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Form WH-3, WH-1U
State Form 962                   Indiana Department of Revenue 
                          Annual Withholding Reconciliation Tax Form WH-3

This packet contains form WH-3 for reconciling taxes withheld on employees. Your WH-3 return is due on the date printed on the form. 
                                 Make sure the information on this page is correct and complete.

                                                                                             Payments must be made with U.S. funds. 
                                                                                             Please do not include check stubs when 
                                                                                             mailing your payments.

                                                                                             Location
                                                                                             Taxpayer ID
                                                                                             Filing Period
                                                                                             Letter ID
                                                                                             Date Issued

  (This form must be filed even if no tax was withheld. Give this packet to your tax preparer, if you use one. Do not throw this packet away.)

• No tax is due: A return must be filed by the taxpayer even when no tax is due unless the Indiana tax account has been properly closed. If no 
  return is filed, an estimated return will be filed by the Department using the best information available (IC 6-8.1-10-3). A tax liability notice will 
  be issued.

• Electronic Filing: Pursuant to IC 6-3-4-16.5, any employer that files a combined total of more than 25 W-2, W-2G, and 1099 forms in a 
  calendar year is required to file those forms and the WH-3 electronically.  This law applies to all withholding statements filed after December 31, 
  2012. 
   
  To be considered as an electronic filing method, you must use the INTIME portal or DOR’s bulk SFTP process. 
   
  If your withholding file size is 10MB or less, you will manually enter or batch upload via intime.dor.in.gov.  
   
  If your withholding file size is larger than 10MB, your file must be uploaded via bulk SFTP (Secure File Transfer Protocol). For more 
  information about DOR’s bulk SFTP process, visit www.in.gov/dor/business-tax/bulk-filing-your-indiana-business-taxes.

• Closed Business: Do not write changes on the tax return. Instead, complete and file Form BC-100 or close your business at intime.dor.in.gov.

• Who Should File: This form should be filed by all withholding agents who withhold state and/or county income tax from employees and 
  nonresident contractors during the calendar year.

• When To File: Form WH-3, Schedule IN-WH-3, and state copies of Form W-2, W-2G, (also Form 1099 if state withholding is included) must 
  be filed on or before the last day in January.

• Late Filings: A penalty of $10 will be charged per W-2, W-2G, and 1099 statement not included or that is filed past the due date. An extension 
  of time to file may be requested. The Department will accept a copy of the federal withholding extension (8809) to submit Form WH-3.

• Pay by (EFT) Electronic Funds Transfer: To remit an underpayment by EFT, initiate a supplemental payment for the tax year’s final period.

What’s new for Form WH3

You will no longer be required to provide the breakdown of county tax withheld for each county when filing Form WH-3. 
You must complete Schedule IN-WH3 if you file your Form WH-3 by paper.

State Form 962
(R36 / 7-23)

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04 Instructions for Completing Annual Reconciliation Form WH-3
05 Line 1 − Enter the total Indiana state income tax withheld as shown on Line 26 of Schedule IN-WH3.
06 Line 2 − Enter the total of county tax withheld during the tax year as shown on Line 27 of Schedule IN-WH3.
07 Line 3 − Add Lines 1 and 2; and enter the total here. If your account has been overpaid, continue to Line 4. If you
08 have underpaid the withholding tax, see instructions for underpayment of Indiana withholding.
09 Line 4 − Complete this line only if your account has been overpaid and you are claiming a refund. Enter the amount of your overpayment on Line 4.
No refund will be issued unless all areas of the Form WH-3 are complete and all W-2, W-2G, and 1099 forms are enclosed.
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11 Line 5 – Enter the amount of wages, salary, tips, or other compensation subject to state/and or county tax from Form W-2 for your employees. The amount
to be entered is the greater of state income or county income reported on Form W-2. Do not include amounts from other forms such as Form W-2G
12 or Form 1099 on this line. If you have multiple withholding accounts, enter only the amounts from Form W-2 provided for that account.
13 Note: Remittance must be made with the WH-1U or by EFT, but not with the WH-3. Do not staple documents together.
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Taxpayer ID Number For Tax Year
16 3
17 WH−3 9999999999999 9999
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20 XXXXXXXXXXXXXXXXXXXXXXXXXXX Due on or Before
XXXXXXXXXXXXXXXXXXXXXXXXXXX
21 XXXXXXXXXXXXXXXXXXXXXXXXXXX 9999999999
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23 XXXXXXXXXXXXXXXXXXXXXXXXXXX
24
25 Enter the total amount of state tax withheld during the tax year as shown on Line 26 of
26 Schedule IN-WH3 1. 9999999999. 99
27
28 Enter the total amount of county tax withheld during the tax year as shown on Line 27 of
29 Schedule IN-WH3 2. 9999999999. 99
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31 Total − Add Lines 1 & 2 3. 9999999999. 99
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33 Refund Claimed − See the instructions 4. 9999999999. 99
34
Any amount due must be paid on the
35 WH−1U.
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** Compare the amount on Line 3 with the amount of withholding tax you actually paid (excluding late fees and interest) for the tax year. If you underpaid your
38 withholding tax, complete Form WH-1U and mail it along with your payment.
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41 5. Enter total amount of wages subject to state and/or county tax 9999999999 .99 Total # of W-2, W-2G, and 1099 forms enclosed 999
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45 X Authorized Signature________________________________________________ Date _________________ Phone _____________________________
46 I declare under penalties of perjury that this is a true, correct and complete return.
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48 Check if amending or correcting a previously filed WH-3.
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56 Use Address Below if Claiming a Refund For All Other Returns Use Address Below
57 INDIANA DEPARTMENT OF REVENUE Indiana Department of Revenue
58 P.O. BOX 7220 P.O. Box 6108
59 INDIANAPOLIS, IN 46207−7220 Indianapolis, IN 46206−6108
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62 *20123111694*
63 20123111694
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Use this Address for filing Form WH-3 with less than 25 paper W-2, W-2G, and
1099 forms.
Mail To
Indiana Department of Revenue
P.O. Box 6108
Indianapolis, IN 46206−6108

Underpayment of Indiana Withholding Filing Instructions

If you have underpaid the withholding tax, you must remit the amount due. If you normally remit by check, you must use Form WH-1U.

Enter the amount due on Line A. If you are making the underpayment remittance late, penalty and interest are due. If you are paying the
underpayment by check, include the penalty and interest on Line B. * Penalty is 10% of Line A or $5, whichever is greater. The total amount due
should be entered on Line C. Call 317-232-2240 for further information and for the current interest rate.

If you normally remit by EFT, make a supplemental payment for the final period of the year. Your supplemental payment together with all your other
credits should equal the amount on Line 3 of the WH-3. Do not send a WH-1U.

Underpayment Form
State Form 49170
Signature of Officer Title WH-1U (R20 / 8-22)
Date Phone #

Taxpayer ID Number Due Date
W

Underpayment Amount A.
Calendar Year Ending .

Penalty & Interest due B. .

Amount being paid C. .

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