Employee State Income Tax (SIT) Packet - Payroll Services

DIVISION OF FINANCE
TAX COMPLIANCE & REPORTING
Howdy,
Texas A&M University is a registered employer with other states and their local taxing jurisdictions. These states and
any applicable local taxing entities have unique tax laws and these laws vary with each state. Some states require TAMU
employees, including student workers who maintain their tax residency for that state, to have State Income Tax (SIT)
and/or Local Income Tax (LIT) withheld even if they perform services outside of that state. Some states also require SIT
and/or LIT to be withheld if a TAMU employee physically works in that state even though the employee maintains their
tax residency in Texas.
Therefore, any employee who claims residency in a state other than Texas will have SIT and or LIT deducted even if
working in Texas. Also, any employee who physically works in a state other than Texas will have SIT and/or LIT deducted
even if claiming residency in Texas.
For State Income Tax reporting purposes please complete the Employee State Income Tax Verification Form along with
the required State W-4 form and if a Pennsylvania resident the Pennsylvania Residency Certification.
This packet contains the following documents:
1. Instructions to help you complete the Employee State Income Tax Verification form.
2. Employee State Income Tax Verification Form
To be completed by ALL employees who work or reside in a state other than Texas.
3. Military Spousal Relief Act Election Form
Complete if applicable to you.
4. Pennsylvania Residency Certification Form
ONLY residents of Pennsylvania are required to complete this form.
This form is in addition to the Employee State Income Tax Verification Form.
5. Additional TAMU Texarkana Employee Forms
ONLY TAMU Texarkana Employees are required to complete these forms.
These forms are in addition to the Employee State Income Tax Verification Form:
(Complete the one applicable to you)
Texarkana Withholding Exemption Rules
AR4EC – State of Arkansas Employee’s Withholding Exemption Certificate
AR4EC(TX) – State of Arkansas Texarkana Employee’s Withholding Exemption Certificate
AR4ECSP – State of Arkansas Employee’s Special Withholding Exemption Certificate
Please complete and return all forms to cflemings@tamu.edu.
Best Regards,
Tax Compliance and Reporting,
Texas A&M University
General Services Complex Suite 1201
6003 TAMU
College Station, TX 77843-6003
Tel. 979.845.2711 Fax 979.458.3131
#318 Employee State Income Tax (SIT) Verification
DIVISION OF FINANCE
TAX COMPLIANCE & REPORTING
Instructions for completing the Employee State Income Tax Verification Form
Employee Name:
Enter your first and last name
Employee UIN:
Enter your University Identification Number
Campus Location:
Select the campus where you are employed
Physical Work Location:
Enter the city and state of the place where you physically works for TAMU or any of the TAMU System Parts
Date began at physical work location:
If you work in a state other than Texas, list the date you began working at that location
Residency Certification:
Select one of the residency certifications
First option (Texas resident): If this option is chosen, no further information is needed. Sign, date and return the form.
Second option (Out-of-State resident): If this option is chosen, complete the remainder of the form.
Third option (Texas resident): Choose this option if you changed your resident address in SSO because you will be moving to the
state in question and will not be working for TAMU or any of its System parts.
Withholding Basis:
Select one of the withholding basis options
First withholding option: Select this option and return your state’s W-4 if you are not a resident of the below listed states. The state W-4s can be
found at http://www.bls.gov/jobs/statetax.htm.
Second withholding option: Select this option if you are a resident of the below listed states. These states do not have a state withholding
allowance form; therefore, your Federal W-4 will be used as your withholding basis.
States that do not have a State W-4 (Select the 2nd option above if you are a resident of one of these states)
Colorado
Montana
North Dakota
Pennsylvania
Delaware
Nebraska
Oklahoma
South Carolina
Idaho
New Mexico
Oregon
Utah
Military Verification:
Select either ‘Yes or No’ to verify your military affiliation. Also complete and sign page 2 if you selected ‘Yes’ for question #2.
Proof of your eligibility for exemption under the MRRA will be needed. Notification of the required documentation needed to verify
your eligibility will be sent once the completed SIT verification form has been received.
Please make sure we have your correct address. You may review your address and make changes if needed in Single Sign On (SSO) at
https://sso.tamus.edu.
IF THERE ARE CHANGES IN YOUR RESIDENCE CITY/STATE, COMPLETE THIS FORM AGAIN BASED ON THE CHANGE NEEDED AND
SUBMIT. IT IS YOUR RESPONSIBILITY TO NOTIFY US OF A CHANGE SO THAT WE MAY UPDATE YOUR SIT WITHHOLDING WITHIN A
TIMELY MANNER.
#318 Employee State Income Tax (SIT) Verification
DIVISION OF FINANCE
TAX COMPLIANCE & REPORTING
Employee State Income Tax (SIT) Verification
This form is used for State Income Tax reporting purposes by Tax Compliance & Reporting to verify the physical work location and residence
of employees whose payroll records show an out of state residence address. This form is to be completed by the employee. Please complete
this form and return to Tax Compliance & Reporting, as noted at the bottom of the form by email, fax or mail. Instructions for this form can
be found at http://payroll.tamu.edu/media/680721/318_employee_sit_verification_packet.pdf
Employee Name
Employee UIN
Please select your campus location:
TAMU System
TAMU College Station
TAMU Galveston
TAMU Kingsville
Physical Work Location
Where you physically work for TAMU, or any of the TAMU System Parts?
(City and State)
City:_____________________________________ State:__________________
TAMU West Texas
TAMU Cent TX
TAMU Texarkana
TAMU Tarleton
Date you began at Physical Work Location
If you physically work in a state other than Texas, please list the date you
began working in that state for TAMU or any of the TAMU System Parts.
MM________ DD________ YY_______
Residency Certification
The payroll records show you claim residency in a state other than Texas , is that correct?
No, I certify that I am a bona fide resident of the State of Texas and not subject to state income tax withholding of any
other state. (If this option is chosen, you may skip the remainder of this form, sign, date and return to payroll@tamu.edu. Also, please update your
residence and mailing address in Single Sign On at https://sso.tamus.edu)
Yes, I certify that I am a resident of the state indicated below and subject to the state income tax withholding of that
state. (If this option is chosen, complete all sections below, sign, date and return to payroll@tamu.edu.)
City and State you claim residency:
City:_____________________________________ State:__________________
Employee Mailing Address (City & State only):
City:_____________________________________ State:__________________
No, an out-of-state residence is listed for me because I am/will be moving to that residence due to my TAMU
employment ending on ____________ or going on LWOP effective ____________ (Enter the dates associated with each option).
By selecting this option I am certifying that I will not be working for TAMU while residing out-of-state.
(If this option is chosen, you may skip the remainder of this form, sign, date and return to payroll@tamu.edu.)
WITHHOLDING BASIS
Please select one of the options below to provide a basis for deducting state income tax if you work and/or reside in a state other than
Texas and it is determined you are subject to that state’s income tax.
Withhold State Income Tax based upon the attached state withholding allowance form. You must print and return this form.
State W-4 forms can be found at http://www.bls.gov/jobs/statetax.htm. Please complete and return along with this form.
As a resident of Colorado, Delaware, Idaho, Montana, Nebraska, New Mexico, North Dakota, Oklahoma, Oregon, Pennsylvania, South
Carolina or Utah withhold State Income Tax on the same basis as my current federal tax Form W-4. These states do not have a state
withholding allowance form.
MILITARY VERIFICATION
YES
NO
Are you currently serving in the Armed Forces?
Are you the spouse of someone serving in the Armed Forces?
If you are a military spouse, please complete page 2.
If you are not a military spouse, please disregard page 2.
Please make sure we have your correct address. You may review your address in Single Sign On (SSO) at https://sso.tamus.edu.
**IF THERE ARE CHANGES IN YOUR RESIDENCE CITY/STATE, COMPLETE THIS FORM AGAIN BASED ON THE CHANGE NEEDED AND SUBMIT.
IT IS YOUR RESPONSIBILITY TO NOTIFY US OF A CHANGE SO THAT WE MAY UPDATE YOUR SIT WITHHOLDING WITHIN A TIMELY MANNER.
__________________________________________________
__________________________________________________
____________________
Employee Name—Print
Employee Signature
Date
#318 Employee State Income Tax (SIT) Verification
DIVISION OF FINANCE
TAX COMPLIANCE & REPORTING
Complete only if you are a Military Spouse
Military Spouse Residency Relief Act (MSRRA)
A military spouse is exempt from income taxes in a state where income was earned when all four
qualifications are met:
The spouse currently resides in a state different than the state of his or her domicile;
The spouse resides in the state solely to live with the service member;
The service member is present in the state in compliance with military orders; and
The spouse and service member are both able to claim the same domicile.
Please click the below link for more information on the Military Spouse Residency Relief Act
http://www.taxadmin.org/fta/rate/s_475.pdf
If you are a military spouse, please select the correct box to answer the following questions:
Yes No
1. Do you reside in a state different than the state of your domicile?
2. Do you reside in the state solely to live with the service member?
3. Is the service member in the state due to military orders?
4. Are you and the service member able to claim the same domicile?
Proof of your eligibility for exemption under the MRRA will be needed. Notification of the required documentation
needed to verify your eligibility will be sent once the completed SIT verification form has been received.
__________________________________________________
__________________________________________________
____________________
Employee Name—Print
Employee Signature
Date
SUBMIT FORM(S) TO:
Texas A&M University
Tax Compliance & Reporting
Attn: Cynthia Flemings
#318 Employee State Income Tax (SIT) Verification
SUBMIT VIA:
EPA: Include with your EPA Docs
Email:tax@tamu.edu
Fax: (979) 845-3131
Mail: 6003 TAMU, College Station,
Texas 77843-6003
QUESTIONS:
tax@tamu.edu
979-458-4095
Website: payroll.tamu.edu/tax/stateincome-tax/
CLGS-32-6 (8-11)
**Pennsylvania Residents Only**
RESIDENCY CERTIFICATION FORM
Local Earned Income Tax Withholding
TO E M P L O Y E R S / TA X PAY E R S :
This form is to be used by employers and/or taxpayers to report essential information for the collection and distribution of Local Earned Income Taxes.
This form must be utilized by employers when a new employee is hired or when a current employee notifies employer of a name and/or address change.
EMPLOYEE INFORMATION - RESIDENCE LOCATION
NAME (Last Name, First Name, Middle Initial)
SOCIAL SECURITY NUMBER
STREET ADDRESS (No PO Box, RD or RR)
SECOND LINE OF ADDRESS
CITY
STATE
ZIP CODE
DAYTIME PHONE NUMBER
MUNICIPALITY (City, Borough or Township)
COUNTY
RESIDENT PSD CODE
TOTAL RESIDENT EIT RATE
EMPLOYER INFORMATION - EMPLOYMENT LOCATION
EMPLOYER BUSINESS NAME (Use Federal ID Name)
EMPLOYER FEIN
STREET ADDRESS WHERE ABOVE EMPLOYEE REPORTS TO WORK (No PO Box, RD or RR)
SECOND LINE OF ADDRESS
CITY
STATE
ZIP CODE
PHONE NUMBER
MUNICIPALITY (City, Borough or Township)
COUNTY
WORK LOCATION PSD CODE
WORK LOCATION NON-RESIDENT EIT RATE
CERTIFICATION
Under penalties of perjury, I (we) declare that I (we) have examined this information, including all accompanying
schedules and statements and to the best of my (our) belief, they are true, correct and complete.
SIGNATURE OF EMPLOYEE
PHONE NUMBER
DATE (MM/DD/YYYY)
EMAIL ADDRESS
For information on obtaining the appropriate MUNICIPALITY (City, Borough, Township), PSD CODES and EIT (Earned Income Tax) RATES,
please refer to the Pennsylvania Department of Community & Economic Development website:
www.newPA.com
** Texas A&M TEXARKANA Employees **
Please review the following Texarkana Withholding Rules and
complete one of the AR4EC withholding forms.
STATE OF ARKANSAS
Department of Finance
and Administration
REVENUE DIVISION
Individual Income Tax
Withholding Branch
th
7 and Wolfe Streets, Room 1362
Post Office Box 8055
Little Rock, Arkansas 72203-8055
Phone: (501) 682-7290
Fax:(501)683-1036
http://www.state.ar.us/dfa
Texarkana Withholding Exemption Rules
This is a brief explanation of the rules concerning the taxability of income earned from Arkansas sources while a
resident of Texarkana, Arkansas or Texarkana, Texas. This exemption only applies if the taxpayer is living within
the city limits of Texarkana, Arkansas or Texarkana, Texas. The exemption does not apply if the taxpayer lives on a
rural route or in a town in the surrounding area of Texarkana. This supersedes any previous withholding rules. Any
questions should be referred to the Arkansas Withholding Branch.
Texarkana, Arkansas Residents
Arkansas residents whose permanent residence is within the city limits of Texarkana, Arkansas are exempt from
Arkansas individual income taxes. All income received is exempt while the taxpayer is a resident of Texarkana,
Arkansas. The taxpayer is required to file an Arkansas Individual Income Tax Return and submit all appropriate W2’s and schedules to support the income and deductions. The form AR-TX is also submitted with the tax return
which reports the exempt amount of wages earned from a particular employer.
Arkansas employers are not required to withhold Arkansas taxes on these employees as long as a form AR-TX is
completed stating that the employee actually lives within the city limits of Texarkana, Arkansas and reports the
amount of exempt wages. This form is completed by the employer and given to the employee to be filed with the
Arkansas individual income tax return. A copy is also sent to the State Withholding Branch along with the state’s
copy of W-2’s.
Arkansas employers are required to withhold Arkansas taxes if the employee moves from Texarkana, Arkansas.
The form AR-TX will then report only the exempt amount of wages (Those earned while a resident of Texarkana,
Arkansas)
Texarkana, Texas Residents
Texas residents whose permanent residence is within the city limits of Texarkana, Texas are exempt from
Arkansas individual income taxes on income earned from businesses in Texarkana, Arkansas only. This is the only
income that is exempt. Any income received from any other sources in Arkansas is fully taxable. The taxpayer is
required to file an Arkansas Individual Income Tax Return and submit all appropriate W-2’s and schedules to
support the income and deductions. The form AR-TX is also submitted with the tax return which reports the exempt
amount of wages earned from a particular employer.
Texarkana, Arkansas employers are not required to withhold Arkansas taxes on these employees as long as a form
AR-TX is completed stating that the employee actually lives within the city limits of Texarkana, Texas and reports
the amount of exempt wages.
This form is completed by the employer and given to the employee to be filed with the Arkansas individual income
tax return. A copy is also sent to the State Withholding Branch along with the State’s copy of W-2’s.
Non-Texarkana, Arkansas employers must withhold Arkansas taxes on employees regardless of the fact that they
live in Texarkana, Texas.
“EQUAL OPPORTUNITY EMPLO YER”
AR4EC
STATE OF ARKANSAS
Employee’s Withholding Exemption Certificate
Print Full Name_ ________________________________________________ Social Security Number_____________________________________
Print Home Address______________________________________________ City______________________________State_ _____ Zip__________
How to Claim Your Withholding
Employee:
File this form with
your employer.
Otherwise, your
employer must
withhold state
income tax from
your wages without
exemptions or
dependents.
Employer:
Keep this certificate
with your records.
See instructions below
Number of Exemptions
Claimed
1. CHECK ONE OF THE FOLLOWING FOR EXEMPTIONS CLAIMED
a.
You claim yourself. (Enter one exemption).......................................................................1a
b.
You claim yourself and your spouse. (Enter two exemptions)..........................................1b
c.
Head of Household, and you claim yourself. (Enter two exemptions)..............................1c
2. NUMBER OF CHILDREN or DEPENDENTS. (Enter one exemption per dependent).................. 2
3. TOTAL EXEMPTIONS. (Add Lines 1a, b, c, and 2)
If no exemptions or dependents are claimed, enter zero............................................................... 3
4. Additional amount, if any, you want deducted from each paycheck. (Enter dollar amount).......... 4
5. I qualify for the low income tax rates. (See below for details)........................................................ 5 Please check filing status:
Single
Married Filing Jointly
Head of Household
Yes
No
I certify that the number of exemptions and dependents claimed on this certificate does not exceed the number to which I am entitled.
Signature:_______________________________________________________________________________________Date:__________________ Instructions
TYPES OF INCOME - This form can be used for withholding on all types
of income, including pensions and annuities.
NUMBER OF EXEMPTIONS – (Husband and/or Wife) Do not claim more
than the correct number of exemptions. However, if you expect to owe more
income tax for the year, you may increase your withholding by claiming a
smaller number of exemptions and/or dependents, or you may enter into an
agreement with your employer to have additional amounts withheld. This is
especially important if you have more than one employer, or if both husband
and wife are employed.
DEPENDENTS – To qualify as your dependent (line 2 of form), a person
must (a) receive more than 1/2 of their support from you for the year, (b)
not be claimed as a dependent by such person’s spouse, (c) be a citizen
or resident of the United States, and (d) have your home as their principal
residence and be a member of your household for the entire year or be
related to you as follows: son, daughter, grandchild, stepson, stepdaughter,
son-in-law or daughter-in-law; your father, mother, grandparent, stepfather,
stepmother, father-in-law or mother-in-law; your brother, sister, stepbrother,
stepsister, half brother, half sister, brother-in-law or sister-in-law; your uncle,
aunt, nephew or niece (but only if related by blood).
CHANGES IN EXEMPTIONS OR DEPENDENTS – You may file
a new certificate at any time if the number of exemptions or dependents
INCREASES. You must file a new certificate within 10 days if the number
of exemptions or dependents previously claimed by you DECREASES for
any of the following reasons:
AR4EC (R 12/29/14)
(a) Your spouse for whom you have been claiming an exemption is divorced or legally separated from you, or claims
his or her own exemption on a separate certificate, or
(b) The support you provide to a dependent for whom you claimed
an exemption is expected to be less than half of the total support for the year.
OTHER DECREASES in exemptions or dependents, such as the death of a
spouse or a dependent, does not affect your withholding until next year, but
requires the filing of a new certificate by December 1 of the year in which
they occur.
You may claim additional amounts of withholding tax if desired. This will
apply most often when you have income other than wages.
You qualify for the low income tax rates if your total income from all
sources is:
(a) Single
$11,591 to $15,200
(b) Married Filing Jointly
$19,547 to $24,400
1 or less dependents)
(c) Married Filing Jointly
$23,525 to $30,400
(2 or more dependents)
(d) Head of Household/Qualifying Widow(er) $16,479 to $21,400
(e) Head of Household/Qualifying Widow(er) $19,644 to $24,200
(2 or more dependents)
For additional information consult your employer or write to:
Arkansas Withholding Tax Section
P. O. Box 8055
Little Rock, Arkansas 72203-8055
FORM AR4EC(TX)
State of Arkansas
Texarkana Employee's Withholding Exemption Certificate
Employee Full Name
SSN
Employee Address
City
State
Zip
If Texarkana Exmption is Claimed for Arkansas Income Tax Withholding, Check One of the Following:
Texarkana, ARKANSAS (resident within city limits only)
Texarkana, TEXAS (resident within city limits only)
The above information is correct as of this date:
Under penalty of perjury, I certify that the above information is true and if there is a change in my status, I will
notify my employer within seven (7) days after the change occurs.
Signature
Date
INSTRUCTIONS FOR THE TEXARKANA EXEMPTION CERTIFICATE
Any employee who qualifies for the exemption should check the appropriate box then sign and date the form.
The place of physical residency should be placed in the employee address field. A post office box or route
number is not acceptable.
It is the responsibility of the employee to notify the employer within seven (7) days after any change to the
exemption claimed.
The completed certificate should be maintained by the employer.
The employer does not have the authority to cease withholding Arkansas Income Tax unless the employee
qualifies for, and checks, one the exemptions above.
Employees exempt from Arkansas Withholding, who would be required to file a return without the exemption,
must still file an Arkansas Individual Income Tax return.
If you have any questions regarding the Texarkana exemption please contact the Withholding Tax Department
at 501-682-7290.