Form Tc-96y - Utah Employer'S Income Withholding Annual Return

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Cut here and submit lower portion
WT
UTAH Employer's Income Withholding ANNUAL Return, TC-96Y
$
¢
Tax Period
Due Date
Account No.
Tax
1. Amount
withheld this
Y
year
2. Amount
remitted with
Under penalties provided by law, I declare, to the best of my knowledge, that this return is true and correct.
this return
X
File a return even if there is no tax liability.
Date
Signature
Make check or money order payable to the Utah State Tax
Commission. Do not send cash. Do not staple check to
this coupon. Detach stub from check.
UTAH STATE TAX COMMISSION
210 N 1950 W
SLC UT 84134-0100

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