Fillable Printable Employee's Withholding Certificate - Connecticut

Employee's Withholding Certificate - Connecticut

Employees: See Employee General Instructions on Page 2.Sign and return Form CT-W4 to your employer. Keep a copy for your records.

. Withholding Code: Enter Withholding Code letter chosen from above. .......................1.

2. Additional withholding amount per pay period: If any, see Page 3 instructions. . .........2. $

3. Reduced withholding amount per pay period: If any, see Page 3 instructions. ............3. $

Form

CT-W4

Employee’s Withholding Certiﬁ cate

Department of Revenue Services

State of Connecticut

(Rev. 06/12)

Effective January 1, 2012

* Filing jointly includes ﬁling jointly for federal and Connecticut and

ﬁling jointly for Connecticut only.

Our expected combined annual gross income is less than or

equal to $24,000 or I am claiming exemption under the Military

Spouses Residency Relief Act (MSRRA) *** and no withholding

is necessary. E

My spouse is employed and our expected combined annual

gross income is greater than $24,000 and less than or equal

to $100,500. See Certain Married Individuals, Page 2. A

My spouse isnot employed and our expected combined

annual gross income is greater than $24,000. C

My spouse is employed and our expected combined

annual gross income is greater than $100,500. D

I have signiﬁcant nonwage income and wish to avoid having

too little tax withheld. D

I am a nonresident of Connecticut with substantial other income. D

Withholding

Code

Filing Jointly *

My expected annual gross income is less than or equal to

$12,000 or I am claiming exemption under the MSRRA ***

and no withholding is necessary. E

My expected annual gross income is greater than $12,000. A

I have signiﬁcant nonwage income and wish to avoid having

too little tax withheld. D

I am a nonresident of Connecticut with substantial other income. D

Withholding

Code

Filing Separately **

My expected annual gross income is less than or equal to

$13,500 and no withholding is necessary. E

My expected annual gross income is greater than $13,500. F

I have signiﬁcant nonwage income and wish to avoid having

too little tax withheld. D

I am a nonresident of Connecticut with substantial other income. D

Withholding

Code

Single

My expected annual gross income is less than or equal to

$19,000 and no withholding is necessary. E

My expected annual gross income is greater than $19,000. B

I have signiﬁcant nonwage income and wish to avoid having

too little tax withheld. D

I am a nonresident of Connecticut with substantial other income. D

Withholding

Code

Head of Household

My expected annual gross income is less than or equal to

$24,000 or I am claiming exemption under the MSRRA ***

and no withholding is necessary. E

My expected annual gross income is greater than

$24,000. C

I have signiﬁ cant nonwage income and wish to avoid having

too little tax withheld. D

I am a nonresident of Connecticut with substantial other income. D

Withholding

Code

Qualifying Widow(er) With Dependent Child

Employee Instructions

• Read instructions on Page 2 before completing this form.

• Select the ﬁling status you expect to report on your Connecticut

income tax return. See instructions.

• Choose the statement that best describes your gross income.

• Enter the Withholding Code on Line 1 below.

Check if you are claiming

the MSRRA exemption

and enter state of legal

residence/domicile:

_____________________



Employers: See Employer Instructions on Page 2.

Complete this form in blue or black ink only.

** Filing separately includes ﬁling separately for federal and

Connecticut and ﬁling separately for Connecticut only.

*** If you are claiming the Military Spouses Residency Relief Act

(MSRRA) exemption, see instructions on Page 2.

First name Ml Last name

Home address Social Security Number

City/town State ZIP code

Declaration: I declare under penalty of law that I have examined this certiﬁ cate and, to the best of my knowledge and belief, it is true, complete,

and correct. I understand the penalty for reporting false information is a ﬁ ne of not more than $5,000, imprisonment for not more than ﬁ ve years,

or both.

Employee’s signature Date

Is this a new or rehired employee?



Yes



Enter date hired:

Employer’s business name

Employer’s business address Federal Employer Identiﬁ cation Number

City/town State ZIP code

Contact person Telephone number

mm/dd/yyyy

( )

Employee General Instructions

Form CT-W4, Employee’s Withholding Certificate,provides your

employer with the necessary information to withhold the correct amount

of Connecticut income tax from your wages to ensure that you will not

be underwithheld or overwithheld.

You are required to pay Connecticut income tax as income is earned

or received during the year. You should complete a newForm CT-W4

at least once a year or if your tax situation changes.

If your circumstances change, such as you receive a bonus or your

ﬁling status changes, you must furnish your employer with a new

Form CT-W4 within ten days of the change.

Gross Income

For Form CT-W4purposes, gross income means all income from all

sources, whether received in the form of money, goods, property, or

services, not exempt from federal income tax, and includes any additions

to income from Schedule 1 of Form CT-1040, Connecticut Resident

Income Tax Return or Form CT-1040NR/PY, Connecticut Nonresident

and Part-Year Resident Return.

Filing Status

Generally, the ﬁling status you expect to report on your Connecticut

income tax return is the same as the ﬁling status you expect to report on

your federal income tax return. However, special rules apply to married

individuals who ﬁle a joint federal return but have a different residency

status. Nonresidents and part-year residents should see the instructions

to Form CT-1040NR/PY.

If you are a spouse in a same sex marriage,youmust recalculate your

federal adjusted gross income as if your ﬁ ling status for federal income

tax purposes were married ﬁling jointly or married ﬁ ling separately.

Check Your Withholding

You may be underwithheld if any of the following apply:

• You have more than one job;

• You qualify under Certain Married Individuals and do not use the

Supplemental Table on Page 3 and Page 4; or

• You have substantial nonwage income.

If you are underwithheld, you should consider adjusting your withholding

or making estimated payments using Form CT-1040ES, Estimated

Connecticut Income Tax Payment Coupon for Individuals. You may also

select Withholding Code “D” to elect the highest level of withholding.

If you owe $1,000 or more in Connecticut income tax over and above

what has been withheld from your income for the prior taxable year, you

may be subject to interest on the underpayment at the rate of 1% per

month or fraction of a month.

You may be overwithheld if your combined annual income is more than

$200,000 but less than $700,000 and your Connecticut ﬁ ling status

is ﬁling jointly. To help determine if your withholding is correct, see

Informational Publication 2012(7), Is My Connecticut Withholding

Correct?

Nonresident Employees Working Partly Within and Partly

Outside of Connecticut

If you work partly within and partly outside of Connecticut for the same

employer, you should also complete Form CT-W4NA, Employee’s

Withholding or Exemption Certiﬁcate - Nonresident Apportionment, and

provide it to your employer. The information on Form CT-W4NA and

Form CT-W4 will help your employer determine how much to withhold

from your wages for services performed within Connecticut. To obtain

Form CT-W4NA, visit the Department of Revenue Services (DRS)

website at www.ct.gov/DRS or request the form from your employer.

Any nonresident who expects to have no Connecticut income tax liability

should choose Withholding Code “E.”

Certain Married Individuals

If you are a married individual ﬁling jointly and you and your spouse

both select Withholding Code “A,” you may have too much or too

little Connecticut income tax withheld from your pay. This is because

the phaseout of the personal exemption and credit is based on your

combined incomes. The withholding tables cannot reﬂect your exact

withholding requirement without considering the income of your spouse.

Form CT-W4 (Rev. 06/12)

To minimize this problem, use the Supplemental Table on Page 3 and

Page 4 to adjust your withholding. You are not required to use this table.

Do not use the supplemental table to adjust your withholding if you use

the worksheet in IP 2012(7).

Armed Forces Personnel and Veterans

If you are a Connecticut resident, your armed forces pay is subject to

Connecticut income tax withholding unless you qualify as a nonresident

or Connecticut income tax purposes.

If you qualify as a nonresident,

you may request that no Connecticut income tax be withheld from your

armed forces pay by entering Withholding Code “E” on Line 1.

Military Spouses Residency Relief Act (MSRRA)

If you are claiming an exemption from Connecticut income tax under the

MSRRA, you must provide your employer with a copy of your military

spouse’s Leave and Earnings Statement (LES) and a copy of your

military dependent ID card.

See Informational Publication

2009(21), Connecticut Income Tax

Information for Armed Forces Personnel and Veterans.

Employer Instructions

For any employee who does not complete Form CT-W4, you are required

to withhold at the highest marginal rate of 6.7% without allowance for

exemption. You are required to keep Form CT-W4 in your ﬁ les for

each employee. See Informational Publication 2012(1),Connecticut

Employer’s Tax Guide,Circular CT,for complete instructions.

Report Certain Employees Claiming Exemption From Withholding

to DRS

Employers are required to ﬁle copies of Form CT-W4 with DRS for

certain employees claiming “E” (no withholding is necessary). See

IP 2012(1). Mail copies of Forms CT-W4 meeting the conditions listed

in IP 2012(1) under Reporting Certain Employees to DRS on Page 12

with Form CT-941, Connecticut Quarterly Reconciliation of Withholding,

if you ﬁle a paper return. If you ﬁle Form CT -941 electronically, mail only

the copies of Forms CT-W4 meeting the conditions listed in IP 2012(1) to:

DRS, PO Box 2931, Hartford CT 06104-2931.

Report New and Rehired Employees to the Department of Labor

(DOL)

New employees are workers not previously employed by your business,

or workers rehired after having been separated from your business for

more than sixty consecutive days.

Employers with offices in Connecticut or transacting business in

Connecticut are required to report new hires to the DOL within 20 days

of the date of hire.

New hires can be reported by:

•Using the Connecticut New Hire Reporting website at

www.ctnewhires.com;

• Faxing copies of completed Forms CT-W4 to 800-816-1108; or

• Mailing copies of completed Forms CT-W4 to:

CT Department of Labor

Ofﬁce of Research, Form CT-W4

200 Folly Brook Boulevard

Wethersﬁeld CT 06109

For more information on DOL requirements or for alternative reporting

options, visit the DOL website at www.ctdol.state.ct.us or call DOL

at 860-263-6310.

For More Information

Call DRS during business hours, Monday through Friday:

• 800-382-9463 (Connecticut calls outside the Greater Hartford calling

area only); or

• 860-297-5962 (from anywhere).

TTY, TDD, and Text Telephone users only may transmit inquiries

anytime by calling 860-297-4911.

Forms and Publications

Visit the DRS website at www.ct.gov/DRS to download and print

Connecticut tax forms and publications.

Page 2 of 4

2,000 4,000 6,000 8,000 10,000 12,000 14,000 16,000 18,000 20,000 22,000 24,000 26,000

3,0000 0 0 0 0 0 (15) (42) (99) (156) (248) (318) (485)

6,0000 0 0 0 0 0 (15) (42) (99) (141) (225) (295) (414)

9,0000 0 0 0 0 0 (15) (35) (77) (119) (182) (192) (308)

12,0000 0 0 0 0 0 0 (12) (54) (48) (60) (106) (249)

15,000(23) (23) (23) (23) (15) 0 0 9 27 36 (24) (70) (162)

18,000(99) (99) (99) (84) (69) (54) (6) 54 36 18 (42) 20 (111)

21,000(203) (195) (180) (165) (129) (54) (3) 9 (9) 24 27 10 (87)

24,000(325) (310) (295) (232) (145) (106) (82) (70) 20 14 0 0 (12)

27,000(586) (550) (475) (409) (370) (331) (256) (181) (170) (142) (113) (6) 25

30,000(792) (705) (666) (627) (588) (441) (405) (347) (319) (206) (87) 20 18

33,000(956) (917) (878) (788) (686) (618) (548) (447) (312) (156) (75) 20 18

36,000(1,167) (1,128) (981) (930) (845) (760) (605) (414) (279) (156) (75) 20 18

39,000(1,193) (1,091) (1,023) (938) (810) (618) (420) (267) (144) (21) 60 155 153

42,000(1,200) (1,115) (1,030) (860) (642) (450) (285) (132) (9) 114 195 290 288

45,000(1,208) (1,080) (888) (675) (495) (315) (150) 3 126 249 330 425 423

48,000(1,130) (912) (720) (540) (360) (180) (15) 138 261 384 465 560 468

51,000(1,110) (930) (750) (570) (390) (210) (45) 108 231 354 390 395 303

54,000(1,120) (940) (760) (580) (400) (220) (55) 98 221 254 245 250 158

57,000(1,035) (855) (675) (495) (315) (135) 30 138 171 204 195 200 108

60,000(950) (770) (590) (410) (230) (50) 25 88 121 154 145 150 58

63,000(885) (705) (525) (345) (210) (120) (45) 18 51 84 75 80 (12)

66,000(800) (620) (440) (350) (260) (170) (95) (32) 1 34 25 30 (62)

69,000(715) (580) (490) (400) (310) (220) (145) (82) (49) (16) (25) (20) (112)

72,000(720) (630) (540) (450) (360) (270) (195) (132) (99) (66) (75) (70) 18

75,000(770) (680) (590) (500) (410) (320) (245) (182) (149) (116) (36) 153 298

78,000(800) (710) (620) (530) (440) (350) (275) (212) (179) 34 213 370

81,000(830) (740) (650) (560) (470) (380) (305) (153) 64 334

84,000(860) (770) (680) (590) (500) (410) (155) 96 281

87,000(890) (800) (710) (620) (441) (167) 145

90,000(920) (830) (740) (470) (192) 50

93,000(950) (771) (497) (170)

96,000(800) (552) (280)

99,000 (500)

Supplemental Table for Qualifying Widow(er) With Dependent Child and

Married Couples Filing Jointly - Effective January 1, 2012

For married couples who both select Withholding Code “A” on Form CT-W4 (combined income is $100,500 or less).

Form CT-W4 Effective January 1, 2012

Instructions

1. Reading across the top of the table, select the approximate annual wage income of one spouse. Reading down the left

column, select the approximate annual wage income of the other spouse. See Page 4 for the continuation of this table.

2. At the intersection of the two numbers is an adjustment amount. This is a yearly adjustment amount.

3. To calculate the adjustment for each pay period, complete the following worksheet.

A. Adjustment amount 3A.________________

B. Pay periods in a year: See pay period table. 3B.________________

C. Pay period adjustment: Divide Line 3A by Line 3B. 3C.________________

4. If the adjustment is positive, enter the adjustment amount from Line 3C on Form CT-W4, Line 2, of one spouse. If the

adjustment is negative, enter the adjustment amount in brackets from Line 3C on Form CT-W4, Line 3, of one spouse.

Pay Period Table

If you are paid: Pay periods

in a year:

Weekly .......................52

Biweekly .......................26

Semi-monthly ................24

Monthly .......................12

(Rev. 06/12)

This table joins the table on Page 4.

Annual Salary

Page 3 of 4

Supplemental Table for Qualifying Widow(er) With Dependent Child and

Married Couples Filing Jointly - Effective January 1, 2012

For married couples who both select Withholding Code “A” on Form CT-W4 (combined income is $100,500 or less).

(Rev. 06/12)

Form CT-W4 Effective January 1, 2012

Annual Salary28,000 30,000 32,000 34,000 36,000 38,000 40,000 42,000 44,000 46,000 48,000 50,000 52,000

3,000(647) (752) (866) (1,007) (1,148) (1,148) (1,136) (1,158) (1,163) (1,125) (1,023) (992) (1,031)

6,000(525) (666) (807) (948) (981) (1,020) (1,025) (1,030) (950) (822) (720) (722) (761)

9,000(467) (608) (698) (776) (888) (893) (855) (753) (630) (540) (450) (452) (491)

12,000(408) (441) (570) (665) (760) (680) (552) (450) (360) (270) (180) (182) (221)

15,000(258) (370) (465) (518) (506) (383) (293) (203) (113) (23) 68 66 26

18,000(224) (319) (329) (291) (279) (189) (99) (9) 81 171 261 259 220

21,000(158) (146) (113) (113) (113) (23) 68 158 248 338 428 426 341

24,0008 20 20 20 20 110 200 290 380 470 560 468 339

27,0007 7 7 7 7 97 187 277 367 412 412 320 191

30,0000 0 0 0 0 90 180 270 270 270 270 178 49

33,0000 0 0 0 0 90 135 135 135 135 135 43 (86)

36,0000 0 0 0 0 0 0 0 0 0 0 (92) (221)

39,000135 135 135 90 0 0 0 0 0 0 0 (92) (221)

42,000270 270 180 90 0 0 0 0 0 0 0 (92) (221)

45,000360 270 180 90 0 0 0 0 0 0 0 (92) (132)

48,000360 270 180 90 0 0 0 0 0 0 0 88 147

51,000195 105 15 (75) (165) (165) (165) (165) (165) (76) 108 253

54,00050 (40) (130) (220) (310) (310) (310) (310) (130) 58 210

57,0000 (90) (180) (270) (360) (360) (271) (87) 150

60,000(50) (140) (230) (320) (410) (230) (42) 110

63,000(120) (210) (300) (301) (207) 30

66,000(170) (260) (170) (72) (10)

69,000 (131) (37) 110

72,000 98 160

This table joins the table on Page 3.

Page 4 of 4