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Department of Revenue Services

Form CT-941 (DRS/P)

2007

State of Connecticut

PO Box 2931

Connecticut Reconciliation of Withholding

Hartford, CT 06104-2931

for Household Employers

(Rev. 12/07)

Reminders:

General Instructions

See instructions on back.

Complete the return in blue or black ink only.

Sign and date the return in the space provided.

All household employers registered for Connecticut income tax

withholding are required to file Form CT-941 (DRS/P), Connecticut

If payment is due, remit payment with this return.

Reconciliation of Withholding for Household Employers, as long

Make your check payable to: Commissioner of Revenue Services.

as they have an active withholding account with the Department

DRS may submit your check to your bank electronically.

of Revenue Services (DRS) even if no tax is due.

Write your Connecticut Tax Registration Number on your check.

Due Date: April 15, 2008. If the due date falls on a Saturday,

Where to File: Visit the Taxpayer Service Center (TSC) at the

Sunday, or legal holiday, the next business day is the due date.

DRS website to electronically file this return.

Mail your completed return and payment (if applicable) to:

Household employers who are registered to withhold

Department of Revenue Services

Connecticut income tax from wages of their household

State of Connecticut

employees are not to file Form CT-941 (DRS/P) for each calendar

PO Box 2931

quarter, but instead are required to file one Form CT-941 (DRS/P)

Hartford CT 06104-2931.

for the entire 2007 calendar year, the due date of which is

Amended Return: To amend Form CT-941 (DRS/P), use Form

April 15, 2008. Payment of the Connecticut income tax withheld

CT-941X, Amended Connecticut Reconciliation of Withholding.

from wages of household employees during the entire calendar

year is to accompany Form CT-941 (DRS/P). See Informational

For Further Information: Call DRS during business hours,

Publication 2008(1), Connecticut Circular CT, Employer’s Tax Guide.

Monday through Friday:

Rounding Off to Whole Dollars: You must round off cents to

•

1-800-382-9463 (Connecticut calls outside the Greater Hartford

the nearest whole dollar on your returns and schedules. Round

calling area only); or

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

•

860-297-5962 (from anywhere).

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

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

TTY, TDD, and Text Telephone users only may transmit

Enter name and address below. Please print or type.

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

inquiries anytime by calling 860-297-4911.

cents and round off only the total. If you do not round, DRS will

Taxpayer Service Center (TSC):

disregard the cents.

The Connecticut Taxpayer Service Center (TSC) is an

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

interactive tax organization tool that allows taxpayers to file,

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

pay, and manage their state tax responsibilities electronically.

entered on the line.

Through our website at the TSC offers a fast,

DRS.

easy, and secure way to conduct business with

Separate Here and Mail Coupon to DRS. Keep a Copy for Your Records.

........................................................

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CT-941 (DRS/P)

Connecticut Reconciliation of Withholding for Household Employers

2007

Connecticut Tax Registration Number

Federal Employer ID Number

Enter Reporting Quarter (1, 2, 3, or 4)

Due Date

Annual Filer (4)

April 15, 2008

Read Instructions Before Completing

Household Employer

1. Gross wages

Enter name and address below. Please print or type.

2. Gross Connecticut wages

3. Connecticut tax withheld

4. Credit from prior year

5. Payments made for this year

6. Total Payment: Add Line 4 and Line 5

7. Net tax due (or credit): Line 3 minus Line 6

8a. Penalty:

+ 8b. Interest:

= 8

9. Amount to be credited

10. Amount to be refunded

Check if you no longer have employees in Connecticut and

11. Total amount due: Add Line 7 and Line 8.

enter date of last payroll __________________________ .

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.

Signature ________________________________________________________

Mail to:

Department of Revenue Services

State of Connecticut

PO Box 2931

Title _______________________________________

Date _______________

Hartford CT 06104-2931

Form Ct-941 (Drs/p) - Connecticut Reconciliation Of Withholding For Household Employers - 2007

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