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Utah State Tax Commission
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Discrepancy Report
For Annual Withholding Reconciliation
Tax year for this report
TC-941D
Rev. 12/08
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 lines 4 and 6 of your Utah Annual Withholding Reconciliation, form TC-941R, 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-941R 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 quarterly TC-941R, line 5 $ $ Column C Utah withholding tax as reported on TC-941R, line 4 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 Utah Withholding Returns, TC941, during the year. Column B: Enter the sum of the withholding reported on TC-941R, line 5 for each account number. Column C: Enter the total withholding reported on the TC-941R, line 4 for each 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-941s and TC-941R 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 in Column D), you have underpaid. 3. You 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 in Column D), you have overpaid. You may pay the additional tax or request the refund by filing an amended form TC-941 for the period(s) you either underpaid or overpaid.