You should complete this worksheet before you telefile your withholding tax return. Withholding tax payments can be made through Electronic Funds Transfer (EFT) after filing your return. Telefile will follow this worksheet as it tells you what information to enter. You may enter the information on this worksheet or print it and write the information in the fields provided. Before you call Telefile be sure to:

Record your Personal Identification Number (PIN) on all Telefile worksheets Complete this worksheet Use dollars and cents for all entries. The last two positions are assumed to be cents. If the amount for any line item is zero, you must enter 00. If you owe money for the current tax period, you should transmit your payment electronically after completing your Telefile return Retain your Telefile Worksheet for your records Write your confirmation number in the space provided along with the date & time of filing

PIN: FID: Tax Period: A. Amount Withheld: The following fields are for depository filers only. B. Total Previous Payments: C. Credit from Previous Quarter: You are now ready to Telefile. Please call (617) 660-2020 or (413) 781-9400. Overpayment: Tax Due: Zero Balance: Date: / / Time: Return Confirmation #: Payment Confirmation #:

Retain for your records. DO NOT mail to Massachusetts Department of Revenue.

Commonwealth of Massachusetts Department of Revenue Customer Service Phone: (617) 887-6367