Employees: See Employee General Instructions on Page 2. Sign and return Form CT-W4 to your employer. Keep a copy for your records.
1
. Withholding Code: Enter Withholding Code letter chosen from above. ....................... 1.
2. Additional withholding amount per pay period: If any, see instructions. . ..................... 2. $
3. Reduced withholding amount per pay period: If any, see instructions. ........................ 3. $
Form
CT-W4
Employee’s Withholding Certicate
Department of Revenue Services
State of Connecticut
(Rev. 12/20)
Eective January 1, 2021
Employee Instructions
Read the instructions on Page 2 before completing this form.
Select the ling status you expect to report on your Connecticut
income tax return. See instructions.
Choose the statement that best describes your gross income.
Enter the Withholding Code on Line 1 below.
Check if you are claiming
the MSRRA exemption
and enter state of legal
residence/domicile:
_____________________
Employers: See Employer Instructions, on Page 2.
Complete this form in blue or black ink only.
Declaration: I declare under penalty of law that I have examined this certicate and, to the best of my knowledge and belief, it is true, complete, and
correct. I understand the penalty for reporting false information is a ne of not more than $5,000, imprisonment for not more than ve years, or both.
Is this a new or rehired employee?
No
Yes
Enter date hired:
mm/dd/yyyy
* If you are claiming the Military Spouses Residency Relief Act (MSRRA) exemption, see instructions on Page 2.
Our expected combined annual gross income is less than or
equal to $24,000 or I am claiming exemption under the Military
E
Spouses Residency Relief Act (MSRRA)* and no withholding
is necessary.
My spouse is employed and our expected combined annual
gross income is greater
than $24,000 and less than or equal A
to $100,500. See Certain Married Individuals, Page 2.
My spouse is not employed and our expected combined
C
annual gross income is greater than $24,000.
My spouse is employed and our expected combined
D
annual gross income is greater than $100,500.
I have signicant nonwage income and wish to avoid having
D
too little tax withheld.
I am a nonresident of Connecticut with substantial other income.
D
Withholding
Code
My expected annual gross income is less than or equal to
$24,000 or I am claiming exemption under the MSRRA* and
E
no withholding is necessary.
My expected annual gross income is greater
than $24,000.
C
I have signicant nonwage income and wish to avoid having too
D
little tax withheld.
I am a nonresident of Connecticut with substantial other income.
D
Withholding
Code
Qualifying Widow(er)
Married Filing Jointly
My expected annual gross income is less than or equal to
$12,000 or I am claiming exemption under the MSRRA* and
E
no withholding is necessary.
My expected annual gross income is greater
than $12,000. A
I have signicant nonwage income and wish to avoid having
D
too little tax withheld.
I am a nonresident of Connecticut with substantial other income.
D
Withholding
Code
My expected annual gross income is less than or equal to
E
$15,000 and no withholding is necessary.
My expected annual gross income is greater
than $15,000.
F
I have signicant nonwage income and wish to avoid having
D
too little tax withheld.
I am a nonresident of Connecticut with substantial other income.
D
Withholding
Code
My expected annual gross income is less than or equal to
E
$19,000 and no withholding is necessary.
My expected annual gross income is greater
than $19,000.
B
I have signicant nonwage income and wish to avoid having
D
too little tax withheld.
I am a nonresident of Connecticut with substantial other income.
D
Withholding
Code
Married Filing Separately
Single
Head of Household
First name Ml Last name Social Security Number
Home address (number and street, apartment number, suite number, PO Box)
City/town State ZIP code
Employee’s signature Date
Employer’s business name Federal Employer Identication Number
Employer’s business address
City/town State ZIP code
Contact person Telephone number
Form CT-W4 (Rev. 12/20)
Page 2 of 2
Form CT-W4 Instructions
Employee General Instructions
Form CT-W4, Employee’s Withholding Certicate, provides your
employer with the necessary information to withhold the correct
amount of Connecticut income tax from your wages to ensure that
you will not be underwithheld or overwithheld.
You are required to pay Connecticut income tax as income is earned
or received during the year. You should complete a new
Form CT-W4
at least once a year or if your tax situation changes.
If your circumstances change, such as you receive a bonus or your
ling status changes, you must furnish your employer with a new
Form CT-W4 within ten days of the change.
Gross Income
For Form CT-W4 purposes, gross income means all income from
all sources, whether received in the form of money, goods, property,
or services, not exempt from federal income tax, and includes any
additions to income from
Schedule 1 of Form CT-1040, Connecticut
Resident Income Tax Return or
Form CT-1040NR/PY, Connecticut
Nonresident and Part‑Year Resident Income Tax Return.
Filing Status
Generally, the ling status you expect to report on your Connecticut
income tax return is the same as the ling status you expect to report
on your federal income tax return. However, special rules apply to
married individuals who le a joint federal return but have a dierent
residency status. Nonresidents and part-year residents should see
the instructions to Form CT-1040NR/PY.
Check Your Withholding
You may be underwithheld if any of the following apply:
You have more than one job;
You qualify under Certain Married Individuals; or
You have substantial nonwage income.
If you are underwithheld, you should consider adjusting your
withholding or making estimated payments using
Form CT-1040ES,
Estimated Connecticut Income Tax Payment Coupon for Individuals.
You may also select Withholding Code
“D” to elect the highest level
of withholding.
If you owe $1,000 or more, after subtracting from your Connecticut
income tax the amount withheld from your income for the prior taxable
year, and any PE Tax Credit, you may be subject to interest on the
underpayment at the rate of 1% per month or fraction of a month.
To help determine if your withholding is correct, see Informational
Publication 2021(7), Is My Connecticut Withholding Correct?
Certain Married Individuals
If you are a married individual ling jointly and you and your spouse
both select Withholding Code
“A,” you may have too much or too
little Connecticut income tax withheld from your pay. This is because
the phase-out of the personal exemption and credit is based on your
combined incomes. The withholding tables cannot reect your exact
withholding requirement without considering the income of your spouse.
To minimize this problem, and determine if you need to adjust your
withholding using Line 2 or Line 3, see IP 2021(7).
Nonresident Employees Working Partly Within and Partly
Outside of Connecticut
If you work partly within and partly outside of Connecticut for
the same employer, you should also complete
Form CT-W4NA,
Employee’s Withholding or Exemption Certicate - Nonresident
Apportionment, and provide it to your employer. The information on
Form CT-W4NA and Form CT-W4 will help your employer determine
how much to withhold from your wages for services performed within
Connecticut. For Convenience of the Employer Test information, see
Form CT-W4NA. To obtain Form CT-W4NA, visit the Department of
Revenue Services (DRS) website at portal.ct.gov/DRS or request
the form from your employer. Any nonresident who expects to have no
Connecticut income tax liability should choose Withholding Code
“E.”
Armed Forces Personnel and Veterans
If you are a Connecticut resident, your armed forces pay is subject
to Connecticut income tax withholding unless you qualify as a
nonresident for Connecticut income tax purposes. If you qualify as
a nonresident, you may request that no Connecticut income tax be
withheld from your armed forces pay by entering Withholding Code
“E”
on Line 1.
Military Spouses Residency Relief Act (MSRRA)
If you are claiming an exemption from Connecticut income tax under
the MSRRA, you must provide your employer with a copy of your
military spouse’s Leave and Earnings Statement (LES) and a copy
of your military dependent ID card.
See
Informational Publication 2019(5), Connecticut Income Tax
Information for Armed Forces Personnel and Veterans.
Employer Instructions
For any employee who does not complete Form CT-W4, you are required
to withhold at the highest marginal rate of 6.99% without allowance
for exemption. You are required to keep Form CT-W4 in your les for
each employee. See Informational Publication 2021(1), Connecticut
Employer’s Tax Guide, Circular CT, for complete instructions.
Report Certain Employees Claiming Exemption From Withholding
to DRS
Employers are required to le copies of Form CT-W4 with DRS for
certain employees claiming “E” (no withholding is necessary). See
IP 2021(1). Mail copies of Forms CT-W4 meeting the conditions listed
in IP 2021(1) under Reporting Certain Employees to:
Department of Revenue Services
PO Box 2931
Hartford CT 06104-2931
Report New and Rehired Employees to the Department of Labor
New employees are workers not previously employed by your
business, or workers rehired after having been separated from your
business for more than sixty consecutive days.
Employers with oces in Connecticut or transacting business in
Connecticut are required to report new hires to the Department of
Labor (DOL) within 20 days of the date of hire.
New hires can be reported by:
Using the Connecticut New Hire Reporting website at
www.ctnewhires.com;
Faxing copies of completed Forms CT-W4 to 800-816-1108; or
Mailing copies of completed Forms CT-W4 to:
Connecticut Department of Labor
Oce of Research, CT-W4
200 Folly Brook Blvd
Wetherseld CT 06109
For more information on DOL requirements or for alternative reporting
options, visit the DOL website at www.ctdol.state.ct.us or call DOL
at 860-263-6310.
For More Information
Call DRS Monday through Friday, 8:30 a.m. to 4:30 p.m. at:
800-382-9463 (Connecticut calls outside the Greater Hartford
calling area only); or
860-297-5962 (from anywhere).
TTY, TDD, and Text Telephone users only may transmit inquiries
anytime by calling 860-297-4911. Taxpayers may also call 711 for
relay services. A taxpayer must tell the 711 operator the number he or
she wishes to call. The relay operator will dial it and then communicate
using a TTY with the taxpayer.
Forms and Publications
Visit the DRS website at portal.ct.gov/DRS to download and print
Connecticut tax forms and publications.