Form Ct-941 Hhe - Connecticut Reconciliation Of Withholding For Household Employers - 2015

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Department of Revenue Services
2015
Form CT-941 HHE
State of Connecticut
PO Box 2931
Connecticut Reconciliation of Withholding for Household Employers
Hartford CT 06104-2931
(Rev. 10/15)
General Instructions
Rounding Off to Whole Dollars: You must round off cents
to the nearest whole dollar on your returns and schedules.
Form CT-941 HHE must be paid and fi led electronically. Do
If you do not round, the Department of Revenue Services
not send this paper return to the Department of Revenue
(DRS) will disregard the cents.
Services (DRS), unless you have been granted a waiver
Round down to the next lowest dollar all amounts that include
from DRS. See Electronic Filing Waiver instructions on back.
1 through 49 cents. Round up to the next highest dollar all
Form CT-941 HHE is used to reconcile annual Connecticut
amounts that include 50 through 99 cents. However, if you
income tax withholding from household employee wages only.
need to add two or more amounts to compute the amount
Do not use this form to amend a previously fi led Form CT-941
to enter on a line, include cents and round off only the total.
HHE. See Amended Returns, on this page.
Example: Add two amounts ($1.29 + $3.21) to compute the
When to File
total ($4.50) to enter on a line. $4.50 is rounded to $5.00 and
Form CT-941 HHE is due April 15, 2016. If the due date falls
entered on the line.
on a Saturday, Sunday, or legal holiday, the return will be
Amended Returns
considered timely if fi led by the next business day.
Amend Form CT-941 HHE electronically. See Taxpayer
Household employers registered to withhold Connecticut
Service Center (TSC) below. Only taxpayers that have been
income tax from their household employee wages must fi le
granted a waiver from electronic fi ling and payment from
one Form CT-941 HHE for the entire calendar year even if
DRS may fi le a paper Form CT-941X, Amended Connecticut
no tax is due. See Informational Publication 2015(1.1),
Reconciliation of Withholding, to amend a previously fi led
Connecticut Employer’s Tax Guide, Circular CT.
Form CT-941 HHE.
Name
Connecticut Tax Registration Number
This return MUST be fi led electronically!
Address
Federal Employer ID Number (FEIN)
DO NOT MAIL paper return to DRS.
City
State
Zip Code
Annual Filer
4
Check here
If you no longer have employees in Connecticut, and enter date
Due date
/
/
April 15, 2016
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
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
This return MUST be fi led electronically!
Title
Telephone number
DO NOT MAIL paper return to DRS.
(
)

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