WTH 10001
Revised 11-2021         Oklahoma Quarterly Wage Withholding Tax Return
                                                        Taxpayer Copy/Worksheet
A. Taxpayer FEIN        B. Quarter Ending                          C. Due Date

                                                                                                                                    - - - - - - - - Dollars - - - - - - -  - Cents - 

                                                                                                                      1. Wages Paid    _____________________  . ______

                                                                                                                      2. Tax Withheld    _____________________  . ______

                                                                                                                      3. Interest (+)   _____________________  . ______

                                                                                                                      4. Penalty  (+)   _____________________  . ______

                                                                                                                      5. Total    (=)  _____________________  . ______

                 Use this worksheet to calculate tax, then enter the figures on the coupon below.
                   Instructions for completing Oklahoma Quarterly Wage Withholding Tax Return
                When to File                            If you must contact us in writing, include your name and                  Specific Line Instructions
All returns are due quarterly on or before the 20th day account number, and mail your correspondence to:                 Line 1. Wages Paid - Enter the total Oklahoma wages 
of the month following each calendar quarter.           Oklahoma Tax Commission                                          paid this quarter.
                When to Pay                             Oklahoma City, OK 73194
                                                                                                                         Line 2. Tax Withheld - Enter the amount of Oklahoma 
If the amount withheld is less than $500 per quarter,              Specific Item Instructions                            Income Tax withheld from the wages of your 
submit payment with this return. If the amount withheld                                                                  employees this quarter.
exceeds $500 per quarter, submit monthly payment        Item E. Address Change - Check Box E to notify us of 
with payment coupon WTH-10004. This return is to be     address change. Write new address in section E.                  Line 3. Interest - A bill will be issued after return is 
used to report the accumulative total for the quarter.  Item F. Out of Business - If this is your last return as         posted to account. Interest is calculated by 1.25% for 
                  Paper                                 an employer, check Box F and give the Date Out of                each month on the unpaid tax liability and returns not 
                                                        Business.                                                        postmarked on or before their due date.
If filing by paper, make checks or money orders pay-
able to the Oklahoma Tax Commission and mail with       Item G. Amended Return - Check to correct a                      Line 4. Penalty - A bill will be issued after return is 
your return to (This address is for payments ONLY):     previously filed return.  In Item B include the reporting        posted to account. If this return or any payment is 
Oklahoma Tax Commission                                 period you are amending. Enter total corrected                   filed after the due date, multiply the amount on line 2 
PO Box 26860                                            amounts on lines 1, 2 and 5 of the return and not the            by 10%.
Oklahoma City, OK 73126-0860                            amount of the adjustment.                                        Line 5. Total - Total the amounts on lines 2 through 4 
Do NOT mail correspondence to the address above.        Item H. Number of Employees - Enter the number of                and enter on line 5.
                                                        employees for this filing period on the line provided.

Do not fold, staple or paper clip. Please Detach Here and Return Coupon Below.                                                               Do not tear or cut below line.

         WTH 10001

       Oklahoma Quarterly Wage Withholding Tax Return
A. Taxpayer FEIN   B. Quarter Ending                    C. Due Date                      D. Filing Frequency

                                                        Date Out                         G. Amended                      H. Number of Employees:
                                                        of Business:  __________________            Report
-Office Use Only-  E. Address Change            F. Out of Business   MM/DD/YY                                            - - - - - - - - - - - Dollars - - - - - - - - -   - Cents - 
                                                                                         1. Wages Paid
E: ___________________________________________________                                   2. Tax Withheld
  Name
___________________________________________________                                      3. Interest (+)
  Address
___________________________________________________                                      4. Penalty (+)
  City                               State                      ZIP
                                                                                         5. Total  (=)

         Signature:  _____________________________________    Date:  ______________
         The information contained in this return and any attachments is true and correct to the best of my knowledge.