Form Ct-941 Hhe - Connecticut Reconciliation Of Withholding For Household Employers - 2013

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Department of Revenue Services
Form CT-941 HHE
2013
State of Connecticut
Connecticut Reconciliation of Withholding
PO Box 2931
Hartford CT 06104-2931
for Household Employers
(Rev. 01/14)
amounts that include 50 through 99 cents. However, if you
General Instructions
need to add two or more amounts to compute the amount
Complete the return in blue or black ink only.
to enter on a line, include cents and round off only the total.
Household employers registered to withhold Connecticut
Example: Add two amounts ($1.29 + $3.21) to compute the
income tax from their household employee wages must fi le
total ($4.50) to enter on a line. $4.50 is rounded to $5.00 and
one Form CT-941 HHE for the entire calendar year even
entered on the line.
if no tax is due. See Informational Publication 2013(1),
Connecticut Employer’s Tax Guide, Circular CT.
When to File
Amended returns: Use Form CT-941X, Amended Connecticut
Form CT-941 HHE is due April 15, 2014. If the due date falls
Reconciliation of Withholding, to amend Form CT-941 HHE.
on a Saturday, Sunday, or legal holiday, the next business
day is the due date.
Rounding Off to Whole Dollars: You must round off cents
to the nearest whole dollar on your returns and schedules.
Return Instructions
If you do not round, the Department of Revenue Services
Complete all requested information on the front and back of
(DRS) will disregard the cents.
this return. See instructions on back. Sign and date the return
Round down to the next lowest dollar all amounts that include
in the space provided. If payment is due, remit payment with
this return.
1 through 49 cents. Round up to the next highest dollar all
Connecticut Tax Registration Number
Name
Address
Federal Employer ID Number (FEIN)
City
State
Zip Code
Annual Filer
4
Check here
If you no longer have employees in Connecticut, and enter date
Due date
/
/
April 15, 2014
of last payroll:
M M
D D
Y Y Y Y
1. Gross wages ..........................................................................................................................
1
00
2. Gross Connecticut wages ......................................................................................................
2
00
3. Connecticut tax withheld ....................................................................................................
3
00
4. Credit from prior year ............................................................................................................
4
00
5. Payments made for this year .................................................................................................
5
00
6. Total payments: Add Line 4 and Line 5. ................................................................................
6
00
7. Net tax due (or credit): Subtract Line 6 from Line 3. .............................................................
7
00
8a. Penalty: .........................................................................
8a
00
8b. Interest: .........................................................................
8b
00
8 Total penalty and interest: Add Line 8a and Line 8b. ...............................................................
8
00
9. Amount to be credited ...........................................................................................................
9
00
10. Amount to be refunded .........................................................................................................
10
00
For faster refund, use Direct Deposit by completing Lines 10a, 10b, and 10c.
10a. Checking
Savings
10b. Routing number
10c. Account number
10d. Will this refund go to a bank account outside the U.S.?
Yes
11
11. Total amount due: Add Line 7 and Line 8. ..........................................................................
00
Mail to:
Department of Revenue Services
P.O. Box 2931
Hartford, CT 06104-2931.
Declaration: 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
Date
Title
Telephone number
(
)

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