Fillable 2021 W-4MN, Minnesota Employee Withholding Allowance/Exempon Cercate (Gustavus Adolphus College)

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2021 W-4MN, Minnesota Employee Withholding Allowance/Exempon Cercate (Gustavus Adolphus College)

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Secon 2 — Exempon From Minnesota Withholding
CompleteSecon2ifyouclaimtobeexemptfromMinnesotaincometaxwithholding(see Secon 2 instrucons for qualicaons).Ifapplicable,
checkoneboxbelowtoindicatewhyyoubelieveyouareexempt:
A ImeettherequirementsandclaimexemptfrombothfederalandMinnesotaincometaxwithholding
B EventhoughIdidnotclaimexemptfromfederalwithholding,IclaimexemptfromMinnesotawithholding,because:
• IhadnoMinnesotaincometaxliabilitylastyear
• IreceivedarefundofallMinnesotaincometaxwithheld
• IexpecttohavenoMinnesotaincometaxliabilitythisyear
CAlloftheseapply:
• MyspouseisamilitaryservicememberassignedtoamilitarylocationinMinnesota
• Mydomicile(legalresidence)isinanotherstate
• IaminMinnesotasolelytobewithmyspouse.Mystateofdomicileis
D IamanAmericanIndianthatresidesandworksonareservaon
E IamamemberoftheMinnesotaNaonalGuardoranacvedutyU.S.militarymemberandclaimexemptfromMinnesotawithholding
onmymilitarypay
F IreceiveamilitarypensionorothermilitaryrerementpayascalculatedunderU.S.Code,tle10,secons1401through1414,1447
through1455,and12733,andIclaimexemptfromMinnesotawithholdingonthisrerementpay
Minnesota Allowances and Addional Withholding
1 Minnesota Allowances. EnterStepFfromSecon1aboveorStep10oftheItemizedDeduconsWorksheet .. 1
2 AddionalMinnesotawithholdingyouwantdeductedeachpayperiod(see instrucons) ................... 2
2021 W-4MN, Minnesota Employee Withholding Allowance/Exempon Cercate
Employees: Givethecompletedformtoyouremployer.
Employers
SeetheemployerinstruconstodetermineifyoumustsendacopyofthisformtotheMinnesotaDepartmentofRevenue.Ifrequired,enteryour
informaonbelowandmailthisformtotheaddressintheinstrucons.(Incompleteformsareconsideredinvalid.)Wemayassessa$50penaltyfor
eachrequiredFormW-4MNnotledwithus. Keepacopyforyourrecords.
Employee’sSignature Date DaymePhoneNumber
I cerfy that all informaon provided in Secon 1 OR Secon 2 is correct. I understand there is a $500 penalty for ling a false Form W-4MN.
Employees
CompleteFormW-4MNsothatyouremployercanwithholdthecorrectMinnesotaincometaxfromyourpay.ConsidercomplenganewForm
W-4MNeachorandwhenyourpersonalornancialsituaonchanges.
Employee’sFirstNameandInial LastName Employee’sSocialSecurityNumber
PermanentAddress
Marital Status (Check one):
City State ZIPCode
Married
Married,butwithholdathigherSinglerate
Single;Married,butlegallyseparated;or
Spouseisanonresidentalien
Read instrucons on back. Complete Secon 1 OR Secon 2, then sign and give the completed form to your employer.
Do not complete both Secon 1 and Secon 2. Compleng both secons will make the form invalid.
Secon 1 — Determining Minnesota Allowances
A Enter“1”ifnooneelsecanclaimyouasadependent ............................................. A
B Enter“1”ifanyofthefollowingapply:...........................................................B
• Youaresingleandhaveonlyonejob
• Youaremarried,haveonlyonejob,andyourspousedoesnotwork
• Yourwagesfromasecondjoboryourspouse’swagesare$1500orless
C Enter“1”ifyouaremarried.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 you avoid having too lile tax withheld.) ..... C
D Enterthenumberofdependents(otherthanyourspouseoryourself)youwillclaimonyourtaxreturn. ... D
E Enter“1”ifyouwillusethelingstatusHeadofHousehold (see instrucons). .......................... E
F Total number of allowances claimed.AddstepsAthroughE.
Ifyouplantoitemizededuconsonyour2021Minnesotaincometaxreturn,youmayalsocompletethe
ItemizedDeduconsandAddionalIncomeWorksheet. ............................................ F
NameofEmployer FederalEmployerIDNumber(FEIN)MinnesotaTaxIDNumber
Address City State ZIPCode
Form W-4MN Employee Instrucons
When should I complete Form W-4MN?
Complete Form W-4MN if any of these apply:
• You begin employment
• You change your ling status
• You reasonably expect to change your ling status in the next calendar year
• Your personal or nancial situation changes
• You claim exempt from Minnesota withholding (see Section 2 instructions for qualications)
If you have not had sucient Minnesota income tax withheld from your wages, we may assess penalty and interest when you le your state
income tax return.
Note: Your employer may be required to submit a copy of your Form W-4MN to the Minnesota Department of Revenue. You may be subject to a
$500 penalty if you provide a false Form W-4MN.
What if I have completed federal Form W-4?
If you completed a 2021 Form W-4, you must complete Form W-4MN to determine your Minnesota withholding allowances.
What if I am exempt from Minnesota withholding?
If you claim exempt from Minnesota withholding, complete only Section 2 of Form W-4MN and sign the form to validate it. If you complete
Section 2, you must complete a new Form W-4MN by February 15 in each following year.
You cannot claim exempt from withholding if all of these apply:
• Another person can claim you as a dependent on their federal tax return
• Your annual income exceeds $1,100
• Your annual income includes more than $350 of unearned income
What if I am a nonresident alien for U.S. income taxes?
If you are a nonresident alien, you are not allowed to claim exempt from withholding. You will check the single box for marital status
regardless of your actual marital status and may enter one personal allowance on Step A. Enter zero on steps B, C, and E.
If you are resident of Canada, Mexico, South Korea, or India, and are allowed to claim dependents, you may enter the number of dependents on
Step D.
Secon 1 — Minnesota Allowances Worksheet
Complete Section 1 to nd your allowances for Minnesota withholding tax. For regular wages, withholding must be based on allowances you
claimed and may not be a at amount or percentage of wages.
If you expect to owe more income tax for the year than will be withheld, you can claim fewer allowances or request additional Minnesota
withholding from your wages. Enter the amount of additional Minnesota income tax you want withheld on line 2 of Section 1.
Nonwage Income
Consider making estimated payments if you have a large amount of “nonwage income.” Nonwage income (other than tax-exempt income)
includes interest, dividends, net rental income, unemployment compensation, gambling winnings, prizes and awards, hobby income, capital
gains, royalties, and partnership income.
Two Earners or Mulple Jobs
If your spouse works or you have more than one job, gure the total number of allowances you are entitled to claim on all jobs using
worksheets from only one Form W-4MN. Usually, your withholding will be more accurate when all allowances are claimed on the Form
W-4MN for the highest paying job and zero allowances are claimed on the others.
Head of Household Filing Status
You may claim Head of Household as your ling status if you are unmarried and pay more than 50% of the costs of keeping up a home for
yourself, your dependents, and other qualifying individuals. Enter “1” on Step E if you may claim Head of Household as your ling status on
your tax return.
What if I itemize deducons on my Minnesota return or have other nonwage income?
Use the Itemized Deductions and Additional Income Worksheet to nd your Minnesota withholding allowances. Complete Section 1 on page 1,
then follow the steps in the worksheet on the next page to nd additional allowances.
Secon 2 — Minnesota Exempon
Your employer will not withhold Minnesota taxes from your pay if you are exempt from Minnesota withholding. You cannot claim exempt
from withholding if all of these apply:
• Another person can claim you as a dependent on their federal tax return
• Your annual income exceeds $1,100
• Your annual income includes more than $350 of unearned income
Complete this form for your employer to calculate the amount of Minnesota income tax to be withheld from your pay.
Connued
Employer instructions are on the next page.
Itemized Deducons and Addional Income Worksheet
1 Enter an estimate of your 2021 Minnesota itemized deductions. For 2021, you may have to reduce your itemized deductions
if your income is over $199,850 ($99,925 for Married Filing Separately). ..........................................
2
Enter one of the following based on your ling status:
...........................................................
a. $25,050 if Married Filing Jointly
b. $18,800 if Head of Household
c. $12,525 if Single or Married Filing Separately
3 Subtract step 2 from step 1. If zero or less, enter 0 .............................................................
4 Enter an estimate of your 2021 additional standard deduction (from page 11 of the Form M1 instructions) ................
5 Add steps 3 and 4 .......................................................................................
6 Enter an estimate of your 2021 taxable nonwage income ........................................................
7 Subtract step 6 from step 5. If zero, enter 0. If less than zero, enter the amount in parentheses...........................
8 Divide the amount on step 7 by $4,350. If a negative amount, enter in parentheses. Do not include fractions ..............
9 Enter the number on step F of Section 1 on page 1 .............................................................
10 Add step 8 and 9 and enter the total here. If zero or less, enter 0. Enter this amount on line 1 of page 1. .................
Box A
Check box A of Section 2 to claim exempt if all of these apply:
• You meet the requirements to be exempt from federal withholding
• You had no Minnesota income tax liability in the prior year and received a full refund of Minnesota tax withheld
• You expect to have no Minnesota income tax liability for the current year
Box B
Check box B of Section 2 if you are not claiming exempt from federal withholding, but meet the second and third requirements for box A.
Box C
Check box C in Section 2 to claim exempt if all of these apply:
• You are the spouse of a military member assigned to duty in Minnesota
• You and your spouse are domiciled in another state
• You are in Minnesota solely to be with your active duty military spouse member
Boxes D-F
If you receive income from the following sources, it is exempt from Minnesota withholding. Your employer will not withhold Minnesota tax
from that income when you check the appropriate box in Section 2.
• Box D: You receive wages as a member of an American Indian tribe living and working on the reservation of which you are an enrolled
member.
• Box E: You receive wages for Minnesota National Guard (MNG) pay or for active duty U.S. military pay. MNG and active duty U.S.
military members can claim exempt from Minnesota withholding on these wages, even if they are taxable federally. For more information,
see Income Tax Fact Sheet 5, Military Personnel.
• Box F: You receive a military pension or other military retirement pay calculated under U.S. Code title 10, sections 1401 through 1414, 1447
through 1455, and 12733. You may claim exempt from Minnesota withholding on this income even if it is taxable federally.
Note: You may not want to claim exempt if you (or your spouse if ling a joint return) expect to have other forms of income subject to
Minnesota tax and you want to avoid owing tax at the end of the year.
If you complete Section 2, you must complete a new Form W-4MN by February 15 in each following year.
Nonresident Alien
If you are a nonresident alien for federal tax purposes, do not complete Section 2.
Addional Minnesota Withholding
If you would like an additional amount of tax to be deducted per payment period, enter the amount on line 2. Do not enter a percentage of the
payment you want to be deducted.
Use of Informaon
All information on Form W-4MN is private by state law. It cannot be given to others without your consent, except to the Internal Revenue Service,
to other states that guarantee the same privacy, and by court order. Your name, address, and Social Security Number are required for identication.
Information about your allowances is required to determine your correct tax. We ask for your phone number so we can call if we have a question.
Quesons?
• Website: www.revenue.state.mn.us
• Email: withholding.tax@state.mn.us
• Phone: 651-282-9999 or 1-800-657-3594 (toll-free)
Form W-4MN Employer Instrucons
Form W-4MN Requirement
Federal Form W-4 will not determine withholding allowances used to determine the amount of Minnesota withholding. Employees completing a
2021 Form W-4 will need to complete 2021 Form W-4MN to determine the appropriate amount of Minnesota withholding.
Lock-In Leers
Internal Revenue Service (IRS) Letter 2800C tells you when the IRS believes your employee may have led an incorrect federal Form W-4. If
you receive this letter, you must provide the Minnesota Department of Revenue with a copy of the employee’s Form W-4MN. We will verify
the number of allowances that the employee may claim for Minnesota purposes. Continue using the Form W-4MN you were using at the time
you received Letter 2800C from the IRS, until we notify you to change the amount of allowances on the employee’s Form W-4MN. If the
employee has not completed a Form W-4MN, have them complete the form and use the allowances calculated on that form until notied by the
department.
Use the amount on line 1 of page 1 for calculating the withholding tax for your employees.
When does an employee complete Form W-4MN?
Employees complete Form W-4MN when they begin employment or when their personal or nancial situation changes.
How should I determine Minnesota withholding for an employee that does not complete Form W-4MN?
If an employee does not complete Form W-4MN and they have a federal Form W-4 (from 2019 or prior years) on le, use the allowances on
their federal Form W-4. Otherwise, withhold Minnesota tax as if the employee is single with zero withholding allowances.
What if my employee claims to be exempt from Minnesota withholding?
If your employee claims exempt from Minnesota withholding, they must complete Section 2 of Form W-4MN. They must provide you with a
new Form W-4MN by February 15 of each year. If you are paying an employee for wages that are exempt from withholding, such as Medicaid
Waiver Payments or wages to H-2A visa workers, do not send us Form W-4MN.
When do I need to submit copies of a Form W-4MN to the department?
You must send copies of Form W-4MN to us if any of these apply:
• The employee claims more than 10 Minnesota withholding allowances
• The employee checked box A or B under Section 2, and you reasonably expect the employee’s wages to exceed $200 per week
• You believe the employee is not entitled to the number of allowances claimed
You do not need to submit Form W-4MN to us if the employee is asking to have additional Minnesota withholding deducted from their pay.
We may assess a $50 penalty for each Form W-4MN you do not le with us when required.
Mail Forms W-4MN to:
Minnesota Department of Revenue
Mail Station 6501
600 N. Robert St.
St. Paul, MN 55146-6501
What if my employee is a resident of a reciprocity state?
If your employee is a resident of North Dakota or Michigan and they do not want you to withhold Minnesota tax from their wages, they must
complete Form MWR, Reciprocity Exemption/Adavit of Residency. They must complete a Form MWR by February 28 of each year, or within
30 days after they begin working or change their permanent residence. See Withholding Fact Sheet 20, Reciprocity - Employee Withholding, for
more information.
What is an invalid Form W-4MN?
A Form W-4MN is considered invalid if any of these apply:
• There is any unauthorized change or addition to the form, including any change to the language certifying the form is correct
• The employee indicates in any way the form is false by the date they provide you with the form
• The form is incomplete or lacks the necessary signatures
• Both Section 1 and Section 2 were completed
• The employer information is incomplete
What if I receive an invalid form?
Do not use the invalid form to calculate Minnesota income tax withholding. Have the employee complete and submit a new Form W-4MN.
If the employee does not give you a valid form, and you have an earlier Form W-4MN from them, use the earlier form to calculate their
withholding.
If a valid Form W-4MN is not completed by the employee, withhold taxes as if the employee is single and claiming zero withholding
allowances.
What if my employee is a nonresident alien of the United States?
If the wages to this employee are subject to income tax withholding, you will use Table 1 and the procedure under Withholding Adjustment
for Nonresident Alien Employees in IRS Publication 15-T to determine the correct Minnesota withholding tax. Do not use this procedure
for nonresident alien students from India and business apprentices from India. See IRS Notice 1392 for special instructions and withholding
exceptions.
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2021 W-4MN, Minnesota Employee Withholding AllowanceExempon Cercate (Gustavus Adolphus College)

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