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1 1 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 52 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 52 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 52 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 51
0 0 0 4 4 4 4 0 Department Use Only
0 0 0 5 5 5 5 0 Form Missouri Department of Revenue (MM/DD/YY)
0 0 0 6 6 6 6 0 MO W-3 Transmittal of Tax Statements
0 0 0 7 7 7 7 0
0 0 0 8 8 8 8 0
0 0 0 9 9 9 9 0
1 1 1 0 0 0 0 1 Missouri Tax I.D. Federal Employer
1 1 1 1 1 1 1 1 Number I.D. Number
1 1 1 2 2 2 2 1
1 1 1 3 3 3 3 1 Do not send payment with this form. If you have withholding tax due, use Form MO-941.
1 1 1 4 4 4 4 1
1 1 1 5 5 5 5 1 W-3 Corrected
1 1 1 6 6 6 6 1
1 1 1 7 7 7 7 1 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)
1 1 1 8 8 8 8 1
1 1 1 9 9 9 9 1
2 2 2 0 0 0 0 2
2 2 2 1 1 1 1 2 Name
2 2 2 2 2 2 2 2
2 2 2 3 3 3 3 2
2 2 2 4 4 4 4 2 Address City State ZIP
2 2 2 5 5 5 5 2
2 2 2 6 6 6 6 2
2 2 2 7 7 7 7 2 1. Total Missouri Income Tax Withheld.................................................. 1 00
2 2 2 8 8 8 8 2
2 2 2 9 9 9 9 2 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.
3 3 3 0 0 0 0 3
Authorized Printed Name
3 3 3 1 1 1 1 3 Signature
3 3 3 2 2 2 2 3
3 3 3 3 3 3 3 3 Signature Title Date Signed
(MM/DD/YY)
3 3 3 4 4 4 4 3
3 3 3 5 5 5 5 3
3 3 3 6 6 6 6 3
3 3 3 7 7 7 7 3
3 3 3 8 8 8 8 3 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).
3 3 3 9 9 9 9 3
Foremployerswithlessthan250employees,youareencouragedtoreportelectronicallythroughourwebsite.Specificationsforpaperlessreportingare
4 4 4 0 0 0 0 4 provided through our website, https://dor.mo.gov/business/withhold/EFW2.php. Information reported electronically through our website should be labeled
4 4 4 1 1 1 1 4 withthenameandaccountnumberoftheemployer.Alternatively,youmaysendallFormW-2(s)and1099-R(s)viapaper,compactdisc,orflashdrive.
4 4 4 2 2 2 2 4 Foremployerswith250ormoreemployees,youmustreportelectronicallythroughourwebsite.Specificationsforpaperlessreportingareprovidedthrough
4 4 4 3 3 3 3 4 website, https://dor.mo.gov/business/withhold/EFW2.php. Information should be labeled with the name and account number of the employer. The
requirementtofileelectronicallyisautomaticallywaivediftheIRShasgrantedawaiverofthefederalrequirementtofileelectronicallyandtheemployerhas
4 4 4 4 4 4 4 4 filedacopyofthewaiverwiththeDepartment.
4 4 4 5 5 5 5 4 NOTE:TheDepartmentwillnotprovidenotificationwhentheinformationisprocessed;norwilltheDepartmentreturncompactdiscsorflashdrivestotheemployer.
4 4 4 6 6 6 6 4 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
4 4 4 7 7 7 7 4 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
4 4 4 8 8 8 8 4 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
4 4 4 9 9 9 9 4 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,
4 4 4 0 0 0 0 4 sent in writing to the address below, or sent by fax to the fax number below.
5 5 5 1 1 1 1 5 NOTE: Do not send copies of W-2C(s) if no change in withholding tax liability.
5 5 5 2 2 2 2 5 TheTransmittalofTaxStatements(FormMOW-3),copiesof allForms W-2(s)and1099-R(s)(Copy1),the compactdisc,orflashdriveis dueon orbeforeFebruary28,
5 5 5 3 3 3 3 5 afterallofyourwithholdingtaxreturnshavebeenfiled.Theduedateforemployerswith250ormoreemployeestofilecopiesofallFormW-2(s)isJanuary31.Ifthedue
datefallsonaSaturday,Sunday,orlegalholiday,thesefilingswillbeconsideredtimelyifpostmarkedorfiledelectronicallythroughtheDepartment’swebsiteonthenext
5 5 5 4 4 4 4 5 business day.
5 5 5 5 5 5 5 5
5 5 5 6 6 6 6 5
5 5 5 7 7 7 7 5 Form MO W-3 (Revised 11-2018)
5 5 5 8 8 8 8 5
5 5 5 9 9 9 9 5 Mail to: Taxation Division Phone:(573) 751-8750 Visit
P.O. Box 3330 Fax: (573) 522-6816 http://dor.mo.gov/business/withhold/
5 5 5 0 0 0 0 5 Jefferson City, MO 65105-3330 E-mail: withholding@dor.mo.gov for more information.
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