Form De 3hw - Employer Of Household Worker(S) Annual Payroll Tax Return
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1EMPLOYER OF HOUSEHOLD WORKER(S)
ANNUAL PAYROLL TAX RETURN
APPROVED EXTENSION TO:
PLEASE PRINT OR TYPE ALL INFORMATION IN BLACK INK - DO NOT ALTER PREPRINTED INFORMATION.
YEAR
DELINQUENT IF
NOT POSTMARKED
YEAR ENDED
DUE
OR RECEIVED BY
EMPLOYER ACCOUNT NUMBER
DO NOT ALTER THIS AREA
P1
P2
C
P
U
S
T
A
Mo.
Day
Yr.
EFFECTIVE
=
=
=
DATE
No Wages Paid This Year
DETAILED INSTRUCTIONS ARE
CHECK BOX
No Longer Have Household Employees (Date)________
IF:
LOCATED ON THE BACK.
Revert to Quarterly Payments (Date)_________________
_
_
_
_
A. TOTAL SUBJECT WAGES PAID THIS CALENDAR YEAR
B. EMPLOYERS UNEMPLOYMENT INSURANCE (UI)
WAGES
UI%
TAXES
(B1)
(B2)
(B3)
X
=
0.00
(Total Employee Wages up to $7,000 per employee per calendar year)
(multiplied by)
WAGES
ETT%
C. EMPLOYMENT TRAINING TAX (ETT)
(C1)
(C2)
(C3)
X
=
0.00
(Total Employee Wages up to $7,000 per employee per calendar year)
(multiplied by)
D. EMPLOYEE STATE DISABILITY INSURANCE (SDI) TAXES
Refer to the publication Tax Rates, Wage Limits, and Value
WAGES
SDI%
of Meals and Lodging (DE 3395) on the Employment Development Department
(D1)
(D2)
(D3)
X
=
0.00
(EDD) website at
(multiplied by)
_
_
_
_
E. CALIFORNIA PERSONAL INCOME TAX (PIT) WITHHELD
(Total PIT Withheld per Forms W-2)
_
_
_
_
F. TOTAL TAXES DUE (Add Items B3, C3, D3, and E)
0.00
_
_
G. LESS VOLUNTARY PREPAYMENT OF TAXES MADE DURING THE YEAR
_
_
_
_
_
_
_
_
H. BALANCE OF TOTAL TAXES DUE
0.00
INCLUDE EMPLOYER ACCOUNT NUMBER ON YOUR CHECK. Do not staple check to return.
Make check payable to the EMPLOYMENT DEVELOPMENT DEPARTMENT.
I.
Be sure to sign this declaration: I declare that the information herein is true and correct to the best of my knowledge and belief.
( ____ )
Signature
Title
Phone
Date
(Employer, Accountant, Preparer, etc.)
MAIL TO: State of California / Employment Development Department / P.O. Box 826221 / MIC 28B / Sacramento, CA 94230-6221
DE 3HW Rev. 10 (7-14)
CU
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Parent category: Financial