The form has been redesigned to meet the branding, for-
matting and instructions standards used for all department
forms. The instructions and form have also been updated
as a result of recent amendments to the federal Service-
members Civil Relief Act.
PURPOSE OF FORM
Complete Form REV-419 so that your employer can with-
hold the correct Pennsylvania personal income tax from
your pay. Complete a new Form REV-419 every year or
when your personal or financial situation changes. Photo-
copies of this form are acceptable.
NOTE: Unless the state of residence changes, res-
idents of the reciprocal states listed in the next para-
graph do not need to refile this application every year.
WHO IS ELIGIBLE FOR NONWITHHOLDING?
You may be entitled to nonwithholding of PA personal in-
come tax if you incurred no liability for income tax the pre-
ceding tax year and/or you anticipate that you will incur no
liability for income tax during the current tax year, according
to the Special Tax Provisions of section 304 of the Tax Re-
form Code, as a resident of the reciprocal state of Indiana,
Maryland, New Jersey, Ohio, Virginia or West Virginia and
your employer agrees to withhold the income tax from that
state or as the spouse of an active duty service member
under the Servicemembers Civil Relief Act (SCRA), as
amended.
WHEN TO CLAIM?
File this certificate with your employer as soon as you de-
termine you are entitled to claim nonwithholding. You must
file a certificate each year you are eligible (see Note above
for an exception). If you are employed by more than one em-
ployer you must file a separate REV-419 with each em-
ployer.
RESPONSIBILITIES OF EMPLOYEES
You must revoke this certification within 10 days from the
day you anticipate you will incur PA personal income tax li-
ability for the current tax year. To discontinue or revoke this
certification, submit notification in writing to your employer.
Claimants who qualify for complete Tax Forgiveness under
section 304 of the Tax Reform Code must file a PA-40,
Pennsylvania Personal Income Tax Return, and Schedule
SP to claim Tax Forgiveness even if they are eligible for non-
withholding.
Under the SCRA, as amended, you may be exempt from
PA personal income tax on your wages if (i) your spouse
is a member of the armed forces present in PA in compli-
ance with military orders; (ii) you are present in PA solely
to be with your spouse; and (iii) you and your spouse both
maintain domicile (state residency) in another state. If you
claim exemption under the SCRA, enter your state of do-
micile (legal residence) on Line d below and attach a copy
of your spousal military identification card and your
spouse’s current military orders to form REV-419. See
Personal Income Tax Bulletin 2010-01 for additional
information.
RESPONSIBILITIES OF EMPLOYER
If you agree not to withhold PA tax because your employee
is a resident of a reciprocal state, you must withhold the
other state’s tax.
Retain Form REV-419 with your records. You are required
to submit a copy of this certificate and accompanying attach-
ments to the
PA DEPARTMENT OF REVENUE, BUREAU
OF INDIVIDUAL TAXES, PO BOX 280507, HARRISBURG,
PA 17128-0507, when:
1. You have reason to believe this certificate is incorrect;
2. The PA taxable gross compensation of any employee
who claimed exemption from nonwithholding on the
form under Section II, Line a, exceeds $1,625 for any
quarter;
3. The employee claims an exemption from withholding on
the basis of residence in a reciprocal state (Indiana,
Maryland, New Jersey, Ohio, Virginia or West Virginia)
and therefore, you agree to withhold income tax of the
employee’s state of residence; or
4. The employee claims an exemption from withholding
under the SCRA, as amended.
DEPARTMENT’S RESPONSIBILITY
Upon receipt of any exemption application, the department
will make a determination and notify the employer if a
change is required. If the department disapproves the ap-
plication, the employer must immediately commence with-
holding at the regular rate. Once a certificate is revoked by
the department, the employer must send any new applica-
tion received from the employee to the department for ap-
proval before implementing the nonwithholding.
GENERAL INFORMATION
GENERAL INSTRUCTIONS
WHAT’S NEW
Instructions for REV-419
Employee’s Nonwithholding Application Certificate
REV-419 IN (EX) 09-20
1www.revenue.pa.gov REV-419
