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Form Ct-1096 - Connecticut Annual Summary And Transmittal Of Information Returns - 2004 Page 2

If you are required to file federal Form 1096, you must file Form

CT-1096. Attach every “state copy” of the following:

Complete for Each Period

• federal Form W-2G;

• federal Form 1098;

• federal Form 1099-MISC;

• federal Form 1099-R;

CONNECTICUT INCOME TAX WITHHELD

• federal Form 1099-S;

PERIOD

• federal Form 1042-S.

FROM NONPAYROLL AMOUNTS

JANUARY 1 -

If you are required by the IRS to file copies of federal Forms 1098,

1099, 1042-S, or W-2G on magnetic media, you must file these

1st QUARTER

MARCH 31

forms on magnetic media with DRS. However, if you file 24 or fewer

APRIL 1 -

Forms 1098, 1099, 1042-S, or W-2G, with DRS, you may be excused

2nd QUARTER

from the magnetic media filing requirements for that particular type of

JUNE 30

information return without obtaining a waiver.

JULY 1 -

For new information regarding magnetic media reporting requirements,

SEPTEMBER 30 3rd QUARTER

visit the DRS Web site at: or call DRS at:

OCTOBER 1 -

1-800-382-9463 (in-state) or

4th QUARTER

860-297-5962 (from anywhere).

DECEMBER 31

TTY, TDD, and Text Telephone users only may transmit

inquiries by calling 860-297-4911.

TOTAL

This should equal Line 1 on the front of this return.

CT-1096 Back

(Rev. 12/03)

Form Ct-1096 - Connecticut Annual Summary And Transmittal Of Information Returns - 2004 Page 2