Form Ct- 4802 - Transmittal Of Informational Returns Reported On Compact Disc
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1Form CT- 4802
Department of Revenue Services
State of Connecticut
Transmittal of Informational Returns
PO Box 5081
Reported on Compact Disc (CD)
Hartford CT 06102-5081
Continuation
(Rev. 09/08)
Complete this form in blue or black ink only.
Page ______
Form CT-4802 is a continuation of Form CT-4804 and should be used only if you are
of
______
reporting for more than four payers. See instructions on Form CT-4804.
Calendar year for which CDs are submitted
Transmitter’s Connecticut Tax Registration Number
Name and address of transmitter; include street, PO Box, city, state, and ZIP Code.
Transmitter’s Federal Employer Identifi cation Number (FEIN)
8 Payer Summary of CD Wage Informational Return
8 Payer Summary of CD Wage Informational Return
Name of payer
Name of payer
Street address
Street address
City
State
ZIP Code
City
State
ZIP Code
Connecticut Tax Registration Number
Connecticut Tax Registration Number
Federal Employer ID Number
Federal Employer ID Number
Type of return
Type of return
Number of 1099 or W-2Gs submitted
Number of 1099 or W-2Gs submitted
Total nonpayroll amounts reported
Total nonpayroll amounts reported
Connecticut tax withheld
Connecticut tax withheld
8 Payer Summary of CD Wage Informational Return
8 Payer Summary of CD Wage Informational Return
Name of payer
Name of payer
Street address
Street address
City
State
ZIP Code
City
State
ZIP Code
Connecticut Tax Registration Number
Connecticut Tax Registration Number
Federal Employer ID Number
Federal Employer ID Number
Type of return
Type of return
Number of 1099 or W-2Gs submitted
Number of 1099 or W-2Gs submitted
Total nonpayroll amounts reported
Total nonpayroll amounts reported
Connecticut tax withheld
Connecticut tax withheld
8 Payer Summary of CD Wage Informational Return
8 Payer Summary of CD Wage Informational Return
Name of payer
Name of payer
Street address
Street address
City
State
ZIP Code
City
State
ZIP Code
Connecticut Tax Registration Number
Connecticut Tax Registration Number
Federal Employer ID Number
Federal Employer ID Number
Type of return
Type of return
Number of 1099 or W-2Gs submitted
Number of 1099 or W-2Gs submitted
Total nonpayroll amounts reported
Total nonpayroll amounts reported
Connecticut tax withheld
Connecticut tax withheld
8 Payer Summary of CD Wage Informational Return
8 Payer Summary of CD Wage Informational Return
Name of payer
Name of payer
Street address
Street address
City
State
ZIP Code
City
State
ZIP Code
Connecticut Tax Registration Number
Connecticut Tax Registration Number
Federal Employer ID Number
Federal Employer ID Number
Type of return
Type of return
Number of 1099 or W-2Gs submitted
Number of 1099 or W-2Gs submitted
Total nonpayroll amounts reported
Total nonpayroll amounts reported
Connecticut tax withheld
Connecticut tax withheld
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