non-tax levy payroll appointment/reappointment...

Non-Tax Levy Payroll Appointment/Reappointment Letter

(Not to be used for Teaching Appointments) Account Name:____________________________ Date:_________________

Account Number:__________________________ Department:___________________________

Name:___________________________________

Address:_________________________________

_________________________________________ Position Title:_____________________ City State Zip Code

Dear ______________________________:

I am pleased to recommend you for (Appointment/Reappointment/Appointment Revision) to the Hunter College Non-Tax Levy Payroll beginning _________ and ending not later than _________.

The rate of compensation is $____ per hour. The maximum total number of hours you may work during the appointment period is ____. The compensation will be paid bi-weekly. Compensation will be based upon number of hours worked as submitted on the attendance report and time sheet. Under the U.S. Fair Labor Standards Act, in this position, you are considered to be ■ a Non-Exempt Employee (meaning, among other things, that you are entitled to overtime pay at the hourly rate equal to 1.5x your regular hourly rate for any hours you work in excess of 40 hour per week) □ an Exempt Employee (meaning you are not covered by certain FLSA provisions, including the overtime pay rules). If you are a Non-Exempt Employee, you will not be permitted to work in excess of 40 hours per week without obtaining advance approval from Giancarlo Bonagura, Vice President for Finance & Administration.

Every Non-Tax Levy Employee is an employee-at-will. Such employee may be terminated by Hunter College at any time. No supervisor or other representative of Hunter College has the authority to enter into any employment agreement that would be contrary to this employment-at-will policy. Employment on the Non-Tax Levy Payroll does not bring with it any associated Hunter College privileges or benefits.

Please complete the following forms and submit with a copy of your Social Security Card (or present original for verification) to Human Resources. *

Form I-9 – U.S. Department of Justice (INS) Employment Eligibility Verification Form W-4 – IRS Employee’s Withholding Allowance Certificate Form IT-2104 – New York State Employee’s Withholding Allowance Certificate Direct Deposit Authorization if you wish to enroll in direct deposit.

If you are in the United States on a Visa, please submit a copy of your Visa and an up to date work authorization. This recommendation will become effective only upon signature of all parties listed below and is contingent on valid US work authorization.

___________________________ ____________________________________ Authorized Signatory of Account Employee Signature Date

__________________________ Employee SSN

COLLEGE ASSOCIATION

NON-TAX LEVY PAYROLL

APPLICANT INFORMATION

Name: Last First Middle

Home Address: Street

City State Zip code Telephone Number: ( ) - -

Social Security Number: - -

E-Mail Address:

The following forms; I-9, W-4, and IT-2104 are to be completed and submitted with a copy of your Social Security Card to Human Resources.

******************************************************************

FOR COLLEGE USE ONLY

******************************************************************

Position Title:

Account Name:

Account Number:

Appointment Dates: To

Appointment Rate:

Account Signatory:

Form W-4 (2015)Purpose. Complete Form W-4 so that your employer can withhold the correct federal income tax from your pay. Consider completing a new Form W-4 each year and when your personal or financial situation changes.Exemption from withholding. If you are exempt, complete only lines 1, 2, 3, 4, and 7 and sign the form to validate it. Your exemption for 2015 expires February 16, 2016. See Pub. 505, Tax Withholding and Estimated Tax.Note. If another person can claim you as a dependent on his or her tax return, you cannot claim exemption from withholding if your income exceeds $1,050 and includes more than $350 of unearned income (for example, interest and dividends).

Exceptions. An employee may be able to claim exemption from withholding even if the employee is a dependent, if the employee:• Is age 65 or older,

• Is blind, or

• Will claim adjustments to income; tax credits; or itemized deductions, on his or her tax return.

The exceptions do not apply to supplemental wages greater than $1,000,000.Basic instructions. If you are not exempt, complete the Personal Allowances Worksheet below. The worksheets on page 2 further adjust your withholding allowances based on itemized deductions, certain credits, adjustments to income, or two-earners/multiple jobs situations.

Complete all worksheets that apply. However, you may claim fewer (or zero) allowances. For regular wages, withholding must be based on allowances you claimed and may not be a flat amount or percentage of wages.Head of household. Generally, you can claim head of household filing status on your tax return only if you are unmarried and pay more than 50% of the costs of keeping up a home for yourself and your dependent(s) or other qualifying individuals. See Pub. 501, Exemptions, Standard Deduction, and Filing Information, for information.Tax credits. You can take projected tax credits into account in figuring your allowable number of withholding allowances. Credits for child or dependent care expenses and the child tax credit may be claimed using the Personal Allowances Worksheet below. See Pub. 505 for information on converting your other credits into withholding allowances.

Nonwage income. If you have a large amount of nonwage income, such as interest or dividends, consider making estimated tax payments using Form 1040-ES, Estimated Tax for Individuals. Otherwise, you may owe additional tax. If you have pension or annuity income, see Pub. 505 to find out if you should adjust your withholding on Form W-4 or W-4P.Two earners or multiple jobs. If you have a working spouse or more than one job, figure the total number of allowances you are entitled to claim on all jobs using worksheets from only one Form W-4. Your withholding usually will be most accurate when all allowances are claimed on the Form W-4 for the highest paying job and zero allowances are claimed on the others. See Pub. 505 for details.Nonresident alien. If you are a nonresident alien, see Notice 1392, Supplemental Form W-4 Instructions for Nonresident Aliens, before completing this form.Check your withholding. After your Form W-4 takes effect, use Pub. 505 to see how the amount you are having withheld compares to your projected total tax for 2015. See Pub. 505, especially if your earnings exceed $130,000 (Single) or $180,000 (Married).Future developments. Information about any future developments affecting Form W-4 (such as legislation enacted after we release it) will be posted at www.irs.gov/w4.

Personal Allowances Worksheet (Keep for your records.)A Enter “1” for yourself if no one else can claim you as a dependent . . . . . . . . . . . . . . . . . . A

B Enter “1” if: { • You are single and have only one job; or• You are married, have only one job, and your spouse does not work; or . . .• Your wages from a second job or your spouse’s wages (or the total of both) are $1,500 or less.

} B

C Enter “1” for your spouse. But, you may choose to enter “-0-” if you are married and have either a working spouse or more than one job. (Entering “-0-” may help you avoid having too little tax withheld.) . . . . . . . . . . . . . . C

D Enter number of dependents (other than your spouse or yourself) you will claim on your tax return . . . . . . . . DE Enter “1” if you will file as head of household on your tax return (see conditions under Head of household above) . . EF Enter “1” if you have at least $2,000 of child or dependent care expenses for which you plan to claim a credit . . . F

(Note. Do not include child support payments. See Pub. 503, Child and Dependent Care Expenses, for details.) G Child Tax Credit (including additional child tax credit). See Pub. 972, Child Tax Credit, for more information.

• If your total income will be less than $65,000 ($100,000 if married), enter “2” for each eligible child; then less “1” if you have two to four eligible children or less “2” if you have five or more eligible children. • If your total income will be between $65,000 and $84,000 ($100,000 and $119,000 if married), enter “1” for each eligible child . . . G

H Add lines A through G and enter total here. (Note. This may be different from the number of exemptions you claim on your tax return.) ▶ H

For accuracy, complete all worksheets that apply. {

• If you plan to itemize or claim adjustments to income and want to reduce your withholding, see the Deductions and Adjustments Worksheet on page 2. • If you are single and have more than one job or are married and you and your spouse both work and the combined earnings from all jobs exceed $50,000 ($20,000 if married), see the Two-Earners/Multiple Jobs Worksheet on page 2 to avoid having too little tax withheld.• If neither of the above situations applies, stop here and enter the number from line H on line 5 of Form W-4 below.

Separate here and give Form W-4 to your employer. Keep the top part for your records.

Form W-4Department of the Treasury Internal Revenue Service

Employee's Withholding Allowance Certificate▶ Whether you are entitled to claim a certain number of allowances or exemption from withholding is

subject to review by the IRS. Your employer may be required to send a copy of this form to the IRS.

OMB No. 1545-0074

20151 Your first name and middle initial Last name

Home address (number and street or rural route)

City or town, state, and ZIP code

2 Your social security number

3 Single Married Married, but withhold at higher Single rate.

Note. If married, but legally separated, or spouse is a nonresident alien, check the “Single” box.

4 If your last name differs from that shown on your social security card,

check here. You must call 1-800-772-1213 for a replacement card. ▶

5 Total number of allowances you are claiming (from line H above or from the applicable worksheet on page 2) 56 Additional amount, if any, you want withheld from each paycheck . . . . . . . . . . . . . . 6 $

7 I claim exemption from withholding for 2015, and I certify that I meet both of the following conditions for exemption.• Last year I had a right to a refund of all federal income tax withheld because I had no tax liability, and• This year I expect a refund of all federal income tax withheld because I expect to have no tax liability.If you meet both conditions, write “Exempt” here . . . . . . . . . . . . . . . ▶ 7

Under penalties of perjury, I declare that I have examined this certificate and, to the best of my knowledge and belief, it is true, correct, and complete.

Employee’s signature (This form is not valid unless you sign it.) ▶ Date ▶

8 Employer’s name and address (Employer: Complete lines 8 and 10 only if sending to the IRS.) 9 Office code (optional) 10 Employer identification number (EIN)

For Privacy Act and Paperwork Reduction Act Notice, see page 2. Cat. No. 10220Q Form W-4 (2015)

Form W-4 (2015) Page 2 Deductions and Adjustments Worksheet

Note. Use this worksheet only if you plan to itemize deductions or claim certain credits or adjustments to income.1 Enter an estimate of your 2015 itemized deductions. These include qualifying home mortgage interest, charitable contributions, state

and local taxes, medical expenses in excess of 10% (7.5% if either you or your spouse was born before January 2, 1951) of your income, and miscellaneous deductions. For 2015, you may have to reduce your itemized deductions if your income is over $309,900 and you are married filing jointly or are a qualifying widow(er); $284,050 if you are head of household; $258,250 if you are single and not head of household or a qualifying widow(er); or $154,950 if you are married filing separately. See Pub. 505 for details . . . . 1 $

2 Enter: { $12,600 if married filing jointly or qualifying widow(er)$9,250 if head of household . . . . . . . . . . .$6,300 if single or married filing separately

} 2 $

3 Subtract line 2 from line 1. If zero or less, enter “-0-” . . . . . . . . . . . . . . . . 3 $4 Enter an estimate of your 2015 adjustments to income and any additional standard deduction (see Pub. 505) 4 $5 Add lines 3 and 4 and enter the total. (Include any amount for credits from the Converting Credits to

Withholding Allowances for 2015 Form W-4 worksheet in Pub. 505.) . . . . . . . . . . . . 5 $6 Enter an estimate of your 2015 nonwage income (such as dividends or interest) . . . . . . . . 6 $7 Subtract line 6 from line 5. If zero or less, enter “-0-” . . . . . . . . . . . . . . . . 7 $8 Divide the amount on line 7 by $4,000 and enter the result here. Drop any fraction . . . . . . . 89 Enter the number from the Personal Allowances Worksheet, line H, page 1 . . . . . . . . . 9

10 Add lines 8 and 9 and enter the total here. If you plan to use the Two-Earners/Multiple Jobs Worksheet, also enter this total on line 1 below. Otherwise, stop here and enter this total on Form W-4, line 5, page 1 10

Two-Earners/Multiple Jobs Worksheet (See Two earners or multiple jobs on page 1.)Note. Use this worksheet only if the instructions under line H on page 1 direct you here.1 Enter the number from line H, page 1 (or from line 10 above if you used the Deductions and Adjustments Worksheet) 12 Find the number in Table 1 below that applies to the LOWEST paying job and enter it here. However, if

you are married filing jointly and wages from the highest paying job are $65,000 or less, do not enter more than “3” . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2

3 If line 1 is more than or equal to line 2, subtract line 2 from line 1. Enter the result here (if zero, enter “-0-”) and on Form W-4, line 5, page 1. Do not use the rest of this worksheet . . . . . . . . . 3

Note. If line 1 is less than line 2, enter “-0-” on Form W-4, line 5, page 1. Complete lines 4 through 9 below to figure the additional withholding amount necessary to avoid a year-end tax bill.

4 Enter the number from line 2 of this worksheet . . . . . . . . . . 45 Enter the number from line 1 of this worksheet . . . . . . . . . . 56 Subtract line 5 from line 4 . . . . . . . . . . . . . . . . . . . . . . . . . 67 Find the amount in Table 2 below that applies to the HIGHEST paying job and enter it here . . . . 7 $8 Multiply line 7 by line 6 and enter the result here. This is the additional annual withholding needed . . 8 $9 Divide line 8 by the number of pay periods remaining in 2015. For example, divide by 25 if you are paid every two

weeks and you complete this form on a date in January when there are 25 pay periods remaining in 2015. Enter the result here and on Form W-4, line 6, page 1. This is the additional amount to be withheld from each paycheck 9 $

Table 1Married Filing Jointly

If wages from LOWEST paying job are—

Enter on line 2 above

$0 - $6,000 06,001 - 13,000 1

13,001 - 24,000 224,001 - 26,000 326,001 - 34,000 434,001 - 44,000 544,001 - 50,000 650,001 - 65,000 765,001 - 75,000 875,001 - 80,000 980,001 - 100,000 10

100,001 - 115,000 11115,001 - 130,000 12130,001 - 140,000 13140,001 - 150,000 14

150,001 and over 15

All Others

If wages from LOWEST paying job are—


$0 - $8,000 08,001 - 17,000 117,001 - 26,000 226,001 - 34,000 334,001 - 44,000 444,001 - 75,000 575,001 - 85,000 685,001 - 110,000 7

110,001 - 125,000 8125,001 - 140,000 9140,001 and over 10

Table 2Married Filing Jointly

If wages from HIGHEST paying job are—


$0 - $75,000 $60075,001 - 135,000 1,000

135,001 - 205,000 1,120205,001 - 360,000 1,320360,001 - 405,000 1,400405,001 and over 1,580

All Others

If wages from HIGHEST paying job are—


$0 - $38,000 $60038,001 - 83,000 1,00083,001 - 180,000 1,120

180,001 - 395,000 1,320395,001 and over 1,580

Privacy Act and Paperwork Reduction Act Notice. We ask for the information on this form to carry out the Internal Revenue laws of the United States. Internal Revenue Code sections 3402(f)(2) and 6109 and their regulations require you to provide this information; your employer uses it to determine your federal income tax withholding. Failure to provide a properly completed form will result in your being treated as a single person who claims no withholding allowances; providing fraudulent information may subject you to penalties. Routine uses of this information include giving it to the Department of Justice for civil and criminal litigation; to cities, states, the District of Columbia, and U.S. commonwealths and possessions for use in administering their tax laws; and to the Department of Health and Human Services for use in the National Directory of New Hires. We may also disclose this information to other countries under a tax treaty, to federal and state agencies to enforce federal nontax criminal laws, or to federal law enforcement and intelligence agencies to combat terrorism.

You are not required to provide the information requested on a form that is subject to the Paperwork Reduction Act unless the form displays a valid OMB control number. Books or records relating to a form or its instructions must be retained as long as their contents may become material in the administration of any Internal Revenue law. Generally, tax returns and return information are confidential, as required by Code section 6103.

The average time and expenses required to complete and file this form will vary depending on individual circumstances. For estimated averages, see the instructions for your income tax return.

If you have suggestions for making this form simpler, we would be happy to hear from you. See the instructions for your income tax return.

First name and middle initial Last name Your social security number

Permanent home address (number and street or rural route) Apartment number

City,village,orpostoffice State ZIPcode

Are you a resident of New York City? ........... Yes NoAre you a resident of Yonkers? ..................... Yes NoComplete the worksheet on page 3 before making any entries.1 TotalnumberofallowancesyouareclaimingforNewYorkStateandYonkers,ifapplicable(from line 17) ........... 12 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 NewYorkStateamount ........................................................................................................................................ 34 New York City amount ........................................................................................................................................... 45 Yonkers amount .................................................................................................................................................... 5

NewYorkStateDepartmentofTaxationandFinance

Employee’sWithholdingAllowanceCertificate NewYorkState•NewYorkCity•Yonkers

SingleorHeadofhousehold Married

Married, but withhold at higher single rate

Note:Ifmarriedbutlegallyseparated,markanX in the Single or Head of household box.

IcertifythatIamentitledtothenumberofwithholdingallowancesclaimedonthiscertificate.Employee’ssignature Date

Employer’s name and address (Employer: complete this section only if you are sending a copy of this form to the NYS Tax Department.) Employeridentificationnumber

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 2015FormIT-2104hasbeenrevisedfortaxyear2015.Theworksheetonpage3,thechartsbeginningonpage4,andtheadditionaldollaramountsintheinstructionsonpage2,usedtocomputewithholdingallowancesortoenteranadditionaldollaramountonline(s)3,4,or5,havebeenrevised.IfyoupreviouslyfiledaFormIT-2104andusedtheworksheet,charts,oradditionaldollaramounts,youshouldcompleteanew2015FormIT-2104andgiveittoyouremployer.

WhoshouldfilethisformThiscertificate,FormIT-2104,iscompletedbyanemployeeandgiventotheemployertoinstructtheemployerhowmuchNewYorkState(andNewYorkCityandYonkers)taxtowithholdfromtheemployee’spay.Themoreallowancesclaimed,thelowertheamountoftaxwithheld.

IfyoudonotfileFormIT-2104,youremployermayusethesamenumberofallowancesyouclaimedonfederalFormW-4.Duetodifferencesintaxlaw,thismayresultinthewrongamountoftaxwithheldforNewYorkState,NewYorkCity,andYonkers.CompleteFormIT-2104eachyear

andfileitwithyouremployerifthenumberofallowancesyoumayclaimisdifferentfromfederalFormW-4orhaschanged.CommonreasonsforcompletinganewFormIT-2104eachyearincludethefollowing:• Youstartedanewjob.• Youarenolongeradependent.• Yourindividualcircumstancesmayhavechanged(forexample,you

were married or have an additional child).• YoumovedintooroutofNYCorYonkers.• Youitemizeyourdeductionsonyourpersonalincometaxreturn.• YouclaimallowancesforNewYorkStatecredits.• Youowedtaxorreceivedalargerefundwhenyoufiledyourpersonalincometaxreturnforthepastyear.

• Yourwageshaveincreasedandyouexpecttoearn$106,200ormoreduringthetaxyear.

• Thetotalincomeofyouandyourspousehasincreasedto$106,200ormoreforthetaxyear.

• Youhavesignificantlymoreorlessincomefromothersourcesorfromanother job.

• Younolongerqualifyforexemptionfromwithholding.

Instructions

Employer: Keepthiscertificatewithyourrecords.Mark an XinboxAand/orboxBtoindicatewhyyouaresendingacopyofthisformtoNewYorkState (see instructions):

A Employeeclaimedmorethan14exemptionallowancesforNYS ............ A

B Employeeisanewhireorarehire ... B Firstdate employee performed services for pay (mm-dd-yyyy) (see instr.):

Aredependenthealthinsurancebenefitsavailableforthisemployee? ............. Yes No

IfYes,enterthedatetheemployeequalifies(mm-dd-yyyy):

IT-2104

of 7 IT-2104 (2015)

• YouhavebeenadvisedbytheInternalRevenueServicethatyouare entitled to fewer allowances than claimed on your original federal FormW-4,andthedisallowedallowanceswereclaimedonyouroriginalFormIT-2104.

Exemption from withholdingYoucannotuseFormIT-2104toclaimexemptionfromwithholding.Toclaimexemptionfromincometaxwithholding,youmustfileFormIT-2104-E,Certificate of Exemption from Withholding, with your employer.Youmustfileanewcertificateeachyearthatyouqualifyforexemption.ThisexemptionfromwithholdingisallowableonlyifyouhadnoNewYorkincometaxliabilityintheprioryear,youexpectnoneinthecurrent year, andyouareover65yearsofage,under18,orafull-timestudentunder25.Youmayalsoclaimexemptionfromwithholdingifyou are a military spouse and meet the conditions set forth under the ServicemembersCivilReliefActasamendedbytheMilitarySpousesResidencyReliefAct.Ifyouareadependentwhoisunder18orafull-timestudent,youmayowetaxifyourincomeismorethan$3,100.

Withholding allowancesYou may not claim a withholding allowance for yourself or, if married, your spouse. Claim the number of withholding allowances you compute inPart1andPart3onpage3ofthisform.Ifyouwantmoretaxwithheld, you may claim fewer allowances. If you claim more than 14 allowances, your employer must send a copy of your Form IT-2104 totheNewYorkStateTaxDepartment.Youmaythenbeaskedtoverifyyourallowances.Ifyouarriveatnegativeallowances(lessthanzero)onlines1or2andyouremployercannotaccommodatenegativeallowances, enter 0 and see Additional dollar amount(s) below.

Income from sources other than wages –Ifyouhavemorethan$1,000ofincomefromsourcesotherthanwages(suchasinterest,dividends, or alimony received), reduce the number of allowances claimedonline1andline2(ifapplicable)oftheIT-2104certificatebyoneforeach$1,000ofnonwageincome.Ifyouarriveatnegativeallowances(lessthanzero),seeWithholding allowances above. You may also considerfilingestimatedtax,especiallyifyouhavesignificantamountsofnonwageincome.EstimatedtaxrequiresthatpaymentsbemadebytheemployeedirectlytotheTaxDepartmentonaquarterlybasis.Formoreinformation,seetheinstructionsforFormIT-2105,Estimated Tax Payment Voucher for Individuals, or see Need help?onpage6.

Other credits (Worksheetline13) – Ifyouwillbeeligibletoclaimany credits other than the credits listed in the worksheet, such as an investmenttaxcredit,youmayclaimadditionalallowances.

FindyourfilingstatusandyourNewYorkadjustedgrossincome(NYAGI)inthechartbelow,anddividetheamountoftheexpectedcreditbythenumber indicated. Enter the result (rounded to the nearest whole number) online13.

Example: You are married and expect your New York adjusted gross income to be less than $318,750. In addition, you expect to receive a flow-through of an investment tax credit from the S corporation of which you are a shareholder. The investment tax credit will be $160. Divide the expected credit by 66. 160/66 = 2.4242. The additional withholding allowance(s) would be 2. Enter 2 on line 13.

Married couples with both spouses working –Ifyouandyourspousebothwork,youshouldeachfileaseparateIT-2104certificatewithyourrespectiveemployers.Yourwithholdingwillbettermatchyourtotaltaxifthehigherwage-earningspouseclaimsallofthecouple’sallowancesandthelowerwage-earningspouseclaimszeroallowances.Do not claim moretotalallowancesthanyouareentitledto.Ifyourcombinedwagesare:• lessthan$106,200,youshouldeachmarkanXintheboxMarried,

but withhold at higher single rateonthecertificatefront,anddividethe

totalnumberofallowancesthatyoucomputeonline17andline28(ifapplicable) between you and your working spouse.

• $106,200ormore,usethechart(s)inPart4andentertheadditionalwithholding dollar amount on line 3.

Taxpayers with more than one job –Ifyouhavemorethanonejob,fileaseparateIT-2104certificatewitheachofyouremployers.Besure to claim only the total number of allowances that you are entitled to.Yourwithholdingwillbettermatchyourtotaltaxifyouclaimallofyourallowancesatyourhigher-payingjobandzeroallowancesatthelower-payingjob.Inaddition,tomakesurethatyouhaveenoughtaxwithheld,ifyouareasingletaxpayerorheadofhouseholdwithtwo or more jobs, and your combined wages from all jobs are under $106,200,reducethenumberofallowancesbysevenonline1andline2(ifapplicable)onthecertificateyoufilewithyourhigher-payingjobemployer.Ifyouarriveatnegativeallowances(lessthanzero),see Withholding allowances above.

Ifyouareasingleoraheadofhouseholdtaxpayer,andyourcombinedwagesfromallofyourjobsarebetween$106,200and$2,231,827,usethe chart(s) in Part 5 and enter the additional withholding dollar amount from the chart on line 3.

Ifyouareamarriedtaxpayer,andyourcombinedwagesfromallofyourjobsare$106,200ormore,usethechart(s)inPart4andentertheadditionalwithholdingdollaramountfromthechartonline3(Substitutethe words Higher-paying job for Higher earner’s wages within the chart).

Dependents – Ifyouareadependentofanothertaxpayerandexpectyourincometoexceed$3,100,youshouldreduceyourwithholdingallowancesbyoneforeach$1,000ofincomeover$2,500.Thiswillensurethatyouremployerwithholdsenoughtax.

Following the above instructions will help to ensure that you will not owe additionaltaxwhenyoufileyourreturn.

Heads of households with only one job – Ifyouwillusethehead-of-householdfilingstatusonyourstateincometaxreturn,markthe Single or Head of householdboxonthefrontofthecertificate.Ifyouhave only one job, you may also wish to claim two additional withholding allowancesonline14.

Additional dollar amount(s)You may ask your employer to withhold an additional dollar amount each payperiodbycompletinglines3,4,and5onFormIT-2104.Inmostinstances, if you compute a negative number of allowances and your employer cannot accommodate a negative number, for each negative allowanceclaimedyoushouldhaveanadditional$1.85oftaxwithheldperweekforNewYorkStatewithholdingonline3,andanadditional$0.80oftaxwithheldperweekforNewYorkCitywithholdingonline4.Yonkersresidentsshoulduse16.75%(.1675)oftheNewYorkStateamountforadditional withholding for Yonkers on line 5.

Note:Ifyouarerequestingyouremployertowithholdanadditionaldollaramountonlines3,4,or5ofthisallowancecertificate,theadditionaldollar amount, as determined by these instructions or by using the chart(s)inPart4orPart5,isaccurateforaweeklypayroll.Therefore,if you are not paid on a weekly basis, you will need to adjust the dollar amount(s)thatyoucompute.Forexample,ifyouarepaidbiweekly,youmust double the dollar amount(s) computed.

Avoid underwithholdingFormIT-2104,togetherwithyouremployer’swithholdingtables,isdesignedtoensurethatthecorrectamountoftaxiswithheldfromyourpay.Ifyoufailtohaveenoughtaxwithheldduringtheentireyear,youmayowealargetaxliabilitywhenyoufileyourreturn.TheTaxDepartmentmustassess interest and may impose penalties in certain situations in addition tothetaxliability.Evenifyoudonotfileareturn,wemaydeterminethatyouowepersonalincometax,andwemayassessinterestandpenaltiesontheamountoftaxthatyoushouldhavepaidduringtheyear.

Single and NYAGI is:

Head of household and NYAGI is:

Married and NYAGI is:

Divide amount of expected credit by:

Less than Less than Less than 66 $212,500 $265,600 $318,750 Between Between Between $212,500and $265,600and $318,750and 68 $1,062,650 $1,594,050 $2,125,450 Over Over Over 88 $1,062,650 $1,594,050 $2,125,450

(continued)

IT-2104 (2015) Page 3 of 7

WorksheetSee the instructions before completing this worksheet.

Part 1 – Complete this part to compute your withholding allowances for New York State and Yonkers (line1).

Part 3 – Complete this part to compute your withholding allowances for New York City (line2).

Part 2 – Complete this part only if you expect to itemize deductions on your state return.

18 Enteryourestimatedfederalitemizeddeductionsforthetaxyear ........................................................................................... 18 19 Enteryourestimatedstate,local,andforeignincometaxesorstateandlocalgeneralsalestaxesincludedonline18 ........ 19 20 Subtractline19fromline18 .................................................................................................................................................... 20 21 Enteryourestimatedcollegetuitionitemizeddeduction .......................................................................................................... 21 22 Addlines20and21 ................................................................................................................................................................. 22 23 Basedonyourfederalfilingstatus,entertheapplicableamountfromthetablebelow ........................................................... 23

Single(cannotbeclaimedasadependent) .... $ 7,900 Qualifyingwidow(er) ........................................ $15,850 Single(canbeclaimedasadependent) ....... $ 3,100 Marriedfilingjointly .......................................... $15,850 Headofhousehold......................................... $11,100 Marriedfilingseparatereturns ......................... $ 7,900

24 Subtractline23fromline22(if line 23 is larger than line 22, enter 0 here and on line 16 above) ....................................................... 24 25 Divideline24by$1,000.Dropanyfractionandentertheresulthereandonline16above ................................................... 25

26 Entertheamountfromline6above ......................................................................................................................................... 26 27 Addlines14through16aboveandentertotalhere ................................................................................................................ 27 28 Addlines26and27.Entertheresulthereandonline2 ......................................................................................................... 28

6 Enter the number of dependents that you will claim on your state return (do not include yourself or, if married, your spouse) ..... 6 For lines 7, 8, and 9, enter 1 for each credit you expect to claim on your state return. 7 College tuition credit .................................................................................................................................................................. 7 8 NewYorkStatehouseholdcredit ............................................................................................................................................... 8 9 Realpropertytaxcredit .............................................................................................................................................................. 9 For lines 10, 11, and 12, enter 3 for each credit you expect to claim on your state return. 10 Child and dependent care credit ................................................................................................................................................ 10 11 Earned income credit ................................................................................................................................................................. 11 12 EmpireStatechildcredit ............................................................................................................................................................ 12 13 Other credits (see instructions) ...................................................................................................................................................... 13 14 Headofhouseholdstatusand only one job (enter 2 if the situation applies) ................................................................................... 14 15 Enteranestimateofyourfederaladjustmentstoincome,suchasalimonyyouwillpayforthetaxyear anddeductibleIRAcontributionsyouwillmakeforthetaxyear.Totalestimate$ . Dividethisestimateby$1,000.Dropanyfractionandenterthenumber .............................................................................. 15 16 Ifyouexpecttoitemizedeductionsonyourstatetaxreturn,completePart2belowandenterthenumberfromline25. All others enter 0 ................................................................................................................................................................... 16 17 Addlines6through16.Entertheresulthereandonline1.Ifyouhavemorethanonejob,orifyouandyourspouseboth work, see instructions for Taxpayers with more than one job or Married couples with both spouses working. ..................... 17

Standard deduction table

EmployersBox A – Ifyouarerequiredtosubmitacopyofanemployee’sFormIT-2104totheTaxDepartmentbecausetheemployeeclaimedmorethan14allowances,markanX inboxAandsendacopyofFormIT-2104to:NYS Tax Department, Income Tax Audit Administrator,WithholdingCertificateCoordinator,WAHarrimanCampus, Albany NY 12227-0865.Iftheemployeeisalsoanewhireorrehire, see Box B instructions.

Duedatesforsendingcertificatesreceivedfromemployeesclaimingmorethan14allowancesare:Quarter Due date Quarter Due dateJanuary–March April30 July–September October31April–June July31 October–December January31

Box B – IfyouaresubmittingacopyofthisformtocomplywithNewYorkState’sNewHireReportingProgram,markanX inboxB.Enterthefirstdayanyservicesareperformedforwhichtheemployeewillbepaidwages, commissions, tips and any other type of compensation. For servicesbasedsolelyoncommissions,thisisthefirstdayanemployeeworking for commissions is eligible to earn commissions. Also, mark an X in the Yes or Noboxindicatingifdependenthealthinsurancebenefitsareavailabletothisemployee.IfYes,enterthedatetheemployeequalifiesforcoverage.Mailthecompletedform,within20daysofhiring,to:NYS TaxDepartment,NewHireNotification,POBox15119,AlbanyNY12212-5119. Toreportnewly-hiredorrehiredemployeesonlineinsteadofsubmitting this form, go to www.nynewhire.com.

of 7 IT-2104 (2015)

Part 4 – These charts are only for married couples with both spouses working or married couples with one spouse working more than onejob,andwhosecombinedwagesarebetween$106,200and$2,231,827.

Enter the additional withholding dollar amount on line 3.

Theadditionaldollaramount,asshownbelow,isaccurateforaweeklypayroll.Ifyouarenotpaidonaweeklybasis,youwillneedtoadjustthesedollaramount(s).Forexample,ifyouarepaidbiweekly,youmustdoublethedollaramount(s)computed.

$106,200 $127,500 $148,700 $169,950 $191,200 $233,700 $276,250 $318,750 $371,900 $425,050 $478,200 $127,499 $148,699 $169,949 $191,199 $233,699 $276,249 $318,749 $371,899 $425,049 $478,199 $531,299

$53,100 $74,299 $11 $16

$74,300 $95,549 $11 $17 $22 $27

$95,550 $116,799 $8 $15 $20 $27 $34

$116,800 $127,499 $2 $10 $16 $23 $32 $31

$127,500 $138,099 $4 $13 $20 $30 $29

$138,100 $148,699 $2 $10 $17 $27 $29 $26

$148,700 $159,349 $4 $14 $25 $29 $24

$159,350 $170,149 $2 $11 $21 $27 $24 $22

$170,150 $191,199 $4 $16 $22 $23 $22 $18

$191,200 $233,699 $6 $12 $18 $20 $18 $19

$233,700 $276,249 $6 $12 $23 $25 $19 $18

$276,250 $318,749 $6 $18 $30 $26 $19

$318,750 $371,899 $10 $20 $27 $22

$371,900 $425,049 $8 $16 $23

$425,050 $478,199 $8 $16

$478,200 $531,299 $8

Combined wages between $106,200 and $531,299Higher earner’s wages

$531,300 $584,450 $637,600 $690,700 $743,850 $797,000 $850,150 $903,300 $956,450 $1,009,550 $1,062,650 $1,115,850 $584,449 $637,599 $690,699 $743,849 $796,999 $850,149 $903,299 $956,449 $1,009,549 $1,062,649 $1,115,849 $1,168,949

$233,700 $276,249 $18

$276,250 $318,749 $20 $16

$318,750 $371,899 $15 $17 $19 $14

$371,900 $425,049 $18 $11 $13 $15 $7 $7

$425,050 $478,199 $23 $18 $11 $13 $15 $7 $7 $7

$478,200 $531,299 $16 $23 $18 $11 $13 $15 $7 $7 $7 $7

$531,300 $584,449 $8 $16 $23 $18 $11 $13 $15 $7 $7 $7 $8 $11

$584,450 $637,599 $8 $16 $23 $18 $11 $13 $15 $7 $7 $8 $11

$637,600 $690,699 $8 $16 $23 $18 $11 $13 $15 $7 $8 $11

$690,700 $743,849 $8 $16 $23 $18 $11 $13 $15 $8 $11

$743,850 $796,999 $8 $16 $23 $18 $11 $13 $16 $11

$797,000 $850,149 $8 $16 $23 $18 $11 $14 $19

$850,150 $903,299 $8 $16 $23 $18 $12 $17

$903,300 $956,449 $8 $16 $23 $20 $15

$956,450 $1,009,549 $8 $16 $24 $23

$1,009,550 $1,062,649 $8 $17 $27

$1,062,650 $1,115,849 $9 $19

$1,115,850 $1,168,949 $9

Combined wages between $531,300 and $1,168,949

Higher earner’s wages

IT-2104 (2015) Page 5 of 7

$1,168,950 $1,222,100 $1,275,300 $1,328,400 $1,381,500 $1,434,700 $1,487,800 $1,540,900 $1,594,050 $1,647,250 $1,222,099 $1,275,299 $1,328,399 $1,381,499 $1,434,699 $1,487,799 $1,540,899 $1,594,049 $1,647,249 $1,700,399

$584,450 $637,599 $14 $17

$637,600 $690,699 $14 $17 $20 $23

$690,700 $743,849 $14 $17 $20 $23 $26 $30

$743,850 $796,999 $14 $17 $20 $23 $26 $30 $33 $36

$797,000 $850,149 $14 $17 $20 $23 $26 $30 $33 $36 $39 $42

$850,150 $903,299 $22 $17 $20 $23 $26 $30 $33 $36 $39 $42

$903,300 $956,449 $20 $25 $20 $23 $26 $30 $33 $36 $39 $42

$956,450 $1,009,549 $18 $23 $29 $23 $26 $30 $33 $36 $39 $42

$1,009,550 $1,062,649 $26 $21 $27 $32 $26 $30 $33 $36 $39 $42

$1,062,650 $1,115,849 $29 $27 $23 $28 $33 $28 $31 $34 $37 $40

$1,115,850 $1,168,949 $19 $29 $27 $23 $28 $33 $28 $31 $34 $37

$1,168,950 $1,222,099 $9 $19 $29 $27 $23 $28 $33 $28 $31 $34

$1,222,100 $1,275,299 $9 $19 $29 $27 $23 $28 $33 $28 $31

$1,275,300 $1,328,399 $9 $19 $29 $27 $23 $28 $33 $28

$1,328,400 $1,381,499 $9 $19 $29 $27 $23 $28 $33

$1,381,500 $1,434,699 $9 $19 $29 $27 $23 $28

$1,434,700 $1,487,799 $9 $19 $29 $27 $23

$1,487,800 $1,540,899 $9 $19 $29 $27

$1,540,900 $1,594,049 $9 $19 $29

$1,594,050 $1,647,249 $9 $19

$1,647,250 $1,700,399 $9

Combined wages between $1,168,950 and $1,700,399


$1,700,400 $1,753,500 $1,806,650 $1,859,800 $1,912,900 $1,966,050 $2,019,200 $2,072,350 $2,125,450 $2,178,650 $1,753,499 $1,806,649 $1,859,799 $1,912,899 $1,966,049 $2,019,199 $2,072,349 $2,125,449 $2,178,649 $2,231,827

$850,150 $903,299 $45 $48

$903,300 $956,449 $45 $48 $51 $54

$956,450 $1,009,549 $45 $48 $51 $54 $57 $60

$1,009,550 $1,062,649 $45 $48 $51 $54 $57 $60 $63 $66

$1,062,650 $1,115,849 $43 $46 $49 $53 $56 $59 $62 $65 $480 $904

$1,115,850 $1,168,949 $40 $43 $46 $49 $53 $56 $59 $62 $477 $904

$1,168,950 $1,222,099 $37 $40 $43 $46 $49 $53 $56 $59 $474 $901

$1,222,100 $1,275,299 $34 $37 $40 $43 $46 $49 $53 $56 $471 $898

$1,275,300 $1,328,399 $31 $34 $37 $40 $43 $46 $49 $53 $468 $895

$1,328,400 $1,381,499 $28 $31 $34 $37 $40 $43 $46 $49 $465 $892

$1,381,500 $1,434,699 $33 $28 $31 $34 $37 $40 $43 $46 $462 $889

$1,434,700 $1,487,799 $28 $33 $28 $31 $34 $37 $40 $43 $459 $886

$1,487,800 $1,540,899 $23 $28 $33 $28 $31 $34 $37 $40 $456 $883

$1,540,900 $1,594,049 $27 $23 $28 $33 $28 $31 $34 $37 $453 $880

$1,594,050 $1,647,249 $29 $27 $23 $28 $33 $28 $31 $34 $450 $877

$1,647,250 $1,700,399 $19 $29 $27 $23 $28 $33 $28 $31 $447 $874

$1,700,400 $1,753,499 $9 $19 $29 $27 $23 $28 $33 $28 $443 $871

$1,753,500 $1,806,649 $9 $19 $29 $27 $23 $28 $33 $440 $867

$1,806,650 $1,859,799 $9 $19 $29 $27 $23 $28 $446 $864

$1,859,800 $1,912,899 $9 $19 $29 $27 $23 $440 $869

$1,912,900 $1,966,049 $9 $19 $29 $27 $435 $864

$1,966,050 $2,019,199 $9 $19 $29 $440 $859

$2,019,200 $2,072,349 $9 $19 $441 $864

$2,072,350 $2,125,449 $9 $431 $865

$2,125,450 $2,178,649 $216 $443

$2,178,650 $2,231,827 $14



Note:Thesechartsdonotaccountforadditionalwithholdinginthefollowinginstances: • amarriedcouplewithbothspousesworking,whereonespouse’swagesaremorethan$1,115,914butlessthan$2,231,827,andtheother

spouse’swagesarealsomorethan$1,115,914butlessthan$2,231,827; • marriedtaxpayerswithonlyonespouseworking,andthatspouseworksmorethanonejob,withwagesfromeachjobunder$2,231,827,but

combinedwagesfromalljobsisover$2,231,827.Ifyouareinoneofthesesituationsandyouwouldliketorequestanadditionaldollaramountofwithholdingfromyourwages,pleasecontacttheTax

Departmentforassistance(seeNeed help?onpage6).

Need help?

Telephone assistanceAutomatedincometaxrefundstatus: (518)457-5149Personal Income TaxInformationCenter: (518)457-5181Toorderformsandpublications: (518)457-5431Text Telephone (TTY) Hotline (for persons with hearing and speech disabilities using a TTY): (518)485-5082

Visit our Web site at www.tax.ny.gov• getinformationandmanageyourtaxesonline• checkfornewonlineservicesandfeatures

Page 6 of 7 IT-2104 (2015)

$106,200 $127,500 $148,700 $169,950 $191,200 $233,700 $276,250 $318,750 $371,900 $425,050 $478,200 $127,499 $148,699 $169,949 $191,199 $233,699 $276,249 $318,749 $371,899 $425,049 $478,199 $531,299

$53,100 $74,299 $13 $18

$74,300 $95,549 $12 $19 $26 $25

$95,550 $116,799 $8 $16 $23 $26 $27

$116,800 $127,499 $2 $11 $18 $21 $25 $28

$127,500 $138,099 $4 $15 $18 $22 $28

$138,100 $148,699 $2 $11 $14 $19 $28 $26

$148,700 $159,349 $4 $11 $15 $27 $24

$159,350 $170,149 $2 $8 $13 $26 $25 $21

$170,150 $191,199 $3 $11 $25 $27 $22 $24

$191,200 $233,699 $8 $20 $29 $26 $24 $18

$233,700 $276,249 $8 $15 $23 $18 $18 $12

$276,250 $318,749 $7 $15 $22 $15 $16

$318,750 $371,899 $8 $16 $22 $14

$371,900 $425,049 $8 $16 $22

$425,050 $478,199 $8 $16

$478,200 $531,299 $8

Combined wages between $106,200 and $531,299Higher wage

$531,300 $584,450 $637,600 $690,700 $743,850 $797,000 $850,150 $903,300 $956,450 $1,009,550 $1,062,650 $1,115,850 $584,449 $637,599 $690,699 $743,849 $796,999 $850,149 $903,299 $956,449 $1,009,549 $1,062,649 $1,115,849 $1,168,949

$233,700 $276,249 $9

$276,250 $318,749 $9 $8

$318,750 $371,899 $16 $8 $8 $8

$371,900 $425,049 $14 $16 $8 $8 $8 $8

$425,050 $478,199 $22 $14 $16 $8 $8 $8 $8 $8

$478,200 $531,299 $16 $22 $14 $16 $8 $8 $8 $8 $8 $8

$531,300 $584,449 $8 $16 $22 $14 $16 $8 $8 $8 $8 $8 $222 $446

$584,450 $637,599 $8 $16 $22 $14 $16 $8 $8 $8 $8 $222 $446

$637,600 $690,699 $8 $16 $22 $14 $16 $8 $8 $8 $222 $446

$690,700 $743,849 $8 $16 $22 $14 $16 $8 $8 $222 $446

$743,850 $796,999 $8 $16 $22 $14 $16 $8 $222 $446

$797,000 $850,149 $8 $16 $22 $14 $16 $222 $446

$850,150 $903,299 $8 $16 $22 $14 $230 $446

$903,300 $956,449 $8 $16 $22 $228 $454

$956,450 $1,009,549 $8 $16 $235 $452

$1,009,550 $1,062,649 $8 $229 $460

$1,062,650 $1,115,849 $114 $240

$1,115,850 $1,168,949 $14

Combined wages between $531,300 and $1,168,949

Higher wage

Part 5 – Thesechartsareonlyforsingletaxpayersandheadofhouseholdtaxpayerswithmorethanonejob,andwhosecombinedwagesarebetween$106,200and$2,231,827.

Enter the additional withholding dollar amount on line 3.

Theadditionaldollaramount,asshownbelow,isaccurateforaweeklypayroll.Ifyouarenotpaidonaweeklybasis,youwillneedtoadjustthesedollaramount(s).Forexample,ifyouarepaidbiweekly,youmustdoublethedollaramount(s)computed.

PrivacynotificationTheCommissionerofTaxationandFinancemaycollectandmaintainpersonalinformationpursuanttotheNewYorkStateTaxLaw,includingbutnotlimitedto,sections5-a,171,171-a,287,308,429,475,505,697,1096,1142,and1415ofthatLaw;andmayrequiredisclosureofsocialsecuritynumberspursuantto42USC405(c)(2)(C)(i).Thisinformationwillbeusedtodetermineandadministertaxliabilitiesand,whenauthorizedbylaw,forcertaintaxoffsetandexchangeoftaxinformationprogramsas well as for any other lawful purpose.Informationconcerningquarterlywagespaidtoemployeesisprovidedtocertainstate agencies for purposes of fraud prevention, support enforcement, evaluation of the effectiveness of certain employment and training programs and other purposes authorizedbylaw.Failuretoprovidetherequiredinformationmaysubjectyoutocivilorcriminalpenalties,orboth,undertheTaxLaw.ThisinformationismaintainedbytheManagerofDocumentManagement,NYSTaxDepartment,WAHarrimanCampus,AlbanyNY12227;telephone(518)457-5181.

(Part 5 continued on page 7)

IT-2104 (2015) Page 7 of 7

$1,168,950 $1,222,100 $1,275,300 $1,328,400 $1,381,500 $1,434,700 $1,487,800 $1,540,900 $1,594,050 $1,647,250 $1,222,099 $1,275,299 $1,328,399 $1,381,499 $1,434,699 $1,487,799 $1,540,899 $1,594,049 $1,647,249 $1,700,399

$584,450 $637,599 $469 $493

$637,600 $690,699 $469 $493 $516 $539

$690,700 $743,849 $469 $493 $516 $539 $562 $585

$743,850 $796,999 $469 $493 $516 $539 $562 $585 $609 $632

$797,000 $850,149 $469 $493 $516 $539 $562 $585 $609 $632 $655 $678

$850,150 $903,299 $469 $493 $516 $539 $562 $585 $609 $632 $655 $678

$903,300 $956,449 $469 $493 $516 $539 $562 $585 $609 $632 $655 $678

$956,450 $1,009,549 $478 $493 $516 $539 $562 $585 $609 $632 $655 $678

$1,009,550 $1,062,649 $476 $501 $516 $539 $562 $585 $609 $632 $655 $678

$1,062,650 $1,115,849 $269 $285 $310 $325 $349 $372 $395 $418 $441 $465

$1,115,850 $1,168,949 $39 $68 $84 $109 $124 $147 $171 $194 $217 $240

$1,168,950 $1,222,099 $14 $39 $68 $84 $109 $124 $148 $171 $194 $217

$1,222,100 $1,275,299 $14 $39 $68 $84 $109 $124 $148 $171 $194

$1,275,300 $1,328,399 $14 $39 $68 $84 $109 $124 $148 $171

$1,328,400 $1,381,499 $14 $39 $68 $84 $109 $124 $147

$1,381,500 $1,434,699 $14 $39 $68 $84 $109 $124

$1,434,700 $1,487,799 $14 $39 $68 $84 $109

$1,487,800 $1,540,899 $14 $39 $68 $84

$1,540,900 $1,594,049 $14 $39 $68

$1,594,050 $1,647,249 $14 $39

$1,647,250 $1,700,399 $14


Higher wage

$1,700,400 $1,753,500 $1,806,650 $1,859,800 $1,912,900 $1,966,050 $2,019,200 $2,072,350 $2,125,450 $2,178,650 $1,753,499 $1,806,649 $1,859,799 $1,912,899 $1,966,049 $2,019,199 $2,072,349 $2,125,449 $2,178,649 $2,231,827

$850,150 $903,299 $701 $725

$903,300 $956,449 $701 $725 $748 $771

$956,450 $1,009,549 $701 $725 $748 $771 $794 $817

$1,009,550 $1,062,649 $701 $725 $748 $771 $794 $817 $841 $864

$1,062,650 $1,115,849 $488 $511 $534 $557 $581 $604 $627 $650 $673 $270

$1,115,850 $1,168,949 $263 $287 $310 $333 $356 $379 $403 $426 $449 $471

$1,168,950 $1,222,099 $240 $263 $287 $310 $333 $356 $379 $403 $426 $449

$1,222,100 $1,275,299 $217 $240 $263 $287 $310 $333 $356 $379 $403 $426

$1,275,300 $1,328,399 $194 $217 $240 $264 $287 $310 $333 $356 $379 $403

$1,328,400 $1,381,499 $171 $194 $217 $240 $263 $287 $310 $333 $356 $379

$1,381,500 $1,434,699 $148 $171 $194 $217 $240 $263 $287 $310 $333 $356

$1,434,700 $1,487,799 $124 $147 $171 $194 $217 $240 $263 $287 $310 $333

$1,487,800 $1,540,899 $109 $124 $147 $171 $194 $217 $240 $263 $287 $310

$1,540,900 $1,594,049 $84 $109 $124 $147 $171 $194 $217 $240 $263 $287

$1,594,050 $1,647,249 $68 $84 $109 $124 $147 $171 $194 $217 $240 $263

$1,647,250 $1,700,399 $39 $68 $84 $109 $124 $147 $171 $194 $217 $240

$1,700,400 $1,753,499 $14 $39 $68 $84 $109 $124 $147 $171 $194 $217

$1,753,500 $1,806,649 $14 $39 $68 $84 $109 $124 $147 $171 $194

$1,806,650 $1,859,799 $14 $39 $68 $84 $109 $124 $147 $171

$1,859,800 $1,912,899 $14 $39 $68 $84 $109 $124 $147

$1,912,900 $1,966,049 $14 $39 $68 $84 $109 $124

$1,966,050 $2,019,199 $14 $39 $68 $84 $109

$2,019,200 $2,072,349 $14 $39 $68 $84

$2,072,350 $2,125,449 $14 $39 $68

$2,125,450 $2,178,649 $14 $39

$2,178,650 $2,231,827 $14


Higher wage

The City University of New York New Employee Tax Compliance Notification Sheet

The Internal Revenue Service (“IRS”), the U.S. government tax authority, has issued strict regulations regarding the taxation and reporting of payments made to non-U.S. citizens. As a result, the City University of New York (“CUNY”) may be required to withhold U.S. income tax and file reports with the IRS in connection with payments made by the CUNY to employees (e.g., faculty, staff, and student employees) who are not U.S. citizens or permanent resident aliens (i.e., green card holders) and who receive payment for services. In addition, CUNY is required to report payments to the IRS. All individuals who are not citizens or permanent resident aliens of the United States are required to complete an Individual Record using the GLACIER online Tax Compliance System. If you are a new employee, you must go in person to receive a password and instructions of how to access GLACIER from the Nonresident Alien Tax Specialist. If you have already completed your Individual Record in GLACIER, additional or updated information may be required. GLACIER is accessible via the Internet from any web-accessible computer from anywhere in the world. When you receive your password and instructions, please complete the information on GLACIER immediately. GLACIER is simple and convenient to use; however, if you assistance, you should contact the Nonresident Alien Tax Specialist. Once you have completed the information in GLACIER, you must schedule an appointment with the Nonresident Alien Tax Specialist; please bring all completed forms and original documents to the appointment. Please note: You must complete the entire process within 7 business days from the date you sign this notification sheet. If you do not complete the entire process within 7 business days, the maximum rate of U.S. federal income tax and all other applicable taxes, including FICA, will be withheld from all payments until you access GLACIER to input information and submit your forms for processing. Any tax withheld because the required tax information was not provided will not be refunded by CUNY.

The Nonresident Alien Tax Specialist is located at: Hunter College – Cash Management

1501 East 212-772-4430 –David Smith

E-mail: [email protected] have been notified of my requirement to complete certain information in GLACIER. I understand that I must go to the Nonresident Alien Tax Specialist office to obtain access and instructions for GLACIER.

_____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________

___________________ ___________________________________ Employee Name (Print) Date

________________ _____________________________ Employee Signature Employee Phone Number

________________ _____________________________ E-mail Address Date

HUNTER COLLEGE - NON TAX LEVY PAYROLL DIRECT DEPOSIT REQUEST/AUTHORIZATION

SECTION “A” AND “B” TO BE COMPLETED BY THE EMPLOYEE

SECTION A: EMPLOYEE INFORMATION

FIRST NAME __________________________ MI _____ LAST NAME __________________________

SOCIAL SECURITY NUMBER # (LAST 4 DIGITS) __________________________________________

PERMANENT ADDRESS _______________________________________ APT# _____

CITY _______________________________ STATE ______ ZIP CODE ____________

TELEPHONE NUMBER (_____) _____________________

NAME OF FINANCIAL INSTITUTION _____________________________________

ACCOUNT TYPE (PLEASE CHECK ONE) CHECKING (attach voided check to section C, or have section C completed by your financial institution) SAVINGS (Section C must be completed by financial institution)

SECTION B: AUTHORIZATION AGREEMENT FOR DIRECT DEPOSIT I hereby authorize Hunter College to deposit my net pay directly into my checking or savings account as requested. I also grant authorization for the reversal of a credit to my account in the event the credit was made in error. I understand that, under the “National Automated Clearing House Association” operating guidelines and rules, Hunter College can only reverse the amount of the incorrect direct deposit. I agree that this authorization will remain in effect until I provide to my agency a written cancellation to terminate the service.

Employee Signature ______________________________________________ Date ________________________

SECTION C: TO BE COMPLETED BY YOUR FINANCIAL INSTITUTION Account Type Savings Checking

Depositor’s Account Number ABA Number

________________________________ _________________________

As representative of the above named financial institution, I certify that this financial institution is ACH capable and agrees to receive and deposit funds to the account shown above.

______________________________________________________________________________________________________________ Print or type Representative’s Name Signature of Representative Telephone Number Date

CANCELLATION I hereby authorize Hunter College to cancel my direct deposit agreement.

Employee Signature __________________________________________________ Date _______________________

AGENCY PAYROLL SECTION

Agency Representative: Name ___________________________ Signature ________________________ Date _______________

Cash Management Business Office Telephone (212) 650-3559 Facsimile (212) 772-4399

TO: NON-TAX LEVY PAYROLL DIRECT DEPOSIT PARTICIPANTS

FROM: DAVID SMITH ASST. DIRECTOR OF FISCAL OPERATIONS

RE: DIRECT DEPOSIT CHECK STUB

A stub will be sent to the Payroll Department, reflecting all payroll information. You have the option to pick up the stub by the Monday following payday, or to have the stub mailed to your department. Please indicate your choice below and return this memo to Cash Management, E1602. Please be advised that if you do not pick up your stub by the end of the second payroll of the month, it will be mailed to your department.

Please indicate your choice below: (Please Print)

________________________________________________________________________ Last Name First Name Department

________________________________________________________________________ SSN Dept. Ext. Home Telephone – area code and number

____________ Please hold my stub in the Payroll Department.

____________ Please send the stub to my Department.

If you have any questions regarding the disposition of your stub, please contact Payroll Distribution at 212-772-4163.

non-tax levy payroll appointment/reappointment...

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