Form Wth10004 - Oklahoma Wage Withholding Tax Payment Record Semi-Weekly Payors Not Paying By Eft

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WTH
10004
Revised 11-2011
Oklahoma Wage Withholding Tax Payment Record
Semi-Weekly Payors Not Paying by EFT
Who Must File a Payment Voucher...All employers who are required to remit according to the Federal Semiweekly Deposit Schedule and
who do not use electronic funds transfer (EFT) for their payment method.
When to File and Make Payment...Withholding tax payments are due on the same dates as required under the Federal Semiweekly
Deposit Schedule. The Withholding Tax Payment Voucher must be submitted with each payment by check for those employers not making
payments by electronic funds transfer (EFT).
Instructions for Completing the Withholding Voucher...
A. Enter the Federal Employers Identification Number (FEIN).
B. Enter the month and year of the reporting period.
C. Enter the date on which employees were paid.
D. Enter the amount of Oklahoma income tax withheld from the wages of your employees for the pay period reported.
E. Check Box E to notify us of address change. Write new address in section E.
F. Enter the amount of withholding tax being paid with the voucher, including any interest and penalty due.
Interest and Penalty for Late Payments...If the remittance is postmarked after the due date, interest and penalty will be due.
Interest: Multiply the amount withheld (Box D) on the payment voucher by 1.25% each month, from due date, until paid.
Penalty: If payment is postmarked after the last day of the month when due multiply the amount withheld (Box D) on the payment
voucher by 10%.
Add the interest and penalty amounts to the amount withheld and record on Line F, “Amount Paid.”
Remember, you must also electronically file an Oklahoma Employers Withholding Tax Report each month on or before the 20th day of the
following month by using QuickTax, which is available at
Write your FEIN on your check and mail it with your completed voucher.
Do not send cash. Do not enclose any other tax reports/correspondence.
Enclose check or money order payable to: Oklahoma Tax Commission.
Record of Withholding Payments
Mail to: Oklahoma Tax Commission
month
date paid
amount
Post Office Box 26860
Oklahoma City, OK 73126-0860
Mandatory inclusion of Social Security and/or FEIN is required on forms filed with
the Oklahoma Tax Commission pursuant to 68 Oklahoma Statute and regulations
thereunder, for identification purposes, and is deemed part of the confidential files and
records of the OTC.
total
The Oklahoma Tax Commission is not required to give actual notice of changes in any state law.
Please Detach Here and Return Coupon Below
Do not fold, staple, or paper clip
Do not tear or cut below line
Oklahoma Withholding Tax Coupon
WTH
Semi-Weekly Payors Not Paying by EFT
A. Taxpayer FEIN
B. Reporting Period
C. Date Payroll Paid
D. Oklahoma Tax Withheld
E. Address Change
___________________________________________________
E.
Name
___________________________________________________
Address
___________________________________________________
- - - - - - - - - Dollars - - - - - - - - -
- - Cents - -
City
State
ZIP
F. Amount Paid __________________________ . __________
Signature: _____________________________________
Date: ______________
Please remit only one check per coupon.
The information contained in this record and any attachments is true and correct to the best of my knowledge.

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