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4        State of Rhode Island Division of Taxation                                                                                                                                                     4
5        Form RI-W3                                                                                                                                                                                     5
6        Transmittal of Wage and Tax Statements                                                     19106199990101                                                                                      6
7                                                                                                                                                                                                       7
8   Name                                                                                  Federal employer identification number                                                                        8
9                                                                                                                                                                                                       9
10  XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX                                                         99-9999999                                                                                       10
11  Address                                                                               For the calendar year ending:                                                                              11
12  XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX                                                                         12312023                                                                         12
13  Address 2                                                                             E-mail address                                                                                             13
14                                                                                                                                                                                                   14
15  XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX                                               XXXXXXXXXXXXXXXXXXXXXXXXXXXXX                                                                              15
    City, town or post office                        State        ZIP code
16                                                                                                                                                                                                   16
17  XXXXXXXXXXXXXXXXXXXXXXXX                         XX           XXXXX                                   Amended Return                                                                             17
18                                                                                                                                                                                                   18
19                                                                                                                                                                                                   19
20                                                                                                                                                                                                   20
21  1a Total tax withheld for the 1st Quarter (January, February, and March) as shown on Form RI-941.............................                                         1a 999999999 99            21
22                                                                                                                                                                                                   22
23  b Total tax withheld for the 2nd Quarter (April, May, and June) as shown on Form RI-941.........................................                                      1b 999999999 99            23
24                                                                                                                                                                                                   24
25  c Total tax withheld for the 3rd Quarter (July, August, and September) as shown on Form RI-941.............................                                           1c 999999999 99            25
26                                                                                                                                                                                                   26
27  d Total tax withheld for the 4th Quarter (October, November, and December) as shown on Form RI-941 ..................                                                 1d 999999999 99            27
28                                                                                                                                                                                                   28
29  e Total tax withheld for the year. Add lines 1a through 1d.......................................................................................                     1e 999999999 99            29
30                                                                                                                                                                                                   30
31                                                                                                                                                                                                   31
32                                                                                                                                                                                                   32
33                                                                                                                                                                                                   33
34  2 Total payments made for the year .................................................................................................................................. 2  999999999 99            34
35                                                                                                                                                                                                   35
36  3 Amount Due. Subtract line 2 from line 1e.............................................................................................................               3  999999999 99            36
37                                                                                                                                                                                                   37
38                                                                                                                                                                                                   38
39                                                                                                                                                                                                   39
40                                                                                                                                                                                                   40
    4 Total amount of state wages, tips, and other compensation for the calendar year ..............................................                                      4
41                                                                                                                                                                           999999999 99            41
42                                                   DRAFT                                                                                                                                           42
    5 Total number of state wage & tax statements (Form W2) sent with this reconciliation form................................                                            5
43                                                                                                                                                                           999999999               43
44                                                                                                                                                                                                   44
45                                                                                                                                                                                                   45
46 Note:                                                                                                                                                                                             46
47 If you are an employer with 25 or more employees, it is required that all of the W-2 forms issued to employ-                                                                                      47
48 ees are submitted electronically to the RI Division of Taxation through electronic file transfer (EFT) or on CD.   48
49                                                                                                                                                                                                   49
50 For more information and to set up secure FTP, please send an email to Tax.ProdControl@tax.ri.gov.                                                                                                50
51                                                                                                                                                                                                   51
52                                                                                                                                                                                                   52
   Under penalties of perjury, I declare that I have examined09/01/2023this return and accompanying schedules and statements, and to the best of my knowledge and 
53  belief, it is true, accurate and complete.  Declaration of preparer (other than taxpayer) is based on all information of which preparer has any knowledge.                                       53
54  Authorized officer signature                             Print name                                Date                                                                  Telephone number        54
55                                                                                                                                                                                                   55
                                                                                          04/22/2021                (999) 999-9999
56  Paid preparer signature                                  Print name                                Date                                                                  Telephone number        56
57                                                                                                                                                                                                   57
58                                              XXXXXXXXXXXXXXXXXXXX                      04/23/2021                (999) 999-9999                                                                   58
    Paid preparer address                            City, town or post office State                ZIP Code                                                                             PTIN
59                                                                                                                                                                                                   59
60  XXXXXXXXXXXXXXXXXXXX                        XXXXXXXXXXXXXX                 XX         XXXXX                                                                           P99999999                  60
61                                                                                                                                                                                                   61
62                                              May the Division of Taxation contact your preparer?   YES                                                                                            62
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34567890123456789012345678901234567890123456789012345678901234567890123456789012Mail to RI Division of Taxation - One Capitol Hill - Providence, RI 02908                                       Revised 
                                                                                                                                                                                              08/2023

    1111111111222222222233333333334444444444555555555566666666667777777777888State of Rhode Island Division of Taxation 
34567890123456789012345678901234567890123456789012345678901234567890123456789012Form RI-W3 - Transmittal of Wage and Tax Statements 
4                                                                                                                               4
5   INFORMATION FOR EMPLOYERS FILING TRANSMITTAL OF WAGE AND TAX STATEMENTS                                                     5
6                                                                                                                               6
7  1.   The employer’s name and address should be pre-printed on the form.  If incorrect, any necessary changes may be          7
8   made directly on the form.  If not pre-printed, enter the employer’s name and address in the space provided.                8
9                                                                                                                               9
10 2.   The employer’s withholding reconciliation account ID should be pre-printed on the form.  DO NOT enter your Federal      10
11  Employer Identification Number in this section if a pre-printed account ID already appears here.                            11
12  If not pre-printed, enter your identification number.                                                                       12
13                                                                                                                              13
14 3.  Form RI-W3 must be filed no later than January 31st following the end of the tax year.                                   14
15                                                                                                                              15
16 4.  Remit Form RI-W3 with copies of all Form W-2 Wage and Tax Statements, and/or Form 1099.  The number of wage              16
17  and tax statements reported on Form RI-W3 should include statements reflecting no withholding as well as those dis          17
18  closing taxes withheld.  These must be accompanied by a totaled list of the amounts of income tax withheld as               18
19  shown on the Form W-2.  This total should agree with the amount stated on line 1e of Form RI-W3.  Employers who             19
20  are not required to withhold tax from any employee according to tax tables must still file all withholding tax forms        20
21  required for the assigned payment frequency.  Submit Form(s) W-2 along with Form RI-W3.                                     21
22                                                                                                                              22
23 5.  Form W-2 must contain the following information:                                                                         23
24  a. Complete name, address and social security number of the employee.                                                       24
25  b. Total wages (including tips) paid in the tax year and compensation not subject to withholding.                           25
26  c. The Rhode Island tax withheld amount clearly identified.                                                                 26
27  d. Full name, address and federal employer identification number of the employer.                                           27
28                                                                                                                              28
29 6.  Do not enclose any remittance for taxes withheld from your employees with the package of wage and tax statements 29
30  and Form RI-W3 being sent to the RI Division of Taxation.  Remittance for taxes withheld must be sent with Form             30
31  RI-941.                                                                                                                     31
32                                                                                                                              32
33 7.  Employers who are required to file W-2s and W-3s electronically for federal tax purposes must file electronically for    33
34  Rhode Island.  Employers filing electronically must submit the Electronic Media Transmittal Form with the CD-ROM            34
35  or DVD.  See W-2 Electronic Filing Requirements        at http://www.tax.ri.gov/taxforms/withholding.php for the            35
36  Electronic Media Transmittal Form and additional specifications.                                                            36
37                                                                                                                              37
38 8.  Further assistance may be obtained at the RI Division of Taxation, One Capitol Hill, Providence, RI 02908 or at          38
39  www.tax.ri.gov                                                                                                              39
40                                                                                                                              40
41                                                                                                                              41
42                           LINE BY LINE INSTRUCTIONS                                                                          42
                             DRAFT 
43                                                                                                                              43
44 1. On line 1a, enter the total tax withheld for the 1st quarter of the year (months of January, February and March) as       44
45  shown on Form RI-941.                                                                                                       45
46 2. On line 1b, enter the total tax withheld for the 2nd quarter of the year (months of April, May and June) as shown on      46
47  Form RI-941.                                                                                                                47
48 3. On line 1c, enter the total tax withheld for the 3rd quarter of the year (months of July, August and September) as        48
49  shown on Form RI-941.                                                                                                       49
50 4. On line 1d, enter the total tax withheld for the 4th quarter of the year (months of October, November and December)       50
51  as shown on Form RI-941.                                                                                                    51
52 5. On line 1e, enter the total tax withheld for the year.  Add lines 1a through 1d.                                          52
   6. On line 2, enter the actual amount of payments made for the calendar year to the RI Division of Taxation. 09/01/2023
53                                                                                                                              53
54 7. Amount Due.  Subtract line 2 from line 1e.  If line 2 is less than line 1e, this is the amount due for the calendar year. 54
55  Remit this balance due along with Form RI-941.                                                                              55
56 8. Enter the total amount of state wages, tips and other compensation for your employees for the calendar year.              56
57 9. Enter the total number of state wage and tax statements (Form W-2) being sent with this transmittal form.                 57
58                                                                                                                              58
59                                                                                                                              59
60Note: If you are an employer with 25 or more employees, it is required that all of the W-2 forms issued to employ- 60
61ees are submitted electronically to the RI Division of Taxation through electronic file transfer (EFT) or on CD.              61
62                                                                                                                              62
For more information and to set up secure FTP, please send an email to Tax.ProdControl@tax.ri.gov.  1111111111222222222233333333334444444444555555555566666666667777777777888
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