Creator:Utah State Tax Commission
Date Created:
Place Created:Salt Lake City, Utah
Keywords:Tracy Hall,income tax reconciliation
Context:income tax withholding reconciliation return form
**************************************************
w50153 4 71	29692	FORM TC-96 rev. 9-71
UTAH STATE TAX COMMISSION ANNUAL INFORMATION AND INCOME TAX WITHHOLDING RECONCILIATION RETURN-1371
1. NUMBER OF STATEMENTS OF FORM TC-99 OR COPIES OF FORM W-2 OR 1099 TRANSMITTED HEREWITH:
(a)	Employees.
(b)	Other......
2. TOTAL UTAH INCOME TAX WITHHELD AS SHOWN BY COPIES OF*FORM TC-99 OR W-2.................................(A) $ -
3. TOTAL UTAH INCOME TAX WITHHELD AS SHOWN ON LINE 1 OF EMPLOYER'S QUARTERLY RETURN (FORM TC-96A):
Quarter ended March 31............$_
Quarter ended June 30.............—
Quarter ended September 30........
Quarter ended December 31........
ACCOUNT NUMBER AND PERIOD
Q- W50153 JAN-DEC 1971
DO NOT FOLD, | STAPLE OR
tUTILATE THIS IOCUMENT.
EMPLOYER'S NAME AND ADDRESS OF PRINCIPAL PLACE OF BUSINESS
HALL H TRACY 1711 N LAMBERT LN PR0V0 UTAH	84601
MA BX 533 UNI V STA PR0V0 UTAH	84601
DO NOT REMIT MONEY ON THIS FORM. PAY- | MENTS TO BE MADE WITH TC-96A ONLY
Any discrepancy between the amounts shown on lines (A) and (B) must be fully explained in an attached statement.	a
FOR USE BY TAX COMMISSION ONLY COMPARED: TC-99_TC-96A -
PAYMENT IS NOT TO BE REMITTED WITH THIS DOCUMENT