Form Tc-941 Draft - Utah Withholding Return, Form Tc-941r - Utah Annual Withholding Reconciliation, Form Tc-941pc - Payment Coupon For Utah Withholding Tax Page 5
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5Return ENTIRE form, coupon and payment to the Utah State Tax Commission
Payment Coupon for Utah Withholding Tax, TC-941PC
TC-941PC Rev. 12/08
W
Payment Due Date (mm/dd/yyyy)
Payment Period Ending (mm/dd/yyyy)
Tax Type
Utah Account ID
T
H
Account name: _______________________________________________
Amount Paid
Do not use this payment coupon as a
return. Use TC-941 to file your return.
Do not send cash. Do not staple check
to this coupon. Detach any check stub.
UTAH STATE TAX COMMISSION
210 N 1950 W
SLC
UT
84134-0100
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