Form Mwr - Minnesota Reciprocity Exemption/affi Davit Of Residency For Tax Year - 2014 Page 2

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Instructions for Form MWR
Instructions for Employees
Penalties
If an employee does not fi ll in every item of
Form MWR or does not provide the form
If you make any statements on this form
Minnesota has income tax reciprocity
to you by the due date, you must withhold
that you know are incorrect, you may be
agreements with Michigan and North
Minnesota income tax, using the same
assessed a $500 penalty.
Dakota.
marital status and number of allowances
Use of Information
If you are a resident of one of these two
claimed on the employee’s federal Form
states and you return to your residence in
All information on Form MWR is private by
W-4.
Michigan or North Dakota at least once a
state law. It may only be given to your state
If the employee provides you with a prop-
month, you do not have to pay Minnesota
of residence, the Internal Revenue Service,
erly completed Form MWR, the employee
income tax on wages you earn for work per-
and to other state tax agencies as provided
is not required to complete Form W-4MN
formed in Minnesota. However, you may be
by law. Th e information may be compared
to claim exemption from Minnesota income
required to pay tax on this income to your
with other information you gave to the
tax withholding.
state of residence.
Department of Revenue.
Submit Completed Forms MWR to
If you’re a resident of Michigan or North
Your name, address and Social Security
the Department
Dakota and do not want Minnesota tax
number are required for identifi cation. Your
By March 31 of each year, send the com-
withheld from your wages, complete this
address is also required to verify your state
pleted Forms MWR to Minnesota Revenue,
form and give it to your employer by the
of residence. Your employer’s name, federal
Mail Station 6501, St. Paul, MN 55146-6501.
later of February 28 or within 30 days
tax ID number, address and phone number
You must keep a copy of all forms for fi ve
aft er you begin working or change your
are required. If you do not complete the
years from the date received.
permanent residence. You must give your
information, your employer is required to
employer a new form each year you do not
withhold Minnesota income tax from your
For new employees or employees who
want Minnesota tax withheld from your
wages.
change their state of residence, send the
wages. You do not need to complete Form
form within 30 days aft er the employee
Th e only information not required is your
W-4MN, Minnesota Employee Withholding
gives it to you.
phone number. However, we ask that you
Allowance/Exemption Certifi cate, to claim
provide it so we can contact you if we have
You may be assessed a $50 penalty for each
exemption from Minnesota withholding
questions.
form you are required to send us but do not.
tax.
Instructions for Employers
Fill Out the Form Completely
Information and Assistance
If you do not fi ll in every item on this form
Employees who reside in Michigan or North
Additional forms and information, includ-
or do not give the form to your employer by
Dakota who ask you not to withhold Min-
ing fact sheets and frequently asked ques-
the due date, your employer must withhold
nesota income tax from their wages must
tions, are available on our website.
Minnesota income tax from your wages
complete this form and give it to you each
Website:
using the same marital status and number
year by the later of February 28 or within
of allowances you claimed on your federal
30 days aft er they begin working for you or
Email: withholding.tax@state.mn.us
Form W-4.
change their residence. Employees who live
Phone: 651-282 9999 or 1-800-657-3594.
in other states, including Minnesota, cannot
To Get a Refund of Tax Already
use this form.
We’ll provide information in other formats
Withheld for the Year
upon request to persons with disabilities.
File Form M1, Minnesota Individual Income
Tax Return, with the Minnesota Depart-
ment of Revenue. See the M1 Instructions
for details.

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