Form NC-3M Annual Withholding Reconciliation - Monthly

ont Amount ont Amount 1 AJanuary 10 AOctober 11 ANovember 12 ADecember 13 TotalATaxAWithheldA(Add Lines 1 12 and enter total) 13 14a Tax Withheld Per W 2AStatements 14a 14b Tax Withheld Per 1099AStatements 14b 15 TotalATaxAWithheldAPerAStatements15 2 AFebruary 3 AMarch 4 April 5 AMay 6 AJune 7 AJuly 9 ASeptember B August compensation Due Date: This report with the copies of the W 2 and 1099 statements for the preceding calendar year must be filed on or before February 28 If your business terminates during the year the report should be filed within thirty days of the last payment of compensation Enter total tax required to be withheld for each month How to Prepare Report: I certify that to the best of my knowledge this return is accurate and complete Line 1 12: Enter on these lines the total tax required to be withheld for each month Line 13: Enter here the total of Lines 1 through 12 Line 14a: Enter on this line the N C income tax withheld from wages as reported on W 2 statements Line 14b: Enter on this line the N C income tax withheld as reported on 1099 statements This includes amounts withheld from Line 15: Enter the total North Carolina income tax withheld as reported on all W 2 and 1099 statements and attach an adding machine tape or other listing to this report If the total tax required to be withheld (Line 13) does not agree with the total tax withheld (Line 15) complete an amended withholding return Form NC 5X and send it along with any payment due Do not mail the amended return and payment with Form NC 3M MAIL TO: North Carolina Department of Revenue P O Box 25000 Raleigh North Carolina 27640 0001 NC 3M Annual Withholding Reconciliation NOTE: If the amount on Line 13 differs from the amount on Line 15 see the instructions for Line 15 personal services compensation paid to nonresidents and amounts withheld from pensions annuities and deferred Purpose: This report serves two purposes to balance the total North Carolina income tax withheld as listed on the W 2 and 1099 statements with the amount required to be withheld for the year and to act as a transmittal form for the N C copies of the W 2 and 1099 statements Signature: Date: Title: Phone: to complete this form Use blue or black ink Web North Carolina Department of Revenue