Wht 436 2026

The document consists of two forms from the Vermont Department of Taxes: the Health Care Contributions Worksheet (Form HC-1) and the Quarterly Withholding Reconciliation and Health Care Contribution form (Form WHT-436). The HC-1 form is used by employers to report uncovered employee counts and calculate health care contributions based on full-time equivalent (FTE) employees. The WHT-436 form consolidates wage withholding, non-wage withholding, and health care contributions due for a reporting period. Employers must retain these forms for their records.

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Click ‘Get Form’ to open the WHT-436 in the editor.
Begin by entering your business name, Federal ID number, and address in the designated fields at the top of the form.
Select the reporting period by checking only one box for the relevant quarter.
In Part I, input the total Vermont wages paid and tax withheld from wages this quarter.
Proceed to Part III. If applicable, check the box certifying that no Healthcare Contribution is due. Otherwise, enter your adjusted uncovered FTE count from the worksheet.
Calculate and enter your total Health Care Contributions due based on your worksheet calculations.
Finally, sign and date the form in Part V to certify its accuracy before submission.

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