Schedule M1w - Minnesota Income Tax Withheld - 2017

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2017 Schedule M1W, Minnesota Income Tax Withheld
Complete this schedule to report Minnesota income tax withheld. Include this schedule when you file your return.
Your First Name and Initial
Last Name
Your Social Security Number
If a Joint Return, Spouse’s First Name and Initial
Spouse’s Last Name
Spouse’s Social Security Number
If you received a W-2, 1099, W-2G, Schedule KPI, KS, or KF that shows Minnesota income tax was withheld, complete this schedule to
determine line 23 of Form M1. List only the forms that report Minnesota income tax withheld. Round dollar amounts to the nearest whole
dollar. You must include this schedule when you file your return. DO NOT send in your W-2, 1099, or W-2G forms; keep them with your tax
records. All instructions are included on this schedule.
1 Minnesota wages and tax withheld from W-2s, other than from W-2G. If you have more than five W-2s, complete line 5 on the back.
A
B—Box 13
C—Box 15
D—Box 16
E—Box 17
If the W-2 is for:
If Retirement Plan
Employer’s 7-digit Minnesota
State wages, tips, etc.
Minnesota tax withheld
(round to nearest whole dollar)
(round to nearest whole dollar)
• you, enter 1
box is checked
state tax ID number
• spouse, enter 2
mark an X below.
MN
MN
MN
MN
MN
Subtotal for additional W-2s (from line 5 on the back) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Total Minnesota tax withheld from all W-2 forms (add amounts in line 1, column E) . . . . . . . . . . . . . . . . . . . 1
2 Minnesota tax withheld from 1099 and W-2G forms. If you have more than four forms, complete line 6 on the back.
A
B
C
D
Income amount (see the table on
If the 1099 or W-2G is for:
Payer’s 7-digit Minnesota state tax ID
Minnesota tax withheld
you, enter 1
number (if unknown, contact the payer)
the back for amounts to include)
(round to nearest whole dollar)
spouse, enter 2
MN
MN
MN
MN
Subtotal for additional 1099 and W-2G forms (from line 6 on the back) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Total Minnesota tax withheld from all 1099 and W-2G forms (add amounts in line 2, column D) . . . . . . . . . 2
3 Total Minnesota tax withheld by partnerships, S corporations, and fiduciaries
(from line 7 on the back) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
4 Total. Add the Minnesota tax withheld on lines 1, 2 and 3.
Enter the total here and on line 23 of Form M1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4
Include this schedule with your Form M1.
If required, include Schedules KPI, KS, and/or KF.
9995

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