Form Ri-W3 - Reconciliation Of Personal Income Tax Withheld By Employers - 2012
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1
22012
RI-W3
STATE OF RHODE ISLAND - DIVISION OF TAXATION
INFORMATION FOR EMPLOYERS FILING RECONCILIATION OF RHODE ISLAND INDIVIDUAL INCOME TAX WITHHELD
1. Enter the employer's name and address in the space provided.
5. Send with Form RI-W3 copies of all wage and tax statements for
the tax year. (Copy I of the six part optional federal form or the state
2. Enter the employer’s federal identification number.
tax department copy of an approved alternate form.) The number of
wage and tax statements reported on reconciliation Form RI-W3
3. Employers filing monthly or quarterly should enter each periodic
should include statements reflecting no withholding, as well as those
payment in the appropriate space on the front of the form. Employers
disclosing taxes withheld. These must be accompanied by a totaled
filing other than monthly or quarterly should fill in the reverse side of
list (preferably in the form of an adding machine tape or a mechani-
the form.
cally prepared listing) of the amounts of income tax withheld as shown
on the Form W-2. This total should agree with the amount stated at
4. Reconciliation Form RI-W3 must be filed no later than February 28,
item 2B of Form RI-W3. Employers who are not required to withhold
following end of the tax year.
tax from any employee according to tax tables must file Forms W-2
with annual return RI-941A.
STATE OF RHODE ISLAND
2012 FORM RI-W3
DIVISION OF TAXATION
ONE CAPITOL HILL - SUITE 7
RECONCILIATION OF PERSONAL INCOME TAX WITHHELD BY EMPLOYERS
PROVIDENCE, RI 02908-5809
1. ENTER PAYMENTS MADE ON EMPLOYER RETURNS OF
NAME
PERSONAL INCOME TAX WITHHELD (FORMS 941M, 941Q)
TAXPAYER’S COPY
ADDRESS
W3
JAN
FEB
MAR
CITY, STATE, ZIP CODE
APR
MAY
JUN
TAXPAYER IDENTIFICATION NUMBER
IF YOU FILED QUARTER-
JUL
AUG
SEP
MONTHLY RETURNS, ENTER
PAYMENTS FOR EACH PERIOD
SIGNATURE
OCT
NOV
DEC
ON BACK OF THIS FORM.
TITLE
DATE
NOTE:
$
2A. TOTAL PAYMENTS
EXPLAIN ANY DIFFERENCE IN
THE AMOUNTS IN ITEMS 2A
AND 2B IN AN ATTACHED
ENTER HERE THE TOTAL NUMBER OF RHODE
2B. TOTAL TAX WITHHELD
$
STATEMENT.
ISLAND STATE WAGE & TAX STATEMENTS (FORM
DURING 2012 AS SHOWN ON
W2) SENT WITH THIS RECONCILIATION FORM.
STATE FORMS TRANSMITTED
STATE OF RHODE ISLAND
2012 FORM RI-W3
DIVISION OF TAXATION
ONE CAPITOL HILL - SUITE 7
RECONCILIATION OF PERSONAL INCOME TAX WITHHELD BY EMPLOYERS
PROVIDENCE, RI 02908-5809
1. ENTER PAYMENTS MADE ON EMPLOYER RETURNS OF
NAME
PERSONAL INCOME TAX WITHHELD (FORMS 941M, 941Q)
W3
ADDRESS
JAN
FEB
MAR
CITY, STATE, ZIP CODE
APR
MAY
JUN
TAXPAYER IDENTIFICATION NUMBER
IF YOU FILED QUARTER-
JUL
AUG
SEP
MONTHLY RETURNS, ENTER
PAYMENTS FOR EACH PERIOD
SIGNATURE
OCT
NOV
DEC
ON BACK OF THIS FORM.
TITLE
DATE
NOTE:
$
2A. TOTAL PAYMENTS
EXPLAIN ANY DIFFERENCE IN
THE AMOUNTS IN ITEMS 2A
AND 2B IN AN ATTACHED
ENTER HERE THE TOTAL NUMBER OF RHODE
2B. TOTAL TAX WITHHELD
$
STATEMENT.
ISLAND STATE WAGE & TAX STATEMENTS (FORM
DURING 2012 AS SHOWN ON
W2) SENT WITH THIS RECONCILIATION FORM.
STATE FORMS TRANSMITTED
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