Form CT-590 "Athlete or Entertainer Request for Waiver of Withholding" - Connecticut

What Is Form CT-590?

This is a legal form that was released by the Connecticut Department of Revenue Services - a government authority operating within Connecticut. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on March 1, 2017;
  • The latest edition provided by the Connecticut Department of Revenue Services;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a printable version of Form CT-590 by clicking the link below or browse more documents and templates provided by the Connecticut Department of Revenue Services.

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Download Form CT-590 "Athlete or Entertainer Request for Waiver of Withholding" - Connecticut

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Department of Revenue Services
Form CT-590
State of Connecticut
Athlete or Entertainer Request for Waiver of Withholding
(Rev. 03/17)
Complete this return in blue or black ink only.
Mail to: DRS, Audit Division, Entertainment Withholding Section,
450 Columbus Blvd Ste 1, Hartford CT 06103-1837.
An athlete, entertainer, performing artist, including a member of an
athletic team, or performing entity uses this form to request a waiver of
Fax to: 860-297-5775
Connecticut income tax withholding from a designated withholding agent.
If the request is granted, DRS will send Form CT-595, Notice to
After completing, signing, and dating this form, the performer or performing
Designated Withholding Agent, to the designated withholding agent
entity submits it to the designated withholding agent.
and a copy to the performer(s) or performing entity. If a designated
If Part I of this form is completed, signed, and dated by the performer(s)
withholding agent has not received Form CT-595 on or before the
or performing entity and taken in good faith, the designated withholding
date that payment is made to the performer or performing entity, the
agent is not required to withhold Connecticut income tax from the payment
designated withholding agent should either (a) presume the request
being made to the performer(s) or performing entity. The designated
has been denied and withhold Connecticut income tax at a rate of
withholding agent must keep this form for at least four years after the
6.99% of the gross payment to the performer or performing entity, or
date of the performance.
(b) the designated withholding agent or the performer or performing
entity may call the DRS Audit Division, Entertainment Withholding
If Part II of this form is completed, signed, and dated by the performer(s)
Section, at 860-297-5925 for information on the status of the request.
or performing entity, the designated withholding agent must mail or fax
this form to the Department of Revenue Services (DRS) and must withhold
The designated withholding agent may be instructed by DRS to return
Connecticut income tax unless DRS grants the request.
any excess amounts withheld to the performer or performing entity.
For more information, see Policy Statement 2015(5), Income Tax
This form must be received by DRS at least 14 calendar days before the
Withholding for Athletes or Entertainers, or call the Entertainment
date of the fi rst payment or the date of the fi rst performance, whichever
Withholding Section at 860-297-5925.
is earlier.
Performer(s) or Performing Entity
Name of performer(s) or performing entity
Social Security Number or Federal Employer Identifi cation Number
Address (number and street), apartment number, PO Box
City, town, or post offi ce
State
ZIP code
Designated Withholding Agent
Name of designated withholding agent
Connecticut Tax Registration Number
Address (number and street), apartment number, PO Box
City, town, or post offi ce
State
ZIP code
Name of venue
Date(s) of performance
Amount to be paid to performer(s) or performing entity
Part I – Designated Withholding Agent Keeps Form - Do Not Send to DRS
Declaration by Resident Performer
I am a resident of Connecticut and reside at the address shown above. I have fi led all required Connecticut tax returns, past and present, and have paid all
required Connecticut taxes, including any required estimated Connecticut income tax for the current taxable year. Should I cease to be a Connecticut resident,
I will promptly inform you. I understand that, even if Connecticut income tax is not withheld from the payment made to me for my performance in Connecticut
at the above-named venue on the above-specifi ed date(s) of performance, the payment remains subject to Connecticut income tax. I declare under penalty of
law that the information contained on this form is, to the best of my knowledge and belief, true, complete, and correct. I understand that the penalty for willfully
delivering a false return, statement, or other document to DRS is a fi ne of not more than $5,000, or imprisonment for not more than fi ve years, or both.
Signature
Date
Declaration by Performer who is an Employee of Designated Withholding Agent
I am treated, for federal income tax withholding purposes, as an employee of the designated withholding agent. Should I cease to be treated, for federal income
tax withholding purposes, as an employee of the designated withholding agent, I will promptly inform you. I declare under penalty of law that the information
contained on this form is, to the best of my knowledge and belief, true, complete, and correct. I understand that the penalty for willfully delivering a false return,
statement, or other document to DRS is a fi ne of not more than $5,000, or imprisonment for not more than fi ve years, or both.
Signature
Date
Declaration by Performing Entity Continuously Maintaining an Offi ce in Connecticut
The performing entity named above has an offi ce in Connecticut at the address shown above, and the offi ce is continuously maintained, occupied, and used by
the performing entity’s regular employees who are regularly in attendance to carry on its business in its own name. The performing entity has fi led all required
Connecticut tax returns, past and present, and has paid all required Connecticut taxes. Should the performing entity cease to have an offi ce in Connecticut, I
will promptly inform you. I understand that, even if Connecticut income tax is not withheld from the payment made for the performing entity’s performance in
Connecticut at the above-named venue on the above-specifi ed date(s) of performance, the payment remains subject to Connecticut income tax. I declare under
penalty of law that the information contained on this form is, to the best of my knowledge and belief, true, complete, and correct. I understand that the penalty for
willfully delivering a false return, statement, or other document to DRS is a fi ne of not more than $5,000, or imprisonment for not more than fi ve years, or both.
Name and title (type or print)
Signature
Date
Department of Revenue Services
Form CT-590
State of Connecticut
Athlete or Entertainer Request for Waiver of Withholding
(Rev. 03/17)
Complete this return in blue or black ink only.
Mail to: DRS, Audit Division, Entertainment Withholding Section,
450 Columbus Blvd Ste 1, Hartford CT 06103-1837.
An athlete, entertainer, performing artist, including a member of an
athletic team, or performing entity uses this form to request a waiver of
Fax to: 860-297-5775
Connecticut income tax withholding from a designated withholding agent.
If the request is granted, DRS will send Form CT-595, Notice to
After completing, signing, and dating this form, the performer or performing
Designated Withholding Agent, to the designated withholding agent
entity submits it to the designated withholding agent.
and a copy to the performer(s) or performing entity. If a designated
If Part I of this form is completed, signed, and dated by the performer(s)
withholding agent has not received Form CT-595 on or before the
or performing entity and taken in good faith, the designated withholding
date that payment is made to the performer or performing entity, the
agent is not required to withhold Connecticut income tax from the payment
designated withholding agent should either (a) presume the request
being made to the performer(s) or performing entity. The designated
has been denied and withhold Connecticut income tax at a rate of
withholding agent must keep this form for at least four years after the
6.99% of the gross payment to the performer or performing entity, or
date of the performance.
(b) the designated withholding agent or the performer or performing
entity may call the DRS Audit Division, Entertainment Withholding
If Part II of this form is completed, signed, and dated by the performer(s)
Section, at 860-297-5925 for information on the status of the request.
or performing entity, the designated withholding agent must mail or fax
this form to the Department of Revenue Services (DRS) and must withhold
The designated withholding agent may be instructed by DRS to return
Connecticut income tax unless DRS grants the request.
any excess amounts withheld to the performer or performing entity.
For more information, see Policy Statement 2015(5), Income Tax
This form must be received by DRS at least 14 calendar days before the
Withholding for Athletes or Entertainers, or call the Entertainment
date of the fi rst payment or the date of the fi rst performance, whichever
Withholding Section at 860-297-5925.
is earlier.
Performer(s) or Performing Entity
Name of performer(s) or performing entity
Social Security Number or Federal Employer Identifi cation Number
Address (number and street), apartment number, PO Box
City, town, or post offi ce
State
ZIP code
Designated Withholding Agent
Name of designated withholding agent
Connecticut Tax Registration Number
Address (number and street), apartment number, PO Box
City, town, or post offi ce
State
ZIP code
Name of venue
Date(s) of performance
Amount to be paid to performer(s) or performing entity
Part I – Designated Withholding Agent Keeps Form - Do Not Send to DRS
Declaration by Resident Performer
I am a resident of Connecticut and reside at the address shown above. I have fi led all required Connecticut tax returns, past and present, and have paid all
required Connecticut taxes, including any required estimated Connecticut income tax for the current taxable year. Should I cease to be a Connecticut resident,
I will promptly inform you. I understand that, even if Connecticut income tax is not withheld from the payment made to me for my performance in Connecticut
at the above-named venue on the above-specifi ed date(s) of performance, the payment remains subject to Connecticut income tax. I declare under penalty of
law that the information contained on this form is, to the best of my knowledge and belief, true, complete, and correct. I understand that the penalty for willfully
delivering a false return, statement, or other document to DRS is a fi ne of not more than $5,000, or imprisonment for not more than fi ve years, or both.
Signature
Date
Declaration by Performer who is an Employee of Designated Withholding Agent
I am treated, for federal income tax withholding purposes, as an employee of the designated withholding agent. Should I cease to be treated, for federal income
tax withholding purposes, as an employee of the designated withholding agent, I will promptly inform you. I declare under penalty of law that the information
contained on this form is, to the best of my knowledge and belief, true, complete, and correct. I understand that the penalty for willfully delivering a false return,
statement, or other document to DRS is a fi ne of not more than $5,000, or imprisonment for not more than fi ve years, or both.
Signature
Date
Declaration by Performing Entity Continuously Maintaining an Offi ce in Connecticut
The performing entity named above has an offi ce in Connecticut at the address shown above, and the offi ce is continuously maintained, occupied, and used by
the performing entity’s regular employees who are regularly in attendance to carry on its business in its own name. The performing entity has fi led all required
Connecticut tax returns, past and present, and has paid all required Connecticut taxes. Should the performing entity cease to have an offi ce in Connecticut, I
will promptly inform you. I understand that, even if Connecticut income tax is not withheld from the payment made for the performing entity’s performance in
Connecticut at the above-named venue on the above-specifi ed date(s) of performance, the payment remains subject to Connecticut income tax. I declare under
penalty of law that the information contained on this form is, to the best of my knowledge and belief, true, complete, and correct. I understand that the penalty for
willfully delivering a false return, statement, or other document to DRS is a fi ne of not more than $5,000, or imprisonment for not more than fi ve years, or both.
Name and title (type or print)
Signature
Date
Part II – Where Form CT-590 Must be Submitted to DRS
Declaration by Nonresident Performer With Annual Connecticut Source Income of $3,000 or Less
I am not a resident of Connecticut and reside at the address shown above. I expect to be paid $3,000 or less, in the aggregate, during the calendar
year for services performed in Connecticut. If I am paid more than $3,000, in the aggregate, for services performed in Connecticut during the calendar
year, I will promptly inform you. I understand that, even if Connecticut income tax is not withheld from the payment made to me for my performance
in Connecticut at the above-named venue on the above-specifi ed date(s) of performance, the payment remains subject to Connecticut income tax.
I declare under penalty of law that the information contained on this form is, to the best of my knowledge and belief, true, complete, and correct. I
understand that the penalty for willfully delivering a false return, statement, or other document to DRS is a fi ne of not more than $5,000, or imprisonment
for not more than fi ve years, or both.
Signature
Date
Declaration by Performing Entity Registered as Employer With DRS
The performing entity named above is registered with DRS to withhold Connecticut income tax as an employer and will withhold and pay over Connecticut
income tax on behalf of members or participants in the performing entity for services performed at the above-named venue on the above-specifi ed
date(s) of performance. The performing entity has fi led all required Connecticut tax returns, past and present, and has paid all required Connecticut
taxes. Should the performing entity cease to be registered with DRS to withhold Connecticut income tax as an employer, I will promptly inform you.
I declare under penalty of law that the information contained on this form is, to the best of my knowledge and belief, true, complete, and correct. I
understand that the penalty for willfully delivering a false return, statement, or other document to DRS is a fi ne of not more than $5,000, or imprisonment
for not more than fi ve years, or both.
Name and title (type or print)
Signature
Date
Form CT-590 Back (Rev. 03/17)
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