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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

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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.

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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

PDF file checksum: 2280317513

(Plugin #1/9.12/13.0)

Removed Elements:

Do not submit payment with this report. Taxes and fees due
, and pay state unemployment insurance, must file this form.
must be reported and paid using forms ES903, CRS-1 or
WC-1. This report is filed for informational purposes only.
with this report. You may file this report when you sign into Taxpayer Access Point (TAP)
online at
QUARTER ENDING
EMPLOYER'S NAME
FEDERAL EMPLOYER IDENTIFICATION NUMBER (FEIN)
DBA
CRS IDENTIFICATION NUMBER
ADDRESS
CITY / STATE / ZIP
RETURN TYPE: Check one.
ORIGINAL
AMENDED
SUPPLEMENTAL
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.
Signature of employer or authorized agent
Print name
Date
Title
E-mail address
Phone
Employer's name
Federal employer's account number (FEIN)
TRD-31109
STATE OF NEW MEXICO
Employer's Quarterly These reports and applicable taxes and fees due may be
, and pay state unemployment
filed
when you sign into Taxpayer Access Point (TAP) online
at
Quarterly Wage, Withholding and Workers' Compensation
Fee Report.
Enter the employer's Federal Employer Identifi
-
and remitted to the Department. The information is gathered
cation Number (FEIN) and CRS Identification Number (CRS
ID). Enter the month, day and four-digit year of the last day
of the calendar quarter of the report period. The date should
. be entered as mm/dd/yyyy. Complete the name and address
Employers who are not required to file Form ES903, must
block, and check the box to indicate whether the report type
file Form TRD-31109. Employers submitting these quarterly
is an original, amended or supplemental report. An amended
detail information reports are not required to file annual W2
report type is a report submitted to supersede a previously
information to the Department.
filed original report. A supplemental report type is a report
submitted to add to the original or amended report.
must be submitted
Complete the total number of pages included in this report.
to the Taxation and Revenue Department by the last day of
When additional space is needed to complete the quarter's
the month following the close of the calendar quarter. If any
report, attach a completed supplemental schedule(s) and
due date falls on a Saturday, Sunday or legal holiday, the due
complete the page numbering on each page. Use as many
date is the next business day.
supplemental schedules to Form TRD-31109,
Employer's
Report,
as needed.
Enter the number of workers (employees)
to whom the Workers' Compensation Fee applies. This is
P.O. Box 2527, Santa Fe, NM 87504-2527. For assistance
the number of covered employees you employed on the last
call (505) 827-0832.
working day of the calendar quarter. If you have no covered
Do not remit taxes or fees due with this report. Filing Form
employees on the last working day of the quarter, enter zero.
TRD-31109 is not a substitute for filing Form CRS-1, reporting
and remitting tax withheld from employees, or WC-1 (RPD-
41054), Workers' Compensation Fee Return, reporting the
In columns 1 and 2, enter the employee's social security
workers' compensation fees paid. Your payment may not be
number and name. Complete the name by entering the last
properly recorded, if paid with Form TRD-31109.
name first, followed by a comma, the first name and the
middle initial. In column 3, enter the gross wages paid to the
employee during the quarter. In column 4, enter the amount
. You must report and pay withholding tax on Form CRS-1 of New Mexico income tax withheld during the quarter. If a
on or before the 25th of the month following the close of your
Workers' Compensation Fee was due for the employee, enter
report period. A report period may be a calendar month, quarter the total fees due for the quarter. Include the employer and
or semi-annual period. Check your registration certificate to employee portions or $4.30 per covered worker (employee).
determine whether you are a monthly, quarterly or semi-annual
filer. You must report and pay workers' compensation fees on
Form WC-1 on or before the last day of the month following At the bottom of Form TRD-31109, and the supplemental
the close of a calendar quarter.
schedule(s), enter the sum of the columns 3, 4 and 5. On the
The Department encourages all taxpayers to file electronically.
and date the report. Include the title, e-mail address and phone
ES-903,
form obtained from your local district office or downloaded
from our web site at
. Do not use a
CRS-1,
Combined Report System
; and
photocopy of the first page of the report. However, you may
•
WC-1,
Workers' Compensation Fee Return.
use quality photocopies of the supplemental page.
PDF file checksum: 1393586045