Name
Signature
I have direct control, supervision, or responsibility for filing this report. Under penalties of perjury, I declare it is a true, accurate, and complete report.
Authorized
Signature
Printed Name
Title
Date Signed
(MM/DD/YY)
1. Total Missouri Income Tax Withheld.................................................. 1 00
Address City State ZIP
W-3 Corrected
Do not send payment with this form. If you have withholding tax due, use Form MO-941.
Form MO W-3 (Revised 11-2018)
Number of
W-2(s)
Number of
1099-R(s)
Tax
Year
Visit
http://dor.mo.gov/business/withhold/
for more information.
Mail to: Taxation Division Phone: (573) 751-8750
P.O. Box 3330 Fax: (573) 522-6816
*14211010001*
14211010001
Check this box if you participate in the Combined
Federal/State Filing (CF/SF) Program
Instructions
1. Total Missouri Income Tax Withheld - Enter total Missouri withholding reported on payee statements issued under this withholding account number (e.g. Box 17 of
federal Form W-2 or Line 12 of federal Form 1099-R).
• Foremployerswithlessthan250employees,youareencouragedtoreportelectronicallythroughourwebsite.Specicationsforpaperlessreportingare
provided through our website, https://dor.mo.gov/business/withhold/EFW2.php. Information reported electronically through our website should be labeled
withthenameandaccountnumberoftheemployer.Alternatively,youmaysendallFormW-2(s)and1099-R(s)viapaper,compactdisc,orashdrive.
• Foremployerswith250ormoreemployees,youmustreportelectronicallythroughourwebsite.Specicationsforpaperlessreportingareprovidedthroughour
website, https://dor.mo.gov/business/withhold/EFW2.php. Information should be labeled with the name and account number of the employer. The
requirementtoleelectronicallyisautomaticallywaivediftheIRShasgrantedawaiverofthefederalrequirementtoleelectronicallyandtheemployerhas
ledacopyofthewaiverwiththeDepartment.
NOTE:TheDepartmentwillnotprovidenoticationwhentheinformationisprocessed;norwilltheDepartmentreturncompactdiscsorashdrivestotheemployer.
IfyoudiscoveranerrorhasoccurredonapreviouslyledEmployer’sReturnofIncomeTaxWithheld(FormMO-941)oranerrorinLine17ontheoriginalW-2(s),you
must correct it by remitting an amended Form MO-941. This form must be used to increase or decrease any previously reported tax amounts. Attach a copy of the Form
W-2C(s) to Form MO W-3 and check the box indicated before submitting. Enter the total new correct amount for all Form W-2(s) in box 1. Corrections by employers
with 250 or more employees must be sent by email to [email protected]
unlesstheemployerhasbeengrantedawaiverofthefederalrequirementtole
electronicallyandhasledthiswaiverwiththeDepartment.Correctionsbyemployerswithlessthan250employeesmaybesentbyemailtotheaboveemailaddress,
sent in writing to the address below, or sent by fax to the fax number below.
NOTE: Do not send copies of W-2C(s) if no change in withholding tax liability.
TheTransmittalofTaxStatements(FormMOW-3),copiesofallFormsW-2(s)and1099-R(s)(Copy1),thecompactdisc,orashdriveisdueonorbeforeFebruary28,
afterallofyourwithholdingtaxreturnshavebeenled.Theduedateforemployerswith250ormoreemployeestolecopiesofallFormW-2(s)isJanuary31.Ifthedue
datefallsonaSaturday,Sunday,orlegalholiday,theselingswillbeconsideredtimelyifpostmarkedorledelectronicallythroughtheDepartment’swebsiteonthenext
business day.
Form
MO W-3
Missouri Department of Revenue
Transmittal of Tax Statements
Department Use Only
(MM/DD/YY)
Missouri Tax I.D.
Number
Federal Employer
I.D. Number
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