Form A-3 Annual Reconciliation of Alabama Income Tax Withheld (Revised: March 2011)

DATE DUE 1 TOTAL TAX REMITTED (COL 2) $ 2 TOTAL AL TAX ON WAGE STATEMENTS AND/OR INFORMATION RETURNS IF AL TAX HAS BEEN REPORTED ON 1099 S OR OTHER INFORMATION RETURNS SUCH RETURNS MUST BE SUBMITTED WITH FORM A 3 AND AMOUNT OF AL TAX INCLUDED IN THE AMOUNT SHOWN IN BLOCK #2 $ 3 ADDITIONAL TAX DUE ENCLOSED REMITTANCE $ 4 OVERPAYMENT REFUND D CREDIT D OVERPAYMENTS LESS THAN $100 00 WILL BE ISSUED A CREDIT OffOff ALABAMA WITHHOLDING TAX ACCOUNT NUMBER ANNUAL RECONCILIATION OF ALABAMA INCOME TAX WITHHELD APRIL $ AUGUST $ click COL 1 TAX WITHHELD COL 2 TAX REMITTED DECEMBER (4th QTR) $ DUE DATE Form A 3 Annual Reconciliation of Income Tax Withheld is due on or before the last day of February following the end of the year being filed Forms W 2 and 1099 with Alabama income tax withheld must be submitted with Form A 3 Employers submitting 25 or more W 2 s are required to file these electronically electronically FEBRUARY $ FORM A 3 STATE OF ALABAMA INSTRUCTIONS FOR PREPARING FORM A 3 JANUARY $ JULY $ JUNE (2nd QTR) $ MARCH (1st QTR) $ MAY $ NAME AND ADDRESS NOTE: DO NOT send without W 2 s A 3 received without W 2 s WILL BE RETURNED NOVEMBER $ OCTOBER $ on line Please PLEASE CUT HERE PLEASE NOTE Revised 3/11 SEPTEMBER (3rd QTR) $ SIGNATURE DATE STEP 1 Enter the amounts of Alabama income tax withheld in the appropriate spaces in Column 1 on the right side of Form A 3 You must list monthly amounts if (a) you withheld $1000 or more during any single month of the year or (b) you filed on a monthly basis during the year Otherwise you may list only quarterly amounts STEP 2 Enter in the appropriate spaces in Column 2 the amounts of Alabama withholding tax actually remitted Include in these amounts credits claimed on Line 5 of Form A 1 or Form A 6 for overpayment of withholding tax for any prior year (Caution: Amounts listed in Columns 1 and 2 should include only Alabama withholding tax Do not include delinquent penalty and/or interest charges ) STEP 3 Add amounts listed in Step 2 (Column 2) Show total in Block 1 STEP 4 Enter in Block 2 the total Alabama income tax withheld on employee W 2 s (or 1099 s if applicable) to be transmitted with Form A 3 This total must be supported by an adding machine tape Note: Employers submitting 25 or more statements are required to file electronically Please visit our web site at: www revenue alabama gov for more information STEP 5 Compare the amounts in Blocks 1 and 2 If the amount in Block 1 is larger your account is overpaid Show amount of overpayment in Block 4 and indicate whether you want a refund or will claim credit on a future return Overpayments of less than $100 00 will be issued as a credit unless written request for a refund is submitted with Form A 3 and W 2 Forms If the amount in Block 2 is larger your account is underpaid Show amount of underpay ment in Block 3 and enclose a check or money order for such amount with Form A 3 when filed Mail Form A 3 and wage and tax information to: Alabama Department of Revenue Withholding Tax Section P O Box 327480 Montgomery AL 36132 7480 (telephone 334 242 1300) The Alabama Department of Revenue requires employers submitting 25 or more W 2 s to electronically submit both the Form A 3 and W 2 s on line W 2 s