Fillable EMPLOYEES CLAIM FOR CREDIT NJ-2450 (The State of New Jersey)

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EMPLOYEES CLAIM FOR CREDIT NJ-2450 (The State of New Jersey)

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Name:
Address:
City, State, Zip Code:
1A. Employer’s Name:
Fed. Emp. I.D. #:
Private Plan #: Wages:
B. Employer’s Name:
Fed. Emp. I.D. #:
Private Plan #: Wages:
C. Employer’s Name:
Fed. Emp. I.D. #:
Private Plan #: Wages:
D. Employer’s Name:
Fed. Emp. I.D. #:
Private Plan #: Wages:
E. Employer’s Name:
Fed. Emp. I.D. #:
Private Plan #: Wages:
F. Employer’s Name:
Fed. Emp. I.D. #:
Private Plan #: Wages:
G. *If additional space is required, enclose a rider and enter the total on this line
2. Total Deducted: Add Lines 1A thru 1G. Enter here.
3. Correct UI/HC/WD and/or Disability Deductions. 93.93 110.50
4. Deduct Line 3 Col. A from Line 2 Col. A. Enter on Page 2, Line 47
of the NJ-1040.
5. Deduct Line 3 Col. B from Line 2 Col. B. Enter on Page 2, Line 48
of the NJ-1040.
EMPLOYEE’S CLAIM FOR CREDIT
FOR EXCESS UI/HC/WD AND DISABILITY CONTRIBUTIONS
FOR CALENDAR YEAR 2001
NJ-2450
Claimant Social Security No.
Note on Joint NJ-1040 Return:
Each spouse must file a separate form when
claiming a refund for excess contributions.
To establish a right to this credit, claimants are required to complete the items below (information is to be transcribed from W-2 forms enclosed
with your New Jersey State Income Tax return). Any items not substantiated by a W-2 or any information that is incomplete, will cause the
claim to be rejected. The amount withheld for the Unemployment Insurance/Health Care Subsidy Fund/Workforce Development Partnership
Fund and the amount of disability insurance withheld must be reported separately on all W-2 statements.
TAKE ALL INFORMATION FROM YOUR W-2 FORMS.
If the amount deducted by any one employer exceeds the maximum for either
UI/HC/WD or disability, insert the maximum in the appropriate Column(s) and contact
that employer for a refund of the balance of the deduction.
COLUMN A
UI/HC/WD
DEDUCTED
COLUMN B
DISABILITY
INSURANCE
DEDUCTED
I hereby apply for a credit for worker contributions deducted in excess of $93.93 for N.J. UI/HC/WD and in excess of $110.50 for N.J. Disability
Insurance by reason of having received wages from two or more employers during the above calendar year and hereby submit the following statement
of wages and deductions.
Claimant’s Signature: ______________________________________________________________ Date: _________________________________
INSTRUCTIONS FOR OBTAINING
A CREDIT FOR EXCESS UI/HC/WD AND DISABILITY DEDUCTIONS
In order to claim the credit, Form NJ-2450, Employee’s Claim for Credit for Excess UI/HC/WD
(Unemployment Insurance/Health Care Subsidy Fund/Workforce Development Partnership
Fund) and Disability Contributions, must be enclosed with the NJ-1040 return. If this form is not
enclosed with the NJ-1040 and if the required information from the W-2 forms is not available
to substantiate the claim, the claim for credit will be denied. The Law prohibits the processing
of claims submitted later than two years after the calendar year in which wages were paid.
If a joint NJ-1040 return is filed and both spouses have excess contributions withheld by two or
more employers, each spouse must file their own claim form along with the NJ-1040 return.
If any single employer withholds more than the maximum for either UI/HC/WD or disability
insurance contributions, you are to enter only the maximum on the claim form. Any amounts
over the maximum were incorrectly withheld and must be refunded by that particular employer.
Refunds of overwithholdings of contributions by an individual employer are the responsibility of
that employer and are not subject to be claimed as a credit on your Gross Income Tax Return.
If additional space is required due to the number of employers, enclose a list with the required
information as on the NJ-2450 form. If this rider is incomplete or not enclosed with the claim,
the claim for credit will be denied.
After lines 1A through 1G are completed, complete all necessary calculations from Lines 2
through 5. Carry the amounts on Line 4 and/or 5 to the specified lines on Page 2 of the NJ-1040
return.
If you are notified that your claim has been rejected by the Division of Taxation for lack of
information or any other reason, you must refile your claim for refund of excess UI/HC/WD or
disability insurance withholdings with the Department of Labor on Form UC-9A, “Employees
Claim for Refund of Excess Contributions”. Once your claim has been rejected by the
Division of Taxation, it cannot be reinstated.
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EMPLOYEES CLAIM FOR CREDIT NJ-2450 (The State of New Jersey)

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Completed 6 August 2020

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