Form Ct-1096 (Drs) - Connecticut Annual Summary And Transmittal Of Information Returns - 2013


Department of Revenue Services
PO Box 5081
Form CT-1096 (DRS)
Hartford, CT 06102-5081
(Rev. 12/12)
Connecticut Annual Summary and Transmittal of Information Returns
Complete this return in blue or black ink only.
Electronic Filing Requirements - Read instructions on back before completing this
Where to File
General Instructions
Use the Taxpayer Service Center (TSC) to electronically fi le this
If you are not required to fi le federal Form 1096, you are not required
return. See TSC on back.
to fi le Form CT-1096 (DRS). Special rules apply to designated
withholding agents. See Policy Statement 2011(2), Income Tax
If fi ling by paper, mail your completed return and every copy 1 of
Withholding for Athletes or Entertainers.
federal Form 1099-MISC, 1099-R, or W-2G to the address on the
return below.
Form CT-1096 (DRS) may be used by new payers or payers who
Group the forms by form number and send each group with a
have not received their 2013 Connecticut Payer of Nonpayroll
separate Form CT-1096.
Amounts Withholding Returns and Instructions.
Line Instructions
See Informational Publication 2013(8), Connecticut Tax Guide for
Payers of Nonpayroll Amounts.
Line 1: Enter Connecticut income tax withheld from Connecticut
nonpayroll amounts during the calendar year. This should equal the
When to File
Total Line on the back of this return.
If filing electronically, Form CT-1096 is due the last day of
Line 2: Enter total:
March 2014. Do not mail Form CT-1096 (DRS) if you are fi ling
electronically. If fi ling by paper, Form CT-1096 (DRS) is due the last
• Connecticut Lottery winnings paid to resident and nonresident
day of February 2014.
individuals, as reported on federal Form W-2G, whether or not
Connecticut income tax was withheld;
If the due date falls on a Saturday, Sunday, or legal holiday, the next
• Other gambling winnings paid to resident individuals, as reported
business day is the due date. See Who Must File Form CT-1096
on federal Form W-2G, whether or not Connecticut income tax
(DRS) on back page.
was withheld;
Rounding Off to Whole Dollars
• Miscellaneous payments reported on federal Form 1099-MISC to
You must round off cents to the nearest whole dollar on your returns
resident individuals or to nonresident individuals if the payments
and schedules. If you do not round, the Department of Revenue
relate to services performed wholly or partly in Connecticut even
Services (DRS) will disregard the cents.
if no Connecticut income tax was withheld; and
Round down to the next lowest dollar all amounts that include
• Distributions from pensions, annuities, retirement, or
1 through 49 cents. Round up to the next highest dollar all amounts
profi t-sharing plans, as reported on federal Form 1099-R, but
that include 50 through 99 cents. However, if you need to add two
only if Connecticut income tax was withheld.
or more amounts to compute the amount to enter on a line, include
Line 3: Enter the number of 1099-MISC, 1099-R, or W-2G forms
cents and round off only the total.
submitted with this return.
Example: Add two amounts ($1.29 + $3.21) to compute the total
Complete all required information on the front and back of this return.
($4.50) to enter on a line. $4.50 is rounded to $5.00 and entered
Sign and date the return in the space provided.
on the line.
Do not make a payment with this return.
Separate here and mail
to DRS. Make a copy for your records.
CT-1096 (DRS)
Connecticut Annual Summary and Transmittal of Information Returns
Connecticut Tax Registration Number
Federal Employer ID Number
Calendar year ending
Due date
February 28, 2014
Enter name and address below. Please print or type.
1. Connecticut income tax withheld from
Connecticut nonpayroll amounts
2. Total nonpayroll amounts reported
with Form CT-1096
3. Number of 1099-MISC, 1099-R, or
W-2Gs submitted
ZIP code
I declare under penalty of law that I have examined this return (including any
accompanying schedules and statements) and, to the best of my knowledge
and belief, it is true, complete, and correct. I understand the penalty for willfully
delivering a false return or document to DRS is a fi ne of not more than $5,000,
imprisonment for not more than fi ve years, or both.
Do not send payment with this return.
Mail to:
Department of Revenue Services
Signature _____________________________________________________________
State of Connecticut
PO Box 5081
Hartford CT 06102-5081
Title _____________________________________ Date ____________________


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