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Form Missouri Department of Revenue
Withholding Compensation Worksheet
5335 Tax Year __ __ __ __

This form is to assist employers in tracking the timely compensation deduction for employer withholding tax.  It should not be submitted to the Department of 
Revenue.  The compensation deduction is computed using an annual accumulative tax withheld total.
Total
Total
Month Tax Withheld 1st $5,000 at 2nd $5,000 at Over $10,000 at  Compensation
 Amount Paid
2% Deduction 1% Deduction 1/2% Deduction  Deduction

January 00 00 00 00 00 00

February 00 00 00 00 00  00 

March 00 00 00 00 00 00 

April 00 00 00 00 00 00

May 00 00 00 00 00 00 

June 00 00 00 00 00 00

July 00 00 00 00 00 00
Taxpayer Record

August 00 00 00 00 00 00

September 00 00 00 00 00 00

October 00 00 00 00 00 00

November 00 00 00 00 00 00

December 00 00 00 00 00 00

Totals t 0 00 (Cannot Exceed)  (Cannot Exceed)  0 00 0 00 0 00
$100.00 $50.00
Form 5335 (Revised 06-2013)