Form 1049w89701 - Claim For Revision
ADVERTISEMENT
1
2STATE OF DELAWARE
CLAIM FOR REVISION
Department of Finance
FOR EIGHTH MONTHLY FILERS
Division of Revenue
DELAWARE INCOME TAX WITHHELD
820 N. French Street
P.O. Box 8911
0089
REV CODE
-42
FORM 1049W89701
Wilmington, Delaware 19899-8911
THIS FORM TO BE USED BY EIGHTH MONTHLY FILING WITHHOLDING AGENTS
TO FILE AN AMENDED EIGHTH MONTHLY WITHHOLDING TAX RETURN
1.
Enter Account Number
2. Business Name
3. Trade Name if Different from Above
4. Business Location Address
5. Mailing Address if Different
City
City
State
Zip Code
State
Zip Code
Calendar year to be adjusted.
If filing corrected W-2s, indicate the number of W-2s attached.
How many W-2s were filed with the original return?
(A)
(B)
(C)
(D)
AMOUNT OF CHANGE
TAX PERIOD ENDING
ORIGINALLY REPORTED CORRECTED AMOUNT
01/31/
02/28/
03/31/
04/30/
05/31/
06/30/
07/31/
08/31/
09/30/
10/31/
11/30/
12/31/
Total
TOTAL AMOUNT DUE
$
or
TOTAL AMOUNT OF OVERPAYMENT (Amount to be refunded, see instructions.)
$
SIGNATURE
TELEPHONE NUMBER
DATE
I declare under penalties as provided by law that the information on this application is true, correct and complete.
*DF42314019999*
Revised 12/30/13
ADVERTISEMENT
0 votes
Related Articles
Related forms
Form 1049w89701 - Claim For Revision For Eight Monthly Filers Delaware Income Tax Withheld - State Of Delaware
Financial
Form 1049w99701 - Claim For Revision For Monthly/quarterly Filers Delaware Income Tax Withheld - 2012
Financial
Related Categories
Parent category: Financial