Form W-3n - Nebraska Reconciliation Of Income Tax Withheld
Download a blank fillable Form W-3n - Nebraska Reconciliation Of Income Tax Withheld in PDF format just by clicking the "DOWNLOAD PDF" button.
Open the file in any PDF-viewing software. Adobe Reader or any alternative for Windows or MacOS are required to access and complete fillable content.
Complete Form W-3n - Nebraska Reconciliation Of Income Tax Withheld with your personal data - all interactive fields are highlighted in places where you should type, access drop-down lists or select multiple-choice options.
Some fillable PDF-files have the option of saving the completed form that contains your own data for later use or sending it out straight away.
ADVERTISEMENT
1
2Amended
Nebraska Reconciliation of Income Tax Withheld
FORM
•This form should be filed after completion of Form 941N.
W-3N
• See for information on e-filing this return.
PLEASE DO NOT WRITE IN THIS SPACE
Y
N
RESET
PRINT
Nebraska ID Number
Due Date
Taxable Year
NAME AND LOCATION ADDRESS
NAME AND MAILING ADDRESS
If you are not licensed to report withholding or are changing name and/or address, see instructions.
WAGE/PAYMENT INFORMATION
1 Federal Forms W-2, W-2G, 1099-R, and 1099-MISC. If 50 or less and not e-filing these forms, attach the
Nebraska copy of these forms. Taxpayers filing more than 50 forms must use the Department's NebFile for
Business program to e-file these forms. ......................................................................... Enter number of forms
1
Check this box if e-filing these forms.
2 Nebraska wages, tips, and other compensation shown on Forms W-2 .................................................................
2 $
3 Nebraska gambling winnings shown on Forms W-2G ...........................................................................................
3
4 Nebraska pensions, annuities, etc., shown on Forms 1099-R ...............................................................................
4
5 Nebraska nonresident personal service payments and any payments to construction contractors subject to
mandatory 5% withholding (see instructions) shown on Forms 1099-MISC..........................................................
5
6 Total payments subject to Nebraska withholding tax
6
(TOTAL of lines 2 through 5) ..
WITHHOLDING INFORMATION
7 Total Nebraska income tax withheld as shown on Forms W-2, W-2G, 1099-R, and 1099-MISC ...........................
7
• If annual filer, skip to line 12
8 Nebraska incentive withholding credits (see instructions) ..............................................
8
9 Income TAX reported for the period ended March 31 (line 6, Form 941N) .....................
9
10 Income TAX reported for the period ended June 30 (line 6, Form 941N) ................... 10
11 Income TAX reported for the period ended Sept. 30 (line 6, Form 941N) .................... 11
12 Income TAX reported for the period ended Dec. 31
(or if annual filer, tax reported for entire year) (line 6, Form 941N)........................ 12
13 Total Nebraska income tax reported (total of lines 8 through 12) .......................................................................... 13
14 If line 13 is less than line 7, enter balance due ...................................................................................................... 14
15 Penalty (see instructions) ....................................................................................................................................... 15
16 Interest (
% per year of line 14 if filed or paid after January 31, see instructions) ................................... 16
17 BALANCE DUE (total of lines 14 through 16).
If the amount due is $2 or more, pay in full with this form ...................................................................................... 17
18 If line 7 is less than line 13, enter the amount of OVERPAYMENT. The overpayment will be transferred to the
next year. Do not take any credit on Form 941N unless shown on line 12 of that form (complete section below) ... 18 $
REASON FOR OVERPAYMENT
(Must complete if line 18 overpayment is claimed.)
Reason for Amending
Under penalties of perjury, I declare that as taxpayer or preparer I have examined this reconciliation, and to the best of my knowledge and belief, it
is correct and complete.
sign
here
Authorized Signature
Date
Signature of Preparer Other than Taxpayer
Date
(
)
(
)
Title
Daytime Phone
Address
Telephone Number
Email Address
THE NEBRASKA COPIES OF FORMS W-2, W-2G, 1099-R, AND 1099-MISC MUST BE E-FILED OR ATTACHED TO THIS RECONCILIATION.
E-file or mail this W-3N and remit payment. If you are filing more than 50 Forms W-2 or 1099, you must file these forms electronically.
NEBRASKA DEPARTMENT OF REVENUE, PO BOX 98915, LINCOLN, NE 68509-8915
8-012-1967 Rev. 12-2011
PLEASE RETAIN A COPY FOR YOUR RECORDS.
Supersedes 8-012-1967 Rev. 11-2010
ADVERTISEMENT
0 votes
Related Articles
Related forms
Related Categories
Parent category: Financial