Fillable Printable Employee's Withholding Certificate - Connecticut
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.
1
. 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 fi ling jointly for federal and Connecticut and
fi ling 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 is not 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 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
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 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
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 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
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 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
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 fi ling 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 fi ling separately for federal and
Connecticut and fi ling 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?
No
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 new Form 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
fi ling status changes, you must furnish your employer with a new
Form CT-W4 within ten days of the change.
Gross Income
For Form CT-W4 purposes, 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 fi ling status you expect to report on your Connecticut
income tax return is the same as the fi ling status you expect to report on
your federal income tax return. However, special rules apply to married
individuals who fi le 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, you must recalculate your
federal adjusted gross income as if your fi ling status for federal income
tax purposes were married fi ling 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 fi ling 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 Certifi cate - 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 fi ling 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 refl ect 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
f
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 fi le 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 fi le a paper return. If you fi le 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
Offi ce of Research, Form CT-W4
200 Folly Brook Boulevard
Wethersfi eld 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
3,000 0 0 0 0 0 0 (15) (42) (99) (156) (248) (318) (485)
6,000 0 0 0 0 0 0 (15) (42) (99) (141) (225) (295) (414)
9,000 0 0 0 0 0 0 (15) (35) (77) (119) (182) (192) (308)
12,000 0 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 Salary 28,000 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
24,000 8 20 20 20 20 110 200 290 380 470 560 468 339
27,000 7 7 7 7 7 97 187 277 367 412 412 320 191
30,000 0 0 0 0 0 90 180 270 270 270 270 178 49
33,000 0 0 0 0 0 90 135 135 135 135 135 43 (86)
36,000 0 0 0 0 0 0 0 0 0 0 0 (92) (221)
39,000 135 135 135 90 0 0 0 0 0 0 0 (92) (221)
42,000 270 270 180 90 0 0 0 0 0 0 0 (92) (221)
45,000 360 270 180 90 0 0 0 0 0 0 0 (92) (132)
48,000 360 270 180 90 0 0 0 0 0 0 0 88 147
51,000 195 105 15 (75) (165) (165) (165) (165) (165) (76) 108 253
54,000 50 (40) (130) (220) (310) (310) (310) (310) (130) 58 210
57,000 0 (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
