Schedule M1w - Minnesota Income Tax Withheld - 2012

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Schedule M1W, Minnesota Income Tax Withheld 2012

Sequence #2

Complete this schedule to report Minnesota income tax withheld. Include this schedule when you file your return.

Your first name and initial

Your Social Security number

Last name

Spouse's Social Security number

If joint return, spouse's first name & initial

Last name

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.

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

• you, enter 1

box is checked,

state tax ID number

(round to nearest whole dollar)

• spouse, enter 2

mark an X below.

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.

If the 1099 or W-2G is for:

Payer’s 7-digit Minnesota state tax ID

Income amount (see the table on

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

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

You must include this schedule with your Form M1.

If required, also include a copy of Schedules KPI, KS and/or KF.