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NY IT-2104 Employee's Withholding Allowance Form

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NY IT-2104 Employee's Withholding Allowance Form
NY IT-2104 Employee
First name and middle initial Last name Your social security number
Permanent home address
(number and street or rural route) Apartment number
City,village,orpostofce State ZIPcode
Are you a resident of New York City ........... Yes No
Are you a resident of Yonkers ..................... Yes No
Complete the worksheet on page 3 before making any entries.
1 TotalnumberofallowancesyouareclaimingforNewYorkStateandYonkers,ifapplicable
(from line 17) ...........
1
2 Total number of allowances for New York City
(from line 28) ..................................................................................
2
Use lines 3, 4, and 5 below to have additional withholding per pay period under special agreement with your employer.
3 NewYorkStateamount ........................................................................................................................................
3
4 New York City amount ...........................................................................................................................................
4
5 Yonkers amount ....................................................................................................................................................
5
NewYorkStateDepartmentofTaxationandFinance
Employee’sWithholdingAllowanceCerticate
NewYorkState•NewYorkCity•Yonkers
SingleorHeadofhousehold
Married
Married, but withhold at higher single rate
Note:Ifmarriedbutlegallyseparated,markanX in
the Single or Head of household box.
IcertifythatIamentitledtothenumberofwithholdingallowancesclaimedonthiscerticate.
Employee’ssignature Date
Employers name and address
(Employer: complete this section only if you are sending a copy of this form to the NYS Tax Department.)
Employeridenticationnumber
Penalty – A penalty of $500 may be imposed for any false statement you make that decreases the amount of money you have withheld
from your wages. You may also be subject to criminal penalties.
Employee: detach this page and give it to your employer; keep a copy for your records.
Changes effective for 2014
FormIT-2104hasbeenrevisedfortaxyear2014.Theworksheeton
page 3 used to compute your withholding allowances and the charts
beginningonpage4usedtoenteranadditionaldollaramountof
withholdinghavebeenrevised.IfyoupreviouslyledaFormIT-2104
andusedtheworksheetorcharts,youshouldcompleteanew2014
FormIT-2104andgiveittoyouremployer.
Whoshouldlethisform
Thiscerticate,FormIT-2104,iscompletedbyanemployeeandgiven
totheemployertoinstructtheemployerhowmuchNewYorkState(and
NewYorkCityandYonkers)taxtowithholdfromtheemployee’spay.The
moreallowancesclaimed,thelowertheamountoftaxwithheld.
IfyoudonotleFormIT-2104,youremployermayusethesamenumber
ofallowancesyouclaimedonfederalFormW-4.Duetodifferencesin
taxlaw,thismayresultinthewrongamountoftaxwithheldforNewYork
State,NewYorkCity,andYonkers.CompleteFormIT-2104eachyear
andleitwithyouremployerifthenumberofallowancesyoumayclaim
isdifferentfromfederalFormW-4orhaschanged.Commonreasonsfor
completinganewFormIT-2104eachyearincludethefollowing:
• Youstartedanewjob.
• Youarenolongeradependent.
• Yourindividualcircumstancesmayhavechanged(forexample,you
were married or have an additional child).
• YoumovedintooroutofNYCorYonkers.
• Youitemizeyourdeductionsonyourpersonalincometaxreturn.
• YouclaimallowancesforNewYorkStatecredits.
• Youowedtaxorreceivedalargerefundwhenyouledyourpersonal
incometaxreturnforthepastyear.
• Yourwageshaveincreasedandyouexpecttoearn$104,600ormore
duringthetaxyear.
• Thetotalincomeofyouandyourspousehasincreasedto$104,600or
moreforthetaxyear.
• Youhavesignicantlymoreorlessincomefromothersourcesorfrom
another job.
• Younolongerqualifyforexemptionfromwithholding.
• YouhavebeenadvisedbytheInternalRevenueServicethatyou
are entitled to fewer allowances than claimed on your original federal
FormW-4,andthedisallowedallowanceswereclaimedonyouroriginal
FormIT-2104.
Instructions
Employers only: Mark an XinboxAand/orboxBtoindicatewhyyouaresendingacopyofthisformtoNewYorkState (see instr.):
A Employeeclaimedmorethan14exemptionallowancesforNYS ............ A
B Employeeisanewhireorarehire ... B Firstd
ate employee performed services for pay (mm-dd-yyyy)
(see instr.):
Aredependenthealthinsurancebenetsavailableforthisemployee ............. Yes No
IfYes,enterthedatetheemployeequalies(mm-dd-yyyy):
IT-2104
NY IT-2104 Employee's Withholding Allowance Form
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