Form It-2104 - Employee'S Withholding Allowance Certificate - 2009
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2IT-2104
New York State Department of Taxation and Finance
Employee’s Withholding Allowance Certificate
(4/09)
New York State • New York City • Yonkers
First name and middle initial
Last name
Your social security number
Permanent home address
Apartment number
(number and street or rural route)
Single or Head of household
Married
Married, but withhold at higher single rate
City, village, or post office
State
ZIP code
Note: If married but legally separated, mark an X in
the Single or Head of household box.
Are you a resident of New York City? ........... Yes
No
Are you a resident of Yonkers? ..................... Yes
No
Complete the worksheet on page 3 before making any entries.
1.
1 Total number of allowances you are claiming for New York State and Yonkers, if applicable
.............
(from line 20)
2.
2 Total number of allowances for New York City
...................................................................................
(from line 31)
Use lines 3, 4, and 5 below to have additional withholding per pay period under special agreement with your employer.
3 New York State amount ..........................................................................................................................................
3.
4 New York City amount ............................................................................................................................................
4.
5 Yonkers amount .....................................................................................................................................................
5.
I certify that I am entitled to the number of withholding allowances claimed on this certificate.
Employee’s signature
Date
Penalty — A penalty of $500 may be imposed for any false statement you make that decreases the amount of money you have
withheld from your wages. You may also be subject to criminal penalties.
Employee: detach this page and give it to your employer; keep pages 3 and 4 for your records.
Employers only: Please mark an X in the appropriate box(es) to indicate why you are sending a copy of this form to New York State:
Employee is a new hire
Employee claimed more than 14 exemption allowances for New York State
Employer’s name and address (Employer: complete this section only if you must send a copy of this form to the NYS Tax Department.) Employer identification number
Instructions
Changes effective for 2009
• Your individual circumstances may have changed (for example, you
were married or have an additional child).
As a result of recent law changes, the New York State personal income tax
and Yonkers resident personal income tax surcharge rates have increased
• You itemize your deductions on your personal income tax return.
for certain taxpayers.
• You claim allowances for New York State credits.
Employers have been notified of any new withholding tables to ensure that
• You owed tax or received a large refund when you filed your personal
the proper amount of tax is withheld for 2009 without any further action on
income tax return for the past year.
your part. However, in certain instances the new tables may result in an
• Your wages have increased and you expect to earn $100,000 or more
insufficient amount of tax being withheld. If you have more than one job, or
during the tax year.
if you are married and both spouses work, you should complete this revised
• The total income of you and your spouse has increased to $100,000 or
Form IT-2104 and give it to your employer. If you do not file a revised
more for the tax year.
Form IT-2104 in these circumstances, you may be underwithheld for New
York State and Yonkers purposes (see Avoid underwithholding on page 2).
• You have significantly more or less income from other sources or from
another job.
Who should file this form
• You no longer qualify for exemption from withholding.
This certificate, Form IT-2104, is completed by an employee and given
• You have been advised by the Internal Revenue Service that you
to the employer to instruct the employer how much New York State (and
are entitled to fewer allowances than claimed on your original federal
New York City and Yonkers) tax to withhold from the employee’s pay. The
Form W-4, and the disallowed allowances were claimed on your original
more allowances claimed, the lower the amount of tax withheld.
Form IT-2104.
If you do not file Form IT-2104, your employer may use the same number
of allowances you claimed on federal Form W-4. Due to differences in
Exemption from withholding
tax law, this may result in the wrong amount of tax withheld for New York
You cannot use Form IT-2104 to claim exemption from withholding.
State, New York City, and Yonkers. Complete Form IT-2104 each year
To claim exemption from income tax withholding, you must file
and file it with your employer if the number of allowances you may claim
Form IT-2104-E, Certificate of Exemption from Withholding, with your
is different from federal Form W-4 or has changed. Common reasons for
employer. You must file a new certificate each year that you qualify for
completing a new Form IT-2104 each year include the following:
exemption. This exemption from withholding is allowable only if you had
• You started a new job.
no New York income tax liability in the prior year, you expect none in the
current year, and you are over 65 years of age, under 18, or a full-time
• You are no longer a dependent.
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