S.
submitted with this return.
Information Returns. No payment is to be made with this
Sign and date the return in the space provided.
return. If the due date falls on a Saturday, Sunday, or legal
Do not make payments with this return. All payments
holiday, the next business day is the due date.
must be made using Form CT-8109 (DRS), Connecticut
Rounding Off to Whole Dollars: You must round off cents
Withholding Tax Payment Form for Nonpayroll
to the nearest whole dollar on your returns and schedules.
Amounts, or Form CT-945 ATHEN, Connecticut Annual
If you do not round, the Department of Revenue Services
Reconciliation of Withholding for Nonpayroll Amounts.
(DRS) will disregard the cents.
Mail your completed Form CT-1096 ATHEN with a copy
Round down to the next lowest dollar all amounts that
of each federal Form 1099-MISC to:
include 1 through 49 cents. Round up to the next highest
Department of Revenue Services
dollar all amounts that include 50 through 99 cents.
State of Connecticut
However, if you need to add two or more amounts to
PO Box 5081
compute the amount to enter on a line, include cents and
Hartford CT 06102-5081
round off only the total.
Example: Add two amounts ($1.29 + $3.21) to compute
the total ($4.50) to enter on a line. $4.50 is rounded to
$5.00 and entered on the line.
Separate Here and Mail Coupon to DRS. Make a Copy for Your Records.
2009
CT-1096 ATHEN
Connecticut Annual Summary and Transmittal of Information Return
Connecticut Tax Registration Number
Federal Employer ID Number
Due date
February 28, 2010
Enter name and address below. Please print or type.
1. Connecticut income tax withheld from
00
Connecticut nonpayroll amounts
1.
Name
2. Total nonpayroll amounts reported with
00
Form CT-1096 ATHEN
2.
Address
3. Number of 1099s or W-2Gs submitted
3.
City
State
ZIP code
Do not send a payment with this return.
Mail to:
Department of Revenue Services
State of Connecticut
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 fi ne of not more than $5,000, or imprisonment for not more than fi ve years, or both.
Signature __________________________________________________________
Title ______________________________________ Date ___________________

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