Twc Form – Fill Out and Use This PDF

Enter your TWC account number. If none has been assigned, leave blank.

2.Erter county code f'om the list printed on the reverse side of the Form C·4 continuation sheet.

3.Leave this space blank.

4Enter your tax rate If you have not been assigned a tax rate. contact the nearest TWC Tax Office

5Leave this space blank.

6.Enter your Federal Employer Identification Number. If none has been assigned leave blank

7Enter the quarter and year (1 st Quarter 2008=1·08)

8.Enter the name of your business and your mailing address.

If your business is a sole proprietorship or partnership, include the name(s) of the owner or partners.

9If your telephone number IS not printed on the form or If the printed number is incorrect, please enter the correct number in the appropriate box on the Status Change Form.

a.Enter the ending date of the calendar quarter during which you paid wages (1 st Quarter 2008= March 31, 2008)

b.Enter the last day of the month after the end of the quarter.

10.For each month, report the average number of employees who worked (include full·time and part-time) in pay periods that include the 12th day of the calendar month

11En'er the county code of the county in which you had the greatest 'lumber of employees (See list on the reverse side of the rOnT C·4 continuation sheet).

12If you had employees In more than one Texas county enter the numbe' of employees outside the county shown in block 11.

13.Enter the total amount of remuneration before deductions (Including wages, commissions and bonuses) paid during the quarter Include amounts paid in cash. plus the value of remuneration paid in any medium other than cash. All tip income, including charged tips, reported in writing by an employee to his or her employer are wages. Payments made to corporate officers for services performed are wages and should be reported.

Note' Wages are reported when they are paid rather tran when they a'e earned

14.Enter the amount of taxable wages paid to each employee during this quarter. Only the first $9000 of wages paid to each errployee during the calendar year are taxable. (See example on the reverse side of payment voucher)

14a If you repor'ed wages to another state dUring the year ｦｏｾ any of your employees isted thiS quarter place an X Ir box 14a

15.Enter the amount of tax due If Texas UI taxes are paid after January 3' and you are preparing Federal Form 940, you must subtract the UI obligation assessment and the Employment and Training Assessment portion that you paid to Texas ..

16.Enter interest due If payment IS late (postmarked after the due date in Item 9bl MUltiply tax due (Item 15) by 1 50 0 for each month past due to a r1aximum of 37 50 0 (See 'everse Side of payr1ent voucher for calculation worksheet)

17Enter penalty due If the report IS late (postmarKed after the due date) Use the calculation worksheet on the reverse side of the payment voucher to figure late reporting penalty or call your nearest TWC Tax Office.

18.Debit or credit balance reflected in your tax account as of the printing of thiS report. To correct an error on a previously reported quarter, contact your nearest TWC Tax Office for instructions on how to make ar adjustment.

DO NOT ATTEMPT TO MAKE THE

ADJUSTMENT ON THIS FORM

19Add tax, Interest and penalty, add or subtract amounts previously due or credited

Total due = Tax ｾ Interest t Penalty t Previous Arrt Due (or· Credit)

20.Enter employee's nine·dlgit social security number. To report more than 5 employees, use a Form C·4 continuation sheet and list all wage data on the C·4 rather thar listing part of the employees on Form C·3

21Enter first "Itlal, second 'lilial, and employee's last nar1e

22Wages are ｲ･ｰｯｾ･､ w'len they are paid rather than when they are ear'led. Enter the total amount of remuneration before deductions (Including wages, commissions, bonuses and reported tips) paid to each Texas employee. If you need additional continuation sheets to report employees. contact the nearest TWC Tax Office

23.Enter total of amounts listed In Item 22, which should equal Item 13

24Use the Status Change Form attached to the return envelope to Make employer nformatlon correclions

25.Sign report and enter title. This report must be signed by an owner partner or officer of the employing unit or by a person for whorr a wrlttel1 authorization has been filed with the TWC. Please Include enclosed payment voucher with report and remittance.