Form Mwr - Reciprocity Exemption/affidavit Of Residency For Tax Year 2011 - 2011 Page 2
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1
2Instructions for Form MWR
Instructions for employees
Instructions for employers
• a paper return, include this form when
you file your Form M1.
Minnesota has income tax reciprocity agree-
Employees who reside in Michigan or
ments with Michigan and North Dakota.
North Dakota who ask you not to withhold
If your return has already been filed, mail
Minnesota income tax from their wages
this form to Minnesota Revenue, Mail Sta-
If you are a resident of one of these two
must complete this form and give it to you
tion 6501, St. Paul MN 55146-6501.
states and you return to your residence in
each year by February 28 or within 30 days
Michigan or North Dakota at least once a
Fill out the form completely
after they begin working for you or change
month, you do not have to pay Minnesota
their residence. Employees who live in other
If you do not fill in every item on this form,
income tax on wages you earn for work in
states, including Minnesota, cannot use this
your employer must withhold Minnesota
Minnesota. You must, however, pay tax to
form.
income tax from your wages using the same
your state of residence on wages earned
marital status and number of allowances
from a Minnesota employer.
If an employee does not fill in every item of
you claimed on your federal Form W-4.
Form MWR, you must withhold Minnesota
If you do not want Minnesota tax with-
income tax, using the same marital status
Sign and date the form. Fill in a phone
held from your wages, complete this form
and number of allowances claimed on the
number where you can be reached during
and give it to your employer by February 28,
employee’s federal Form W-4.
the day.
or within 30 days after you begin working
or change your permanent residence. You
If the employee provides you with a prop-
Penalties
must give your employer a new form each
erly completed Form MWR, the employee
If you make any statements on this form
year if you want to stay exempt from Min-
is not required to complete Form W-4MN
that you know are incorrect, you may be
nesota withholding tax. Do not complete
to claim exemption from Minnesota income
assessed a $500 penalty.
Form W-4MN, Minnesota Employee With-
tax withholding.
holding Allowance/Exemption Certificate, to
Use of Information
Submit completed Forms MWR to the
claim exemption from Minnesota withhold-
All information on Form MWR is private by
department. By March 31 of each year, send
ing tax.
state law. It may only be given to your state
the completed Forms MWR you received
of residence, the Internal Revenue Service
If you do not complete Form MWR and
to Minnesota Revenue, Mail Station 6501,
and to other state tax agencies as provided
give it to your employer by the due date,
St. Paul, MN 55146-6501. You must keep a
by law. The information may be compared
your employer must withhold Minnesota
copy of all forms for five years from the date
with other information you furnished to the
taxes from your wages.
received.
Department of Revenue.
If you want a refund of tax already
For new employees or employees who
Your name, address and Social Security
withheld for the year, and you want your
change their state of residence, send the
number are required for identification.
employer to:
form within 30 days after the employee
Your address is also required to verify your
gives it to you.
• continue withholding Minnesota tax
state of residence. Your employer’s name,
from your wages for next year, include
You may be assessed a $50 penalty for each
Minnesota tax ID number, address and
this form when you file your Form M1,
form you are required to send us but do not.
phone number are required in case we have
Minnesota Individual Income Tax Return.
to contact your employer regarding with-
Information and assistance
Do not give it to your employer.
holding tax from your wages. If you do not
• stop withholding Minnesota tax, give
complete the information, your employer is
If you need help or additional information,
this form to your employer and include a
required to withhold Minnesota income tax
call 651-282-9999 or 1-800-657-3594 (TTY:
copy when you file your Form M1.
from your wages.
Call 711 for Minnesota Relay). Or, send an
email to withholding.tax@state.mn.us.
If you have not yet filed your Form M1 and
The only information not required is your
you will be filing:
phone number. However, we ask that you
Forms are available on our website at
provide it so we can contact you quickly if
or by calling
• electronically, fax this form to the de-
we have questions.
651-296-4444 or 1-800-657-3676 from
partment at 651-556-5130 at least one
within Minnesota. You can also write for
business day before you electronically file
forms at the following address:
your return.
Minnesota Tax Forms
Mail Station 1421
St. Paul, MN 55146-1421
We’ll provide information in other formats
upon request to persons with disabilities.
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