Moving Expense Tax Form (Page 2 of 2) in pdf

Instructions - This form must be prepared for all moving expenses not paid through the HRMIS system. The head of the employee’s

department should prepare it with assistance from the Controller’s Office and the newly relocated employee. In Part I, list any

payments made directly to employees and any payments made to third parties such as moving companies or hotels. Part II, must be

completed because certain moving expenses can be excluded from the employee's taxable wages if the University has documentation

that the employee's new work site is at least 50 miles farther from his former residence than his old work-site was from his old

residence. The IRS provides a standard rate of 27 cents per mile for employees who use their automobiles in connection with a move. If

the University reimburses the employee at the rate of 58.5 cents per mile, then 27 cents per mile should be shown in item A and the

other 31.5 cents per mile in item C. This form cannot be processed without the required signatures in Part III.

See EXAMPLE:

I. Payments: Payment Description Amount Paid by University of Mass

A. Transportation and storage of household goods and personal effects

1. Auto mileage reimbursement at 27 cents per mile

2. Moving household goods

5,000

Sub-Total Part I, Section A

$ 5,000

B. Travel and lodging payments for expenses while moving from old to new home (show temporary living in item C.)

1. Moving family, airfare

1,000

Sub-Total Part I, Section B

$ 1,000

C. List of all other payments (specify)

1. Auto mileage reimbursement in excess of 27 cents per mile.

2. Temporary living expenses

2,800

3. House-hunting

1,200

4. Costs of breaking lease on old residence

800

5. Meals in conjunction with house hunting

200

6. Hiring bonus

2,000

Sub-Total Part I, Section C

$ 7,000

$ 13,000

Total Payments

II. Does the move meet the 50 mile IRS test?

__X__ YES _____NO

III. Required Signatures

____________________________________

__________________________________ ___________________ _______

Employee's Signature

Employee's Name (please print)

Employee's ID#

Date

____________________________________

__________________________________

____________

Department Head’s Signature

Department Head’s Name (please print)

Date

____________________________________

_________________________________

___________

Vice Chancellor’s Signature

Vice Chancellor’s Name (please print)

Date

Tax Result - For federal tax purposes, $7,000 ($13,000 total less a $6,000 exclusion for moving household goods and family) is taxable

as federal and state wages to the new employee. The $6,000 exclusion is available because the 50 mile test is met.

November 2008

Moving Expense Tax Form Page 2

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