Form Tc-96a - Utah Employer'S Amended Income Withholding Return

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Utah Employer's AMENDED Income Withholding Return, TC-96A
WT
$
¢
1. Corrected
total amount
withheld
Account No.
Tax
Tax Period
Due Date
2. Amount
previously
paid
I declare under the penalties provided by law, that to the best of my knowledge
Amount reported on line 1 on this coupon replaces the tax amount
and belief this is a true and correct return.
reported on your original return. Declare the total correct amount.
3. Total
Signature
Date
amount
overpaid
4. Tax
amount
UTAH STATE TAX COMMISSION
paid
210 NORTH 1950 WEST
Make check or money order payable to the Utah State Tax Commission.
SALT LAKE CITY UT 84134 - 0100
Do not send cash. Do not staple check to this coupon.

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