DIVISION OF FINANCE TAX COMPLIANCE & REPORTING

#318 Employee State Income Tax (SIT) Verification Revision 05/06/20

Howdy,

Texas A&M University is a registered employer with other states and their local taxing jurisdictions. These states and any applicable local taxing entities have unique tax laws and these laws vary with each state. Some states require TAMU employees, including student workers who maintain their tax residency for that state, to have State Income Tax (SIT) and/or Local Income Tax (LIT) withheld even if they perform services outside of that state. Some states also require SIT and/or LIT to be withheld if a TAMU employee physically works in that state even though the employee maintains their tax residency in Texas.

Therefore, any employee who claims residency in a state other than Texas will have SIT and or LIT deducted even if working in Texas. Also, any employee who physically works in a state other than Texas will have SIT and/or LIT deducted even if claiming residency in Texas.

For State Income Tax reporting purposes please complete the Employee State Income Tax Verification Form and update, in Workday, your State and Local (if needed) tax elections and if a Pennsylvania resident complete the Pennsylvania Residency Certification.

This packet contains the following documents:

1. Instructions to help you complete the Employee State Income Tax Verification form.

2. Employee State Income Tax Verification Form To be completed by ALL employees who work or reside in a state other than Texas.

3. Military Spousal Relief Act Election FormComplete if applicable to you.

4. Pennsylvania Residency Certification Form (Attached for review only, you will complete in Workday)ONLY residents of Pennsylvania are required to complete this form.

This form is in addition to the Employee State Income Tax Verification Form.

5. Additional TAMU Texarkana Employee Forms (Attached for review only, you will complete in Workday)ONLY TAMU Texarkana Employees are required to complete these forms.

These forms are in addition to the Employee State Income Tax Verification Form: (Complete the one applicable to you)

Texarkana Withholding Exemption Rules AR4EC – State of Arkansas Employee’s Withholding Exemption Certificate AR4EC(TX) – State of Arkansas Texarkana Employee’s Withholding Exemption Certificate AR4ECSP – State of Arkansas Employee’s Special Withholding Exemption Certificate

Please complete and return all forms to tax@tamu.edu.

Best Regards, Tax Compliance and Reporting, Texas A&M University

DIVISION OF FINANCE TAX COMPLIANCE & REPORTING

#318 Employee State Income Tax (SIT) Verification Revision 05/06/20

Instructions for completing the Employee State Income Tax Verification Form

Employee Name: Enter your first and last name

Employee UIN: Enter your University Identification Number

Campus Location: Select the campus where you are employed

Physical Work Location: Enter the city and state of the place where you physically works for TAMU or any of the TAMU System Parts

Date began at physical work location: If you work in a state other than Texas, list the date you began working at that location

Residency Certification: Select one of the residency certifications

First option (Texas resident): If this option is chosen, enter the date your Texas residency began, sign, date and return the form.

Second option (Out-of-State resident): If this option is chosen, complete the remainder of the form.

Third option (Texas resident): Choose this option if you changed your resident address in SSO because you will be moving to the state in question and will not be working for TAMU or any of its System parts.

Withholding Basis: Please log into Workday and update your State/Local tax election to provide a basis for deducting state/local income tax if you work and/or reside in a state other than Texas and it is determined you are subject to that state’s income tax.

State Income Tax Election Instructions: https://fmo.tamu.edu/media/1602273/tax-election-instructions-state.pdf

Local Tax Election Instructions: https://fmo.tamu.edu/media/1602268/tax-election-instructions-local.pdf

Military Verification: Select either ‘Yes or No’ to verify your military affiliation. Also complete and sign page 2 if you selected ‘Yes’ for question #2.

Proof of your eligibility for exemption under the MRRA will be needed. Notification of the required documentation needed to verify your eligibility will be sent once the completed SIT verification form has been received.

Please make sure we have your correct addresses in Workday. Home: Primary Home Address = your residence address

Additional Home Address = your mailing address Work: Primary Work Address = address where you physically work (If out-of-state, list the out-of-state address)

Alternate Work Address = address of your Department

IF THERE ARE CHANGES IN YOUR RESIDENCE CITY/STATE, COMPLETE THIS FORM AGAIN BASED ON THE CHANGE NEEDED AND SUBMIT. IT IS YOUR RESPONSIBILITY TO NOTIFY US OF A CHANGE SO THAT WE MAY UPDATE YOUR SIT WITHHOLDING WITHIN A TIMELY MANNER.

DIVISION OF FINANCE TAX COMPLIANCE & REPORTING

#318 Employee State Income Tax (SIT) Verification Revision 05/06/20

Employee State Income Tax (SIT) Verification This form is used for State Income Tax reporting purposes by Tax Compliance & Reporting to verify the physical work location and residence of employees whose payroll records show an out of state residence address. This form is to be completed by the employee. Please complete this form and return to Tax Compliance & Reporting, as noted at the bottom of the form by email, fax or mail. Instructions for this form can be found at https://fmo.tamu.edu/media/680721/318_employee_sit_verification_packet.pdf

Employee Name Employee UIN

Please select your campus location: TAMU System TAMU College Station TDEM

TAMU Cent TX TAMU Texarkana TAMUGalveston TAMU Tarleton

TAMU Corpus Christi TAMU West Texas TAMU HSC

Physical Work Location Where you physically work for TAMU, or any of the TAMU System Parts?

(City and State)

Date you began at Physical Work Location If you physically work in a state other than Texas, please list the date you began working in that state for TAMU or any of the TAMU System Parts.

City:_____________________________________ State:__________________ MM________ DD________ YY_______ Residency Certification

The payroll records show you claim residency in a state other than Texas , is that correct? No, I certify that I am a bona fide resident of the State of Texas and not subject to state income tax withholding of any other state. (If this option is chosen, enter the date your Texas residency began, sign, date and return to tax@tamu.edu. Also, please update your Primary home and work addresses in Workday) Date Texas residency began: MM________ DD________ YY________ Yes, I certify that I am a resident of the state indicated below and subject to the state income tax withholding of that state. (If this option is chosen, complete the next two lines, sign, date and return to tax@tamu.edu.)

City and State you claim residency in: City:_____________________________________ State:__________________

Employee Mailing Address (City and State only) City:_____________________________________ State:__________________ No, an out-of-state residence is listed for me because I am/will be moving to that residence due to my TAMU employment ending on ____________ or going on LWOP effective ____________ (Enter the dates associated with each option). By selecting this option I am certifying that I will not be working for TAMU while residing out-of-state. (If this option is chosen, you may skip the remainder of this form, sign, date and return to tax@tamu.edu.)

WITHHOLDING BASIS Please log into Workday and update your State/Local tax election to provide a basis for deducting state/local income tax if you work and/or reside in a state other than Texas and it is determined you are subject to that state’s income tax.

State Income Tax Election Instructions: https://fmo.tamu.edu/media/1602273/tax-election-instructions-state.pdf

Local Tax Election Instructions: https://fmo.tamu.edu/media/1602268/tax-election-instructions-local.pdf

MILITARY VERIFICATION YES NO

Are you currently serving in the Armed Forces? Are you the spouse of someone serving in the Armed Forces?

If you are a military spouse, please complete page 2. If you are not a military spouse, please disregard page 2.

Please make sure we have your correct addresses in Workday.

**IF THERE ARE CHANGES IN YOUR RESIDENCE CITY/STATE, COMPLETE THIS FORM AGAIN BASED ON THE CHANGE NEEDED AND SUBMIT. IT IS YOUR RESPONSIBILITY TO NOTIFY US OF A CHANGE SO THAT WE MAY UPDATE YOUR SIT WITHHOLDING WITHIN A TIMELY MANNER.

__________________________________________________ __________________________________________________ ____________________ Employee Name—Print Employee Signature Date

DIVISION OF FINANCE TAX COMPLIANCE & REPORTING

#318 Employee State Income Tax (SIT) Verification Revision 05/06/20

Complete only if you are a Military Spouse

Military Spouse Residency Relief Act (MSRRA) A military spouse is exempt from income taxes in a state where income was earned when all four qualifications are met:

The spouse currently resides in a state different than the state of his or her domicile; The spouse resides in the state solely to live with the service member; The service member is present in the state in compliance with military orders; and The spouse and service member are both able to claim the same domicile.

Please click the below link for more information on the Military Spouse Residency Relief Act http://www.taxadmin.org/fta/rate/s_475.pdf

If you are a military spouse, please select the correct box to answer the following questions:

Yes No

1. Do you reside in a state different than the state of your domicile?

2. Do you reside in the state solely to live with the service member?

3. Is the service member in the state due to military orders?

4. Are you and the service member able to claim the same domicile?

Proof of your eligibility for exemption under the MRRA will be needed. Notification of the required documentation needed to verify your eligibility will be sent once the completed SIT verification form has been received.

__________________________________________________ __________________________________________________ ____________________ Employee Name—Print Employee Signature Date

SUBMIT FORM(S) TO:

Texas A&M University Tax Compliance & Reporting

SUBMIT VIA: Email: tax@tamu.edu Fax: (979) 458-3131 Mail: 6003 TAMU

College Station, Texas 77843-6003

QUESTIONS:

tax@tamu.edu Website:

https://fmo.tamu.edu/tax-compliance-reporting

RESIDENCY CERTIFICATION FORMLocal Earned Income Tax Withholding

EMPLOYEE INFORMATION - RESIDENCE LOCATION

TO EMPLOYERS/TAXPAYERS:

This form is to be used by employers and/or taxpayers to report essential information for the collection and distribution of Local Earned Income Taxes.

This form must be utilized by employers when a new employee is hired or when a current employee notifies employer of a name and/or address change.

NAME (Last Name, First Name, Middle Initial) SOCIAL SECURITY NUMBER

STREET ADDRESS (No PO Box, RD or RR)

SECOND LINE OF ADDRESS

CITY STATE ZIP CODE DAYTIME PHONE NUMBER

CERTIFICATION

SIGNATURE OF EMPLOYEE DATE (MM/DD/YYYY)

PHONE NUMBER EMAIL ADDRESS

MUNICIPALITY (City, Borough or Township)

COUNTY RESIDENT PSD CODE TOTAL RESIDENT EIT RATE

EMPLOYER INFORMATION - EMPLOYMENT LOCATION

EMPLOYER BUSINESS NAME (Use Federal ID Name) EMPLOYER FEIN

STREET ADDRESS WHERE ABOVE EMPLOYEE REPORTS TO WORK (No PO Box, RD or RR)

SECOND LINE OF ADDRESS

CITY STATE ZIP CODE PHONE NUMBER

MUNICIPALITY (City, Borough or Township)

COUNTY WORK LOCATION PSD CODE WORK LOCATION NON-RESIDENT EIT RATE

For information on obtaining the appropriate MUNICIPALITY (City, Borough, Township), PSD CODES and EIT (Earned Income Tax) RATES,

please refer to the Pennsylvania Department of Community & Economic Development website:

www.newPA.com

CLGS-32-6 (8-11)

Under penalties of perjury, I (we) declare that I (we) have examined this information, including all accompanying schedules and statements and to the best of my (our) belief, they are true, correct and complete.

** Texas A&M TEXARKANA Employees **

Please review the following Texarkana Withholding Rules and

complete one of the AR4EC withholding forms.

“EQUAL OPPORTUNITY EMPLO YER”

STATE OF ARKANSAS REVENUE DIVISION Individual Income Tax Department of Finance Withholding Branch 7th and Wolfe Streets, Room 1362 and Administration Post Office Box 8055 Little Rock, Arkansas 72203-8055 Phone: (501) 682-7290 Fax:(501)683-1036 http://www.state.ar.us/dfa

Texarkana Withholding Exemption Rules This is a brief explanation of the rules concerning the taxability of income earned from Arkansas sources while a resident of Texarkana, Arkansas or Texarkana, Texas. This exemption only applies if the taxpayer is living within the city limits of Texarkana, Arkansas or Texarkana, Texas. The exemption does not apply if the taxpayer lives on a rural route or in a town in the surrounding area of Texarkana. This supersedes any previous withholding rules. Any questions should be referred to the Arkansas Withholding Branch.

Texarkana, Arkansas Residents Arkansas residents whose permanent residence is within the city limits of Texarkana, Arkansas are exempt from Arkansas individual income taxes. All income received is exempt while the taxpayer is a resident of Texarkana, Arkansas. The taxpayer is required to file an Arkansas Individual Income Tax Return and submit all appropriate W-2’s and schedules to support the income and deductions. The form AR-TX is also submitted with the tax return which reports the exempt amount of wages earned from a particular employer. Arkansas employers are not required to withhold Arkansas taxes on these employees as long as a form AR-TX is completed stating that the employee actually lives within the city limits of Texarkana, Arkansas and reports the amount of exempt wages. This form is completed by the employer and given to the employee to be filed with the Arkansas individual income tax return. A copy is also sent to the State Withholding Branch along with the state’s copy of W-2’s. Arkansas employers are required to withhold Arkansas taxes if the employee moves from Texarkana, Arkansas. The form AR-TX will then report only the exempt amount of wages (Those earned while a resident of Texarkana, Arkansas)

Texarkana, Texas Residents Texas residents whose permanent residence is within the city limits of Texarkana, Texas are exempt from Arkansas individual income taxes on income earned from businesses in Texarkana, Arkansas only. This is the only income that is exempt. Any income received from any other sources in Arkansas is fully taxable. The taxpayer is required to file an Arkansas Individual Income Tax Return and submit all appropriate W-2’s and schedules to support the income and deductions. The form AR-TX is also submitted with the tax return which reports the exempt amount of wages earned from a particular employer. Texarkana, Arkansas employers are not required to withhold Arkansas taxes on these employees as long as a form AR-TX is completed stating that the employee actually lives within the city limits of Texarkana, Texas and reports the amount of exempt wages. This form is completed by the employer and given to the employee to be filed with the Arkansas individual income tax return. A copy is also sent to the State Withholding Branch along with the State’s copy of W-2’s. Non-Texarkana, Arkansas employers must withhold Arkansas taxes on employees regardless of the fact that they live in Texarkana, Texas.

(a) Your spouse for whom you have been claiming an exemption is divorced or legally separated from you, or claims his or her own exemption on a separate certificate, or (b) The support you provide to a dependent for whom you claimed an exemption is expected to be less than half of the total support for the year. OTHER DECREASES in exemptions or dependents, such as the death of a spouse or a dependent, does not affect your withholding until next year, but requires the filing of a new certificate by December 1 of the year in which they occur.

You may claim additional amounts of withholding tax if desired. This will apply most often when you have income other than wages.

You qualify for the low income tax rates if your total income from all sources is:

(a) Single $11,591 to $15,200(b) Married Filing Jointly $19,547 to $24,400 (1 or less dependents) (c) Married Filing Jointly $23,525 to $30,400 (2 or more dependents)(d) Head of Household/Qualifying Widow(er) $16,479 to $21,400 (1 or less dependents) (e) Head of Household/Qualifying Widow(er) $19,644 to $24,200 (2 or more dependents)

STATE OF ARKANSASEmployee’s Withholding Exemption Certificate

AR4EC

Arkansas Withholding Tax Section

P. O. Box 8055 Little Rock, Arkansas 72203-8055

Print Full Name ________________________________________________ Social Security Number ____________________________________

Print Home Address _____________________________________________ City _____________________________State _____ Zip _________

Employee:File this form with your employer. Otherwise, your employer must withhold state income tax from your wages without exemptions or dependents.

Employer:Keep this certificate with your records.

How to Claim Your WithholdingSee instructions below

1. CHECK ONE OF THE FOLLOWING FOR EXEMPTIONS CLAIMED

a. You claim yourself. (Enter one exemption) ......................................................................1a

b. You claim yourself and your spouse. (Enter two exemptions) .........................................1b

c. Head of Household, and you claim yourself. (Enter two exemptions) .............................1c

2. NUMBER OF CHILDREN or DEPENDENTS. (Enter one exemption per dependent) ................. 2

3. TOTAL EXEMPTIONS. (Add Lines 1a, b, c, and 2) If no exemptions or dependents are claimed, enter zero .............................................................. 3

4. Additional amount, if any, you want deducted from each paycheck. (Enter dollar amount) ......... 4

5. I qualify for the low income tax rates. (See below for details) ....................................................... 5 Please check filing status: Single Married Filing Jointly Head of Household

I certify that the number of exemptions and dependents claimed on this certificate does not exceed the number to which I am entitled.

Signature: ______________________________________________________________________________________Date: _________________

For additional information consult your employer or write to:

Number of Exemptions Claimed

Yes No

TYPES OF INCOME - This form can be used for withholding on all types of income, including pensions and annuities.

NUMBER OF EXEMPTIONS – (Husband and/or Wife) Do not claim more than the correct number of exemptions. However, if you expect to owe more income tax for the year, you may increase your withholding by claiming a smaller number of exemptions and/or dependents, or you may enter into an agreement with your employer to have additional amounts withheld. This is especially important if you have more than one employer, or if both husband and wife are employed.

DEPENDENTS – To qualify as your dependent (line 2 of form), a person must (a) receive more than 1/2 of their support from you for the year, (b) not be claimed as a dependent by such person’s spouse, (c) be a citizen or resident of the United States, and (d) have your home as their principal residence and be a member of your household for the entire year or be related to you as follows: son, daughter, grandchild, stepson, stepdaughter, son-in-law or daughter-in-law; your father, mother, grandparent, stepfather, stepmother, father-in-law or mother-in-law; your brother, sister, stepbrother, stepsister, half brother, half sister, brother-in-law or sister-in-law; your uncle, aunt, nephew or niece (but only if related by blood).

CHANGES IN EXEMPTIONS OR DEPENDENTS – You may file a new certificate at any time if the number of exemptions or dependents INCREASES. You must file a new certificate within 10 days if the number of exemptions or dependents previously claimed by you DECREASES for any of the following reasons:

Instructions

AR4EC (R 12/29/14)

Employee Full Name

Employee Address City State Zip

FORM AR4EC(TX)

Texarkana Employee's Withholding Exemption Certificate

State of Arkansas

Under penalty of perjury, I certify that the above information is true and if there is a change in my status, I will notify my employer within seven (7) days after the change occurs.

DateSignature

INSTRUCTIONS FOR THE TEXARKANA EXEMPTION CERTIFICATE

Any employee who qualifies for the exemption should check the appropriate box then sign and date the form.

The place of physical residency should be placed in the employee address field. A post office box or route number is not acceptable.

It is the responsibility of the employee to notify the employer within seven (7) days after any change to the exemption claimed.

The completed certificate should be maintained by the employer.

SSN

Texarkana, ARKANSAS (resident within city limits only)

Texarkana, TEXAS (resident within city limits only)

If Texarkana Exmption is Claimed for Arkansas Income Tax Withholding, Check One of the Following:

The above information is correct as of this date:

The employer does not have the authority to cease withholding Arkansas Income Tax unless the employee qualifies for, and checks, one the exemptions above.

Employees exempt from Arkansas Withholding, who would be required to file a return without the exemption, must still file an Arkansas Individual Income Tax return.

If you have any questions regarding the Texarkana exemption please contact the Withholding Tax Department at 501-682-7290.