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Utah State Tax Commission
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Discrepancy Report
For Annual Withholding Reconciliation
Tax year for this report
TC-96D
Rev. 6/05
Check box if Amended Report
When To Use This Form If your business changed entity types or merged with another company during the tax year and boxes 3 and 4 of your annual withholding tax reconciliation, form TC-96R, do not balance, you must file this form explaining the discrepancy and reconciling the withholding tax returns with the W-2s (or other withholding forms) issued by your company. Company name Address City State Zip code Federal employer identification no. Utah withholding account number Telephone number
Check the reason your W-2s and/or TC-96R are being filed for more than one Utah Employer Withholding Account. Business merged with another business Business changed from a sole proprietorship to a partnership, LLC or corporation Business changed from a partnership to a sole proprietorship, LLC or corporation Business changed from a LLC to a sole proprietorship, partnership or corporation Business changed from a corporation to a sole proprietorship, partnership or LLC Other (explain): ______________________________________________________________________________ Reconciliation Calculation
Column A Utah employer withholding account numbers Column B Yearly total tax withheld as reported on TC-96M, TC-96Q or TC-96Y $ $ Column C Utah withholding tax as reported on TC-96R, box 3 Column D Difference in amounts reported (subtract Column C from Column B) $
Totals (Column D must equal zero)
$
$
$
Under penalties provided by law, I declare, to the best of my knowledge, this report is true and correct. Date signed Signature X
Instructions For Reconciliation Calculation Above Column A: Enter the Utah employer withholding account number of each account for which you filed periodic withholding returns, TC-96M (monthly), TC-96Q (quarterly), TC-96Y (annual), during the year. Column B: Enter the sum of the withholding reported in box 1 on TC-96M, TC-96Q or TC-96Y for each account number. Column C: Enter the total withholding reported on the TC-96R for the account. Column D: Subtract Column C from Column B and enter the result.The total of Column D should be zero. If the result is not zero, the following are possible explanations. 1. You may have made an error. Check the amounts on TC-96R and TC-96M, TC-96Q or TC-96Y to ensure you entered the correct figures; 2. You may have underpaid the withholding tax. If the withholding reported in Column C is greater than the sum of the withholding in Column B (i.e., the difference is a negative number), you have underpaid; or 3. Your may have overpaid the withholding tax. If the withholding reported in Column C is less than the sum of the withholding in Column B (i.e., the difference is a positive number), you have overpaid. You may pay the additional tax or request the refund by filing an amended return, form TC-96A, for the period(s) you either underpaid or overpaid.