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 must be 
                                                                                                                                                reported and paid using forms ES903, WC-1, TRD-41409, or TRD-
Wage and Contribution Report, and pay state unemployment insurance, must file this form.                                                        41414. This report is filed for informational purposes only.
This report may be filed online at https://tap.state.nm.us. 
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

NEW MEXICO BUSINESS TAX IDENTIFICATION NUMBER (NMBTIN)                                                    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 filed 
Wage and Contribution Report, and pay state unemployment           when  you  sign  into  Taxpayer Access  Point  (TAP)  online  at 
insurance tax, must file Form TRD-31109, Employer's Quarterly      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 Fee 
tax withheld and the workers' compensation  fees collected         Report. Enter the employer's Federal Employer Identification 
and remitted to the Department. The information is gathered        Number (FEIN) and New Mexico Business Tax Identification 
from Form ES903, Employer's Quarterly Wage and Contribu-           Number (NMBTIN). Enter the month, day and four-digit year 
tion Report, or from Form TRD-31109,     Employer's Quarterly      of the last day of the calendar quarter of the report period. The 
Wage, Withholding and Worker's Compensation Fee Report.  date should be entered as mm/dd/yyyy. Complete the name 
Employers who are not required to file Form ES903, must file       and address block, and check the box to indicate whether the 
Form TRD-31109. Employers submitting these quarterly detail  report type is an original, amended or supplemental report. 
information reports are not required to file annual W2 informa-    An amended report type is a report submitted to supersede a 
tion to the Department.                                            previously 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. When 
to the Taxation and Revenue Department by the last day of the      additional space is needed to complete the quarter's report, 
month following the close of the calendar quarter. If any due      attach a completed supplemental schedule(s) and complete 
date falls on a Saturday, Sunday or legal holiday, the due date    the page numbering on each page. Use as many supplemental 
is the next business day.                                          schedules to Form TRD-31109, Employer's Quarterly Wage, 
                                                                   Withholding and Workers' Compensation Fee Report,       as 
File online at https://tap.state.nm.us. If you cannot file online, 
                                                                   needed. Enter the number of workers (employees) to whom 
mail Form TRD-31109 to Taxation and Revenue Department, 
                                                                   the Workers' Compensation Fee applies. This is the number 
P.O. Box 2527, Santa Fe, NM 87504-2527. For assistance call 
                                                                   of covered employees you employed on the last working day 
(505) 827-0832. 
                                                                   of the calendar quarter. If you have no covered employees on 
Do not remit taxes or fees due with this report. Filing Form TRD-the last working day of the quarter, enter zero.  
31109 is not a substitute for filing Form TRD-41409 or TRD-
41414, reporting and remitting tax withheld from employees,        Column Instructions:
or WC-1 (RPD-41054), Workers' Compensation Fee Return,             In columns 1 and 2, enter the employee's social security number 
reporting the workers' compensation fees paid. Your payment        and name. Complete the name by entering the last name first, 
may not be properly recorded, if paid with Form TRD-31109.         followed by a comma, the first name and the middle initial. In 
                                                                   column 3, enter the gross wages paid to the employee during the 
How to pay withholding tax and workers' compensation               quarter. In column 4, enter the amount of New Mexico income 
fees. You must report and pay withholding tax on Form TRD-         tax withheld during the quarter. If a Workers' Compensation 
41409 or TRD-41414 on or before the 25th of the month fol-         Fee was due for the employee, enter the total fees due for the 
lowing the close of your report period. A report period may be     quarter. Include the employer and employee portions or $4.30 
a calendar month, quarter or semi-annual period. Check your        per covered worker (employee). 
registration certificate to determine whether you are a monthly, 
quarterly or semi-annual filer. You must report and pay workers'   Completing the report:
compensation fees on Form WC-1 on or before the last day of  At  the bottom of  Form  TRD-31109, and the supplemental 
the month following 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 from 
    Report;                                                        our web site at www.tax.newmexico.gov. Do not use a photocopy 
•   WC-1, Workers' Compensation Fee Return;                        of the first page of the report. However, you may use quality 
•   TRD-41409, Non-wage Withholding Tax Return; and                photocopies of the supplemental page.  
•   TRD-41414, Wage Withholding Tax Return