Form Ct-8109 (Drs/n) - Connecticut Withholding Tax Payment Form For Nonpayroll Amounts - 2004
ADVERTISEMENT
12004
State of Connecticut
FORM CT-8109 (DRS/N)
Department of Revenue Services
(New 12/03)
CONNECTICUT WITHHOLDING TAX PAYMENT FORM FOR NONPAYROLL AMOUNTS
Purpose: The attached Form CT-8109 (DRS/N), Connecticut
only until the issuance of the Withholding Remittance Coupon
Withholding Tax Payment Form for Nonpayroll Amounts , may
Book for Payers of Nonpayroll Amounts . Once the book is
be used by new payers or payers who have not received the
received, only the preprinted coupons contained in the book
Withholding Remittance Coupon Book for Payers of
should be used.
PAYER’S RECORD OF PAYMENT
Nonpayroll Amounts. This is an interim coupon to be used
1 2 3 4 5 6 7 8
1 2 3 4 5 6 7 8 9 0
1 2 3 4 5 6 7 8
1 2 3 4 5 6 7 8 9 0
1 2 3 4 5 6 7 8
1 2 3 4 5 6 7 8 9 0
1. ENTER QUARTER (1,2,3, or 4)
1 2 3 4 5 6 7 8
1 2 3 4 5 6 7 8 9 0
1 2 3 4 5 6 7 8
1 2 3 4 5 6 7 8 9 0
(see instructions)
1 2 3 4 5 6 7 8
1 2 3 4 5 6 7 8 9 0
1 2 3 4 5 6 7 8
1 2 3 4 5 6 7 8 9 0
2. CONNECTICUT TAX
WITHHELD
3. PAYMENT DATE:
to make a payment to DRS of all Connecticut income tax
Payers of nonpayroll amounts who withhold Connecticut
income tax must use Form CT-8109 (DRS/N) to make a
withheld. However, if the Connecticut withholding tax liability
payment to the Connecticut Department of Revenue Services
is less than $500 for a calendar year, you may remit the tax
(DRS). Due dates for payment of Connecticut withholding tax
annually with Form CT-945, Connecticut Annual
on nonpayroll amounts are the same as the due dates for the
Reconciliation of Withholding for Nonpayroll Amounts .
payer’s deposit of federal income tax withholding. Each time
Do not file Form CT-8109 (DRS/N) if no payment is due.
you are required to make a federal tax deposit, you are required
INSTRUCTIONS FOR COMPLETING FORM CT-8109 (DRS/N)
Enter name, address, and identification numbers in appropriate
Pay the total amount shown on Line 2. If you are filing Form
boxes.
CT-8109 (DRS/N) by mail, send your completed coupon and
Line 1:
payment to: DRS, PO Box 2931, Hartford CT 06104-2931. Make
your check payable to: COMMISSIONER OF REVENUE SERVICES.
Enter the number of the quarter to which this payment applies.
Write your Connecticut Tax Registration Number on your check.
Enter “1” for the 1st quarter (January 1 to March 31); “2” for the 2nd
Electronic Filing Options:
quarter (April 1 to June 30); “3” for the 3rd quarter (July 1 to
File this form by using Connecticut Fast-File –
September 30); or “4” for the 4th quarter (October 1 to
File by Internet:
December 31).
Note: If the tax liability was incurred during one quarter and paid
to DRS in another quarter, enter the number for the quarter in
For information on the Connecticut
which the tax liability was incurred. For example, if the tax liability
Fast-File Program, visit the DRS Web site
was incurred in March and paid to DRS in April, enter “1” on
at: and click on File Returns
Line 1 of Form CT-8109 (DRS/N)
On-Line , or call the DRS Forms Unit at
Line 2:
860-297- 4753 and request DRS 2001(3),
Connecticut Fast-File, booklet.
Enter the total amount of Connecticut income tax withheld from
nonpayroll amounts since your last payment was made to DRS.
SEPARATE HERE AND MAIL COUPON TO DEPARTMENT OF REVENUE SERVICES. KEEP THE TOP PORTION FOR YOUR RECORDS.
2004
CT-8109 (DRS/N)
CONNECTICUT WITHHOLDING TAX PAYMENT FORM FOR NONPAYROLL AMOUNTS
CONNECTICUT TAX REGISTRATION NUMBER
FEDERAL EMPLOYER ID NUMBER
YEAR
2004
1 2 3 4 5 6 7 8 9 0 1
1 2 3 4 5 6 7 8 9 0 1
1 2 3 4 5 6 7 8 9 0 1
1 2 3 4 5 6 7 8 9 0 1
1 2 3 4 5 6 7 8 9 0 1
1 2 3 4 5 6 7 8 9 0 1
ENTER NAME AND ADDRESS BELOW. PLEASE PRINT OR TYPE.
1. QUARTER
1 2 3 4 5 6 7 8 9 0 1
1 2 3 4 5 6 7 8 9 0 1
1 2 3 4 5 6 7 8 9 0 1
1 2 3 4 5 6 7 8 9 0 1
2. CONNECTICUT TAX WITHHELD
Do not file this Form CT-8109 (DRS/N) if no payment is due.
Pay total amount shown on Line 2.
If filing by mail, send your payment to:
DRS, PO Box 2931, Hartford CT 06104-2931
Make your check payable to: Commissioner of Revenue Services.
Write your Connecticut Tax Registration Number on your check.
Electronic Filing Options: Connecticut Fast-File
DO NOT FOLD OR BEND COUPON
File by Internet:
ADVERTISEMENT
0 votes
Related Articles
Related forms
Related Categories
Parent category: Financial