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                                                                                                       Department Use Only
              Form            Missouri Department of Revenue                                           (MM/DD/YY)
 MO W-3                       Transmittal of Tax Statements

Missouri Tax I.D.                                                                           Federal Employer
Number                                                                                      I.D. Number

                              Do not send payment with this form.  If you have withholding tax due, use Form MO-941.

 W-3 Corrected

 Check this box if you participate in the Combined                   Tax                                    Number of                 Number of 
 Federal/State Filing (CF/SF) Program                                Year                                   W-2(s)                    1099-R(s)

Name

Address                                                                                     City                           State            ZIP

                             1.  Total Missouri Income Tax Withheld..................................................   1                   00

              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                                                                    Printed Name
              Signature
 Signature    Title                                                                                                       Date Signed 
                                                                                                                          (MM/DD/YY)

                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).
                 •  For employers with less than 250 employees, you are encouraged to report electronically through our website. Specifications for paperless reporting are  
                   provided through our website, https://dor.mo.gov/business/withhold/EFW2.php. Information reported electronically through our website should be labeled  
                   with the name and account number of the employer. Alternatively, you may send all Form W-2(s) and 1099-R(s) via paper, compact disc, or flash drive.
                 •  For employers with 250 or more employees, you must report electronically through our website. Specifications for paperless reporting are provided through our 
                     website, https://dor.mo.gov/business/withhold/EFW2.php. Information should be labeled with the name and account number of the employer. The  
                   requirement to file electronically is automatically waived if the IRS has granted a waiver of the federal requirement to file electronically and the employer has  
                   filed a copy of the waiver with the Department.
              NOTE: The Department will not provide notification when the information is processed; nor will the Department return compact discs or flash drives to the employer.
              If you discover an error has occurred on a previously filed Employer’s Return of Income Tax Withheld (Form MO-941) or an error in Line 17 on the original W-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 
 Instructions 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 withholding@dor.mo.gov unless the employer has been granted a waiver of the federal requirement to file 
              electronically and has filed this waiver with the Department. Corrections by employers with less than 250 employees may be sent by email to the above email address, 
              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.
              The Transmittal of Tax Statements (Form MO W-3), copies of all Forms W-2(s) and 1099-R(s) (Copy1), the compact disc, or flash drive is due on or before February 28, 
              after all of your withholding tax returns have been filed. The due date for employers with 250 or more employees to file copies of all Form W-2(s) is January 31. If the due 
              date falls on a Saturday, Sunday, or legal holiday, these filings will be considered timely if postmarked or filed electronically through the Department’s website on the next 
              business day.

                                                                                                                                            Form MO W-3 (Revised 11-2018)
Mail to:  Taxation Division                                       Phone: (573) 751-8750                                               Visit 
                    P.O. Box 3330                                 Fax: (573) 522-6816                                     http://dor.mo.gov/business/withhold/
                    Jefferson City, MO 65105-3330                 E-mail:  withholding@dor.mo.gov                          for more information.

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