Form Nc-3m - Annual Withholding Reconciliation - North Carolina Department Of Revenue
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1NC-3M
Annual Withholding Reconciliation
Use blue or black ink
to complete this form.
1 - 02
North Carolina Department of Revenue
Web
Year (YYYY)
File By:
Legal Name (First 21 Characters)
(USE CAPITAL LETTERS FOR NAME AND ADDRESS)
February 28
Account ID
Street Address
City
State
Zip Code (5 Digit)
FEIN or SSN
Purpose: This report serves two purposes - to balance the total North Carolina income tax withheld as listed on the W-2 and 1099 statements with
the amount required to be withheld for the year, and to act as a transmittal form for the N.C. copies of the W-2 and 1099 statements.
Due Date: This report with the copies of the W-2 and 1099 statements for the preceding calendar year must be filed on or before February 28. If
your business terminates during the year, the report should be filed within thirty days of the last payment of compensation.
How to Prepare Report:
Line 1 - 12: Enter on these lines the total tax required to be withheld for each month.
Line 13:
Enter here the total of Lines 1 through 12.
Line 14a:
Enter on this line the N.C. income tax withheld from wages as reported on W-2 statements.
Line 14b: Enter on this line the N.C. income tax withheld as reported on 1099 statements. This includes amounts withheld from
personal services compensation paid to nonresidents and amounts withheld from pensions, annuities, and deferred
compensation.
Line 15:
Enter the total North Carolina income tax withheld as reported on all W-2 and 1099 statements and attach an adding
machine tape or other listing to this report. If the total tax required to be withheld (Line 13) does not agree with the total
tax withheld (Line 15), complete an amended withholding return, Form NC-5X, and send it along with any payment due.
Do not mail the amended return and payment with Form NC-3M.
Enter total tax required to be withheld for each month
Month
Amount
Amount
Month
.
.
1. January
7. July
00
00
.
.
2. February
00
8. August
00
.
.
3. March
9. September
00
00
.
.
4. April
10. October
00
00
.
.
5. May
11. November
00
00
.
.
6. June
12. December
00
00
,
,
.
13.
Total Tax Withheld
13.
00
(Add Lines 1 - 12 and enter total)
,
,
.
14a.
Tax Withheld Per W-2 Statements
14a.
00
,
,
.
14b.
Tax Withheld Per 1099 Statements
14b.
00
,
,
.
15.
Total Tax Withheld Per Statements
15.
00
NOTE: If the amount on Line 13 differs from the
amount on Line 15, see the instructions for Line 15.
Signature:
Date:
I certify that, to the best of my knowledge, this return is accurate and complete.
Title:
Phone: (
)
MAIL TO: North Carolina Department of Revenue, P.O. Box 25000, Raleigh, North Carolina 27640-0001
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