Incentive Withholding Worksheet Page 2

INSTRUCTIONS

The withholding ratio for the prior tax year should be used for the current tax year withholding filings. This worksheet must

be submitted with the Nebraska Withholding Return, Form 941N, filed for the first full calendar quarter of the current tax year.

The previously reported or audited ratio may be used for the withholding filings prior to the due date of the first full calendar

quarter’s Form 941N.

Attach this worksheet to the Nebraska Withholding Return, Form 941N, for the first full calendar quarter of the tax year and to

the Nebraska Reconciliation of Income Tax Withheld, Form W-3N. If the forms are filed electronically, the Incentive Withholding

Worksheet should be mailed to the Nebraska Department of Revenue, P.O. Box 98915, Lincoln, Nebraska 68509-8915.

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