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Department of Revenue Services

Form CT-W3 (DRS/P)

2009

State of Connecticut

Connecticut Annual Reconciliation of Withholding for

PO Box 2930

Hartford CT 06104-2930

Household Employers

(Rev. 12/09)

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

Form CT-W3 (DRS/P) is used by household employer’s only.

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

Do not make a payment with this return.

include cents and round off only the total.

A household employer not registered with Department of

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

Revenue Services (DRS) for Connecticut income tax withholding

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

purposes should enter the words “HOUSEHOLD EMPLOYER” in

entered on the line.

the space reserved for the Connecticut Tax Registration Number

Line Instructions

on this return.

Line

When to File

Enter total Connecticut income tax withheld from wages during

If ﬁ ling electronically, Form CT-W3 (DRS/P) is due the last day

the 2009 calendar year. This should equal the Total line on the

of March 2010 and will be completed as part of the electronic

back of this return.

ﬁ ling process when you upload Copy 1 of federal Forms W-2,

Wage and Tax Statement. If ﬁ ling electronically do not mail in

Line 2

Form CT-W3 (DRS/P). If ﬁ ling by paper, Form CT-W3 (DRS/P) is

Enter total Connecticut wages reported during the 2009

due the last day of February 2010.

calendar year. Connecticut wages are all wages paid to

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

employees who are residents of Connecticut, even if those

business day is the due date.

wages are paid for work performed outside Connecticut by

those resident employees, and wages paid to employees who

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

Form CT-W3 (DRS/P) even if Connecticut income tax was not

are nonresidents of Connecticut if those wages are paid for work

withheld.

performed in Connecticut by those 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 ﬁ ling by paper, mail completed return including

Do not send a payment with this return. Payments are

Forms W-2 to the address on the coupon.

made using Form CT-941 (DRS/P), Connecticut Reconciliation

Rounding Off to Whole Dollars

of Withholding for Household Employer’s or Form CT-941X,

Amended Connecticut Reconciliation of Withholding.

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

Sign and date the return in the space provided.

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

the cents.

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

2009

CT-W3 (DRS/P)

Connecticut Annual Reconciliation of Withholding for Household Employers

Connecticut Tax Registration Number

Federal Employer ID Number

Due date

February 28, 2010

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

Check if you are a household employer and you

Hartford CT 06104-2930

withhold Connecticut income tax from the wages

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

of household employees.

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

Check if you are a household employer and you

a false return or document to DRS is a ﬁ ne of not more than $5,000, or imprisonment

do not withhold Connecticut income tax from the

for not more than ﬁ ve years, or both.

wages of household employees.

Signature ______________________________________________________

Title ____________________________________ Date _________________

Form Ct-W3 (Drs/p) - Connecticut Annual Reconciliation Of Withholding For Household Employers - 2009

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