Form M-4-Ms - Annual Withholding Tax Exemption Certificate For Nonresident Military Spouse

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Form M-4-MS
Massachusetts
Annual Withholding Tax Exemption
Department of
Certificate for Nonresident Military Spouse
Revenue
Read instructions below before completing this form. After completion, give the certificate to your employer. Keep a copy for your records.
Employee name
Employee Social Security number
Military servicemember spouse’s name
Spouse’s Social Security number
Street address where you both currently reside
City/Town
State
Zip
Telephone
Name of military servicemember’s station
City/Town
State
Zip
Telephone
Form M-4-MS is to be used only for employees claiming exemption from Massachusetts income tax withholding requirements because they meet the
conditions set forth under the Servicemembers Civil Relief Act, as amended by the Military Spouses Residency Relief Act (P.L. 111-97).
I certify that:
• I am a legal resident (domiciliary) of the state of
;
• My military servicemember spouse’s domicile is the same as mine;
• My spouse is a member of the armed forces and is present in or near Massachusetts in compliance with military orders; and
• I am present in Massachusetts solely to be with my spouse.
I no longer qualify for the exemption as of (date)
Under penalties of perjury, I declare that to the best of my knowledge and belief the above information is true, correct, and complete.
Employee signature
Date
Telephone
Notice to Employers
Domicile
In order to claim domicile in a state other than the state in which you
Employers are not exempt from withholding tax liability for failing to
currently reside you must have proof that you meet one or more of
withhold the proper Massachusetts tax on a military spouse unless
the criteria listed below. If you previously were not a domiciliary of an-
they have a properly completed Massachusetts Form M-4-MS and sat-
other state you cannot claim that state as your domicile merely by
isfy the additional requirements set forth below.
making an election.
Requirements of Employer
Domicile is a place where a person has established permanent resi-
The employee must show the employer an original of the employee’s
dence with an intention to dwell in that place permanently and to return
current military spouse ID and provide a clear photocopy. The em-
to it after absence. An individual has only one state of domicile at any
ployer must ensure that the ID denotes the employee as a current mili-
time and loses his or her current domicile only when he or she estab-
tary spouse. These IDs are reissued every four years; accordingly,
lishes a new domicile. The domicile is created based on performing
the employer may not accept a military ID that is dated more than four
one or more of the following actions.
years before the date on which it is given to the employer. In addition
to a copy of the military spouse ID, the employee must provide to the
Criteria Used to Determine State of Domicile
employer copies of the following:
Property, ownership and residence. Homestead status; the location
of permanent home; mailing address; amount of time spent in a state.
• Department of Defense Form 2058, State of Legal Residence Cer-
tificate of servicemember;
Financial data. Location of bank accounts; where taxpayer qualifies
for unemployment benefits; state where prior resident tax returns
• Most recent LES, Leave and Earnings Statement, of servicemem-
were filed; state where business is conducted; state where wages
ber; and
are earned.
• Servicemember’s current military orders assigning such service-
Licenses and registrations. Where taxpayer is registered to vote;
member to a post of duty in or near Massachusetts.
state driver’s license; state where vehicles are registered; state where
The employer must keep the Form M-4-MS with the employee’s per-
professional licenses are maintained.
sonnel records. If the employer believes the employee has improperly
Affiliations. Location of fraternal, social or athletic memberships;
claimed the Nonresident Military Spouse Residency Withholding Ex-
union membership location; place of worship.
emption, the employer must contact the Department of Revenue.
Family and dependents. Place of family ties for employee, service-
Note: The Form M-4-MS must be validated on an annual basis. The
member spouse and dependents.
spouse must show continued eligibility for the exemption. Scenarios
that will cause the spouse to no longer be eligible include:
Single Domicile Factor Not Sufficient
• Servicemember leaves the service;
No single factor determines a person’s state of domicile; all factors
must be evaluated together.
• Divorce;
A person’s permanent residence, once established, continues as their
• Voluntary physical separation due to duty changes. The service-
state of domicile until they take steps to establish a new domicile in
member’s orders move him or her to a location outside Massachusetts
another state.
where the spouse is allowed to join him or her but chooses not to; or
• Spouse commits an action that clearly establishes Massachusetts
as his or her state of domicile.
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