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FORM MAINE
W-4ME Employee’s Withholding Allowance Certi cate
1. Type or print your rst name M.I. Last name 2. Your social security number
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Home address (number and street or rural route)
City or town State ZIP code
3.
Single or Head of Household
Married
Married, but withholding at higher single rate
Note: If m arried but legally separated, or spouse is a nonresident
alien, check the single box .
4. Total number of allowances you are claiming from line E of the personal allowances worksheet below...................... 4.
5. Additional amount, if any, you want withheld from your paycheck ................................................................................ 5. $
6. If you do not want any state income tax withheld, check the appropriate box that applies to you (you must qualify - see instructions below). By
signing below, you certify that you qualify for the exemption that you select:
a. You claimed “Exempt” on your federal Form W-4 ............................................................................................................................... 6a.
b. You completed federal Form W-4P and checked the box on line 1 ....................................................................................................6b.
c. You are a resident employee with no Maine tax liability in prior and current years ............................................................................ 6c.
d. You are a recipient of periodic retirement payments with no tax liability in prior and current years .................................................... 6d.
e. Your spouse is a member of the military assigned to a location in Maine and you qualify for exemption under the Military
Spouse’s Residency Relief Act. You must attach supporting documents. See instructions..............................................................6e.
Under penalties of perjury, I certify that I am entitled to the number of withholding allowances or the exemption claimed on this certi cate.
EMPLOYEE’S/PAYEE’S SIGNATURE
(Form is not valid
unless you sign it.) Date
4
TO BE COMPLETED BY EMPLOYER/PAYER (see Instructions)
7. Employer/Payer Name and Address (Employer/Payer: Complete lines 7, 8, 9, and 10 only if sending to Maine 8. Identi cation Number
Revenue Services)
9. Employer/Payer Contact Person: 10. Contact Person’s Phone Number:
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Employee/Payee Instructions
Purpose: Complete Form W-4ME so your employer/payer can withhold
the correct Maine income tax from your pay. Because your tax situation
may change, you may want to recalculate your withholding each year.
Line 4. If you qualify for one of the Maine exemptions from withholding,
complete lines 1, 2, 3 and 6, and sign the form. Otherwise, complete the
Personal Allowances worksheet above. You may claim fewer allowances
than you are entitled to, but you must le a Personal Withholding Allowance
Variance Certi cate to obtain permission from the State Tax Assessor if you
want to claim more allowances than allowed on line E above.
Box 3. Select the marital status that applies to you. You must select the
same marital status you selected on your federal Form W-4, except that
married individuals have the option of withholding at the higher single rate
and if you selected married ling separately on your federal Form W-4, you
should select single. Nonresident aliens are required to check the single
box regardless of actual marital status.
Line 6. Exemptions from withholding:
Line 6a. You may check this box if you claimed Exempt” on your federal
Form W-4. Do not check this box if you want Maine income taxes withheld
even though you are exempt from federal withholding.
Line 6b. You may check this box if you completed federal Form W-4P
and put a check in the box on line 1. Do not check this box if you want
Maine income taxes withheld even though you are exempt from federal
withholding.
Line 6c. You may elect this exemption if you are a resident employee
receiving wages and you meet both of the following conditions:
1. You had no Maine income tax liability last year, and
2. You reasonably expect to have no Maine income tax liability this year.
This exemption will expire at the end of the year and you must complete a
new Form W-4ME for next year or you will be subject to Maine withholding
at the maximum rate.
Line 6d. You may elect this exemption if you receive periodic retirement
payments pursuant to IRC § 3405, you had no Maine income tax liability in
the prior year and you reasonably expect you will have no Maine income
tax liability this year. This election will remain in e ect until you complete a
new Form W-4ME.
Instructions continued on next page
Cut here and give the certi cate above to your employer. Keep the part below for your records.
Personal Allowances Worksheet - for line 4 above
A. Enter “1” for yourself if no one else can claim you as a dependent. .......................................................................................... A. _______________
B. Enter “1” for your spouse if you will le as married ling jointly. You may choose to enter “0” if you are married and have
either a working spouse or more than one job. (Entering “0” may help avoid having too little tax withheld). .............................B. _______________
C. Enter “1” if you will be ling as Head of Household. ..................................................................................................................C. _______________
D. Enter the number of children and dependents eligible for the federal child tax credit or the federal credit for other dependents ...
D. ________________
E. Add lines A through D. (Maximum number of allowances you may claim). ................................................................................E. _______________
Line 6e. If you are the spouse of a member of the military, you may claim
exemption from Maine withholding if you meet the following requirements:
1. Your spouse is a member of the military located in Maine in compliance
with military orders.
2. You are in Maine solely to be with your spouse.
3.
You and your spouse have the same domicile in a state other than Maine.
4. You attach a copy of your spouse’s latest Leave and Earning Statement
re ecting an assignment location in Maine.
5. You present your military ID to your employer. The ID must identify
you as a military spouse.
Your exemption will expire at the end of the calendar year during which
you submit Form W-4ME claiming the exemption, at which time you must
complete and submit a new Maine Form W-4ME for the new year.
Note: You may be subject to penalty if you do not have su cient withholding
to meet your Maine income tax liability.
Employer/Payer Information for Completing Form W-4ME
An employer/payer is required to submit a copy of Form W-4ME, along with a copy of any supporting information provided by the employee/payee, to
Maine Revenue Services if:
A. The employer/payer is required to submit a copy of federal Form W-4 to the Internal Revenue Service either by written notice or by published
guidance as required by federal regulation 26 CFR 31.3402(f)(2)-1(g); or
B. An employee performing personal services in Maine furnishes a Form W-4ME to the employer containing a non-Maine address and, for any reason,
claims no Maine income tax is to be withheld. This submission is not required if the employer reasonably expects that the employee will earn annual
Maine-source income of less than $5,000 or if the employee is a nonresident working in Maine for no more than 12 days for the calendar year and
is, therefore, exempt from Maine income tax withholding.
Submit copies of Form W-4ME directly to the MRS Withholding Unit separately from any other tax ling.
Employers/Payers must complete lines 7 through 10 only if required to submit a copy of Form W-4ME to Maine Revenue Services.
a Line 7 Enter employer/payer name and business address.
a Line 8 Enter employer/payer federal identi cation number (EIN and/or SSN).
a Line 9 Enter employer/payer contact person who can answer questions about withholding (i.e. human resources person, company o cer,
accountant, etc.).
a Line 10 Enter employer/payer contact person’s phone number.
Important Information for Employers/Payers
Missing or invalid Forms W-4, W-4P or W-4ME. If any of the circumstances below occur, the employer or payer must withhold as if the employee or
payee were single and claiming no allowances. Maine income tax must be withheld at this rate until such time that the employee or payee provides a valid
Form W4-ME.
(1) The employee/payee has not provided a valid, signed Form W-4ME;
(2) The employee’s/payee’s Form W-4 or W-4P is determined to be invalid for purposes of federal withholding;
(3) The Assessor noti es the employer/payer that the employee’s/payee’s Form W-4ME is invalid; or
(4) The employee’s/payee’s Personal Withholding Allowance Variance Certi cate has expired, a new variance certi cate has not been approved and
submitted to the employer/payer and the payee has not provided the payer with a valid Form W-4ME.
Exemptions from withholding Form W-4ME, line 6. Generally, employers/payers must withhold from payments subject to Maine income tax unless an
exemption is claimed on line 6.
Federal exemption from withholding (lines 6a and 6b). An employee/payee who is exempt from federal income tax withholding is also exempt from
Maine income tax withholding. This includes recipients of periodic retirement payments who are exempt from federal income tax withholding. The
employee/payee must check the applicable box on line 6. An employee/payee exempt from federal withholding that wants Maine withholding must
leave line 6 blank.
Resident employee exemption from Maine withholding (line 6c). A resident employee who is subject to federal income tax withholding is exempt
from Maine income tax withholding if the employee had no Maine tax liability for the prior year and expects to have no Maine tax liability for the current
year. The exemption on line 6c expires at the end of each year. If the employee fails to submit a new Form W-4ME for the next calendar year, the
employer must begin withholding at the single rate with no allowances.
Withholding from payments to nonresident employees. An employee who is exempt from Maine income tax because of the nontaxable thresholds
applicable to nonresidents is not required to complete and submit Form W-4ME; however, an employee becomes subject to Maine income tax withholding
immediately upon exceeding a threshold at any time during the year. Because all income earned in Maine is taxable by Maine once a threshold is
exceeded, employers should work with a ected employees to ensure that Maine withholding is adequate to cover Maine income tax liability for the year.
This may require the employee submitting a new Form W-4ME with the employer.
Withholding exemption for periodic retirement payments (line 6d). Recipients of periodic retirement payments as de ned by IRC § 3405 that are
subject to federal income tax withholding are exempt from Maine income tax withholding if the recipient certi es (by checking the box on line 6d) that he
or she had no Maine income tax liability for the prior year and expects to have no Maine income tax liability for the current year. The exemption remains
in e ect until the recipient submits an updated Form W-4ME.
Exemptions under the Military Spouse’s Residency Relief Act (MSRRA). If the box on line 6e is checked, the employer must:
(1) Ensure that a copy of the military member’s Leave and Earnings Statement (LES) is attached, and verify that the assignment location entered
on the LES is a location in Maine; and
(2) Review the employee’s military ID to ensure that the date on the ID is not more than four years prior to the date on the employee’s Form W-4ME,
and that the ID denotes the employee as a current military spouse.
An exemption claimed on line 6e expires at the end of the calendar year. If the employee does not submit a new Maine Form W-4ME, the employer
must begin withholding for the rst pay period in the following year at the maximum rate (single with one allowance).
See the employee instructions for line 6e above for more information about this exemption.
Rev. 11/19
Notice to Employers and Other Payers
Maine law requires employers and other persons to withhold money from certain payments, most commonly wages, retirement payments and
gambling winnings, and remit to Maine Revenue Services for application against the Maine income tax liability of employees and other payees.
The amount of withholding must be calculated according to the provisions of Rule No. 803 (See www.maine.gov/revenue/rules) and must
constitute a reasonable estimate of Maine income tax due on the receipt of the payment. Amounts withheld must be paid over to Maine Revenue
Services on a periodic basis as provided by Title 36 M.R.S. Chapter 827 (§§ 5250 - 5255-B) and Rule No. 803 (18-125 C.M.R., ch. 803).