TRD-31109
Rev. 08/20/2016
STATE OF NEW MEXICO
TAXATION AND REVENUE DEPARTMENT
EMPLOYER'S QUARTERLY WAGE, WITHHOLDING AND                                                                                                                   *82260200*
WORKERS' COMPENSATION FEE REPORT
Who Must File: Employers who are not required to submit Form ES903, Employer's Quarterly                                                        Do not submit payment with this report. Taxes and fees due 
Wage and Contribution Report, and pay state unemployment insurance, must file this form.                                                        must be reported and paid using forms ES903, CRS-1 or 
This report may be filed online at https://tap.state.nm.us.                                                                                     WC-1. This report is filed for informational purposes only.
The Taxation and Revenue Department collects information for each employee, the gross wages paid, the state tax withheld and workers' compensation 
fees collected and remitted to the Department from Form ES903, Employer's Quarterly Wage and Contribution Report, or from Form TRD-31109, Employer's 
Quarterly Wage, Withholding and Worker's Compensation Fee Report. Employers who are not required to file Form ES903, must file Form TRD-31109. 
Employers submitting these quarterly detail information reports are not required to file annual W2 information to the Department. Submit Form TRD-31109, 
to the Taxation and Revenue Department by the last day of the month following the close of the calendar quarter. Taxes or fees due may not be remitted 
with this report. You may file this report when you sign into Taxpayer Access Point (TAP)                                                       online at https://tap.state.nm.us. If you cannot file online, mail 
this report to Taxation and Revenue Department, P.O. Box 2527, Santa Fe, NM 87504-2527. For assistance call (505) 827-0832. 
QUARTER ENDING                                                                                            EMPLOYER'S NAME

FEDERAL EMPLOYER IDENTIFICATION NUMBER (FEIN)                                                             DBA

CRS IDENTIFICATION NUMBER                                                                                 ADDRESS                                                              CITY / STATE / ZIP

                                                                                                          RETURN TYPE: Check one.               ORIGINAL                       AMENDED           SUPPLEMENTAL
 Page _______1                                                                       of ________
 If additional space is needed, attach the supplemental                                                                 TOTAL NUMBER OF EMPLOYEES
 schedule(s) and complete the page number information                                                                   Enter the number of covered workers (employees) you employed on the 
 on each page.                                                                                                          last working day of the calendar quarter. Enter zero if none.
  1.                                                                                 EMPLOYEE SOCIAL   2. EMPLOYEE NAME                           3.      GROSS WAGES FOR   4. STATE INCOME            5. WC FEE DUE
          SECURITY NUMBER                                                                                      (Last, first and middle initial) THIS QUARTER                         TAX WITHHELD

Enter total of columns 3, 4 and 5, this page. 

Enter total of columns 3, 4 and 5 from this page and all supplemental 
pages attached to this quarter's report. Enter zero if none.

 I declare that I have examined this return including any accompanying schedules and statements, and to the best of my 
 knowledge and belief, it is true, correct and complete.

 Signature of employer or authorized agent                                                                Print name                                                                             Date

 Title                                                                                                    E-mail address                                                               Phone
                                                                                                          This report can be filed online at https://tap.state.nm.us 

TRD-31109
Rev. 08/20/2016
STATE OF NEW MEXICO
TAXATION AND REVENUE DEPARTMENT                                                                           Page _______ of ________
EMPLOYER'S QUARTERLY WAGE, WITHHOLDING AND 
WORKERS' COMPENSATION FEE REPORT - Supplemental Schedule                    Quarter ending: ______________________
Employer's name                                                          Federal employer's account number (FEIN)

Use this schedule if additional space is needed when filing Form TRD-31109, Employer's Quarterly Wage, Withholding 
and Workers' Compensation Fee Report. Attach all pages of the supplemental schedule to Form TRD-31109 and mail it 
to the address on the front  page of the form. A quality photocopy of this supplemental schedule may be submitted to the 
Department.

  1.          EMPLOYEE SOCIAL   2.                         EMPLOYEE NAME    3.           GROSS WAGES FOR   4.          STATE INCOME   5.       WC FEE DUE 
SECURITY NUMBER               (Last, first and middle initial)           THIS QUARTER                                   TAX WITHHELD

                Enter total of columns 3, 4 and 5, this page. 

TRD-31109                                         STATE OF NEW MEXICO
Rev. 08/20/2016
                                        TAXATION AND REVENUE DEPARTMENT
               EMPLOYER'S QUARTERLY WAGE, WITHHOLDING AND WORKERS' 
                                         COMPENSATION FEE REPORT
                                                      Instructions
Who Must File: Beginning January 1, 2006, Employers who 
are not required to submit Form ES903, Employer's Quarterly  These reports and applicable taxes and fees due may be 
Wage and Contribution Report, and pay state unemployment           filed when you sign into Taxpayer Access Point (TAP) online 
insurance tax, must file Form TRD-31109, Employer's Quarterly      at https://tap.state.nm.us. 
Wage, Withholding and Workers' Compensation Fee Report. 
The Taxation and Revenue Department collects the following         Completing the top portion of Form TRD-31109, Employer's 
information for each employee: the gross wages paid, the state     Quarterly Wage, Withholding and Workers' Compensation 
tax withheld and the workers' compensation fees collected          Fee Report. Enter the employer's Federal Employer Identifi-
and remitted to the Department. The information is gathered        cation Number (FEIN) and CRS Identification Number (CRS 
from Form ES903, Employer's Quarterly Wage and Contribu-           ID). Enter the month, day and four-digit year of the last day 
tion Report, or from Form TRD-31109, Employer's Quarterly          of the calendar quarter of the report period. The date should 
Wage, Withholding and Worker's Compensation Fee Report.  be entered as mm/dd/yyyy. Complete the name and address 
Employers who are not required to file Form ES903, must            block, and check the box to indicate whether the report type 
file Form TRD-31109. Employers submitting these quarterly          is an original, amended or supplemental report. An amended 
detail information reports are not required to file annual W2      report type is a report submitted to supersede a previously 
information to the Department.                                     filed original report. A supplemental report type is a report 
                                                                   submitted to add to the original or amended report.  
Form TRD-31109,  Employer's Quarterly Wage, Withholding 
and Workers' Compensation Fee Report, must be submitted            Complete the total number of pages included in this report. 
to the Taxation and Revenue Department by the last day of          When additional space is needed to complete the quarter's 
the month following the close of the calendar quarter. If any      report,  attach  a  completed  supplemental  schedule(s)  and 
due date falls on a Saturday, Sunday or legal holiday, the due     complete the page numbering on each page. Use as many 
date is the next business day.                                     supplemental  schedules to  Form  TRD-31109, Employer's 
                                                                   Quarterly Wage, Withholding and Workers' Compensation Fee 
File online at https://tap.state.nm.us. If you cannot file online, 
                                                                   Report, as needed. Enter the number of workers (employees) 
mail Form TRD-31109 to Taxation and Revenue Department, 
                                                                   to whom the Workers' Compensation Fee applies. This is 
P.O. Box 2527, Santa Fe, NM 87504-2527. For assistance 
                                                                   the number of covered employees you employed on the last 
call (505) 827-0832. 
                                                                   working day of the calendar quarter. If you have no covered 
Do not remit taxes or fees due with this report. Filing Form       employees on the last working day of the quarter, enter zero.  
TRD-31109 is not a substitute for filing Form CRS-1, reporting 
and remitting tax withheld from employees, or WC-1 (RPD-           Column Instructions:
41054), Workers' Compensation Fee Return, reporting the            In  columns  1  and  2,  enter  the  employee's  social  security 
workers' compensation fees paid. Your payment may not be           number and name. Complete the name by entering the last 
properly recorded, if paid with Form TRD-31109.                    name  first,  followed  by  a  comma,  the  first  name  and  the 
                                                                   middle initial. In column 3, enter the gross wages paid to the 
How to pay withholding tax and workers' compensation               employee during the quarter. In column 4, enter the amount 
fees. You must report and pay withholding tax on Form CRS-1  of New Mexico income tax withheld during the quarter. If a 
on or before the 25th of the month following the close of your     Workers' Compensation Fee was due for the employee, enter 
report period. A report period may be a calendar month, quarter  the total fees due for the quarter. Include the employer and 
or semi-annual period. Check your registration certificate to  employee portions or $4.30 per covered worker (employee). 
determine whether you are a monthly, quarterly or semi-annual 
filer. You must report and pay workers' compensation fees on       Completing the report:
Form WC-1 on or before the last day of the month following  At the bottom of Form TRD-31109, and the supplemental 
the close of a calendar quarter.                                   schedule(s), enter the sum of the columns 3, 4 and 5. On the 
                                                                   first page, also enter the total of columns 3, 4 and 5 from all 
Filing online.                                                     pages of the form and supplemental schedules attached. Sign 
The Department encourages all taxpayers to file electronically.    and date the report. Include the title, e-mail address and phone 
It is safe, secure and saves time and money. Online filing is      number of the employer or authorized agent as requested.
available and is encouraged for the following reports:
•   TRD-31109, Employer's Quarterly Wage, Withholding and          Obtaining a quality paper form:
    Workers' Compensation Fee Report;                              When filing using a paper return, you must use a quality printed 
•   ES-903,    Employer's  Quarterly Wage and Contribution         form obtained from your local district office or downloaded 
    Report;                                                        from our web site at www.tax.newmexico.gov. Do not use a 
•   CRS-1, Combined Report System; and                             photocopy of the first page of the report. However, you may 
•   WC-1, Workers' Compensation Fee Return.                        use quality photocopies of the supplemental page.