Form HW-6 "Employee's Statement to Employer Concerning Non-residence in the State of Hawaii" - Hawaii

What Is Form HW-6?

This is a legal form that was released by the Hawaii Department of Taxation - a government authority operating within Hawaii. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on January 1, 2018;
  • The latest edition provided by the Hawaii Department of Taxation;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form HW-6 by clicking the link below or browse more documents and templates provided by the Hawaii Department of Taxation.

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Download Form HW-6 "Employee's Statement to Employer Concerning Non-residence in the State of Hawaii" - Hawaii

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Clear Form
STATE OF HAWAII — DEPARTMENT OF TAXATION
EMPLOYEE’S STATEMENT TO EMPLOYER CONCERNING
Year
FORM HW-6
(REV. 2020)
NONRESIDENCE IN THE STATE OF HAWAII
2021
(Please Type or Print.)
(ALL lines must be completed, unless otherwise instructed.)
(See separate Instructions.)
Full Name
Social Security Number
Present Home Address (Street, City, State, and Postal/ZIP Code)
Name of Employer and Employer’s Address (Street, City, State, and Postal/ZIP Code)
(NOTE: References to “married” and “spouse” are also references to “in a civil union” and “civil union partner,” respectively.)
1. Are you currently a resident of Hawaii? (See Instructions for a discussion of a “Resident.”)......................................Yes
No
If you checked “Yes,” stop here. Do not complete the rest of this form. Do not file this form with your employer.
Withholding is required on your wages.
2. Have you ever been a resident of Hawaii? .................................................................................................................Yes
No
If you checked “Yes,” answer questions 3 through 34. If you checked “No,” answer questions 3 through 23.
3. Address of your domicile which is your true, fixed, permanent home and principal establishment and to which
place you intend to return whenever you are absent
4. If you are married or have dependents, state their relationships to you and their present addresses.
Otherwise, enter “Not applicable” on line 4a.
Relationship to You
Present Address
a.
b.
5. Can you be claimed as a dependent on another person’s income tax return? (See Instructions.) ............................Yes
No
If you checked “Yes,” is the person who can claim you as a dependent a Hawaii resident? .......................................Yes
No
6. Were you physically present in Hawaii at any time during the calendar years 2017 through 2021? ..........................Yes
No
If you checked “Yes,” state approximately how many days, in the aggregate, you spent in Hawaii during
each of the following years:
2017
2018
2019
2020
2021
If you were present in Hawaii more than 200 days during the year, explain the reason you were in Hawaii.
7. Do you own real property in Hawaii? ..........................................................................................................................Yes
No
If you checked “Yes,” indicate the type of property: Residential
Rental
Other (Explain)
8. Do you own real property outside Hawaii? .................................................................................................................Yes
No
If you checked “Yes,” indicate the type of property: Residential
Rental
Other (Explain)
Note:
If you check “Yes” to any of the questions 9 through 17, please state the reason on the dotted line next to the check boxes.
9. Do you have a Hawaii driver’s license? ......................................................................................................................Yes
No
10. Have you purchased Hawaii auto license plates? ......................................................................................................Yes
No
11. Do your children attend school in Hawaii? .................................................................................................................Yes
No
12. Do you have any checking accounts or safe deposit boxes with banks, or other financial institutions, on
which you have listed a Hawaii address? ...................................................................................................................Yes
No
13. Do you have a Hawaii telephone listing? ....................................................................................................................Yes
No
14. Are you a member of any social, business, or church groups in Hawaii? ..................................................................Yes
No
15. Are you registered to vote in Hawaii? (Except for Presidential Elections as provided under Chapter 14,
Hawaii Revised Statutes) ...........................................................................................................................................Yes
No
16. Will your estate be admitted to probate in Hawaii? ....................................................................................................Yes
No
ID NO 01
FORM HW-6
HW6_I 2020A 01 VID01
Clear Form
STATE OF HAWAII — DEPARTMENT OF TAXATION
EMPLOYEE’S STATEMENT TO EMPLOYER CONCERNING
Year
FORM HW-6
(REV. 2020)
NONRESIDENCE IN THE STATE OF HAWAII
2021
(Please Type or Print.)
(ALL lines must be completed, unless otherwise instructed.)
(See separate Instructions.)
Full Name
Social Security Number
Present Home Address (Street, City, State, and Postal/ZIP Code)
Name of Employer and Employer’s Address (Street, City, State, and Postal/ZIP Code)
(NOTE: References to “married” and “spouse” are also references to “in a civil union” and “civil union partner,” respectively.)
1. Are you currently a resident of Hawaii? (See Instructions for a discussion of a “Resident.”)......................................Yes
No
If you checked “Yes,” stop here. Do not complete the rest of this form. Do not file this form with your employer.
Withholding is required on your wages.
2. Have you ever been a resident of Hawaii? .................................................................................................................Yes
No
If you checked “Yes,” answer questions 3 through 34. If you checked “No,” answer questions 3 through 23.
3. Address of your domicile which is your true, fixed, permanent home and principal establishment and to which
place you intend to return whenever you are absent
4. If you are married or have dependents, state their relationships to you and their present addresses.
Otherwise, enter “Not applicable” on line 4a.
Relationship to You
Present Address
a.
b.
5. Can you be claimed as a dependent on another person’s income tax return? (See Instructions.) ............................Yes
No
If you checked “Yes,” is the person who can claim you as a dependent a Hawaii resident? .......................................Yes
No
6. Were you physically present in Hawaii at any time during the calendar years 2017 through 2021? ..........................Yes
No
If you checked “Yes,” state approximately how many days, in the aggregate, you spent in Hawaii during
each of the following years:
2017
2018
2019
2020
2021
If you were present in Hawaii more than 200 days during the year, explain the reason you were in Hawaii.
7. Do you own real property in Hawaii? ..........................................................................................................................Yes
No
If you checked “Yes,” indicate the type of property: Residential
Rental
Other (Explain)
8. Do you own real property outside Hawaii? .................................................................................................................Yes
No
If you checked “Yes,” indicate the type of property: Residential
Rental
Other (Explain)
Note:
If you check “Yes” to any of the questions 9 through 17, please state the reason on the dotted line next to the check boxes.
9. Do you have a Hawaii driver’s license? ......................................................................................................................Yes
No
10. Have you purchased Hawaii auto license plates? ......................................................................................................Yes
No
11. Do your children attend school in Hawaii? .................................................................................................................Yes
No
12. Do you have any checking accounts or safe deposit boxes with banks, or other financial institutions, on
which you have listed a Hawaii address? ...................................................................................................................Yes
No
13. Do you have a Hawaii telephone listing? ....................................................................................................................Yes
No
14. Are you a member of any social, business, or church groups in Hawaii? ..................................................................Yes
No
15. Are you registered to vote in Hawaii? (Except for Presidential Elections as provided under Chapter 14,
Hawaii Revised Statutes) ...........................................................................................................................................Yes
No
16. Will your estate be admitted to probate in Hawaii? ....................................................................................................Yes
No
ID NO 01
FORM HW-6
HW6_I 2020A 01 VID01
FORM HW-6
(REV. 2020)
PAGE 2
17. Do you file Hawaii resident income tax returns? ........................................................................................................Yes
No
18. With which Internal Revenue Service Center do you file your federal income tax returns?
19. Are you a U.S. citizen? ...............................................................................................................................................Yes
No
If you checked “No,” are you a permanent resident alien of the U.S.? ........................................................................Yes
No
If you are not a permanent resident alien of the U.S., state the type of visa you have.
20. Are you in Hawaii in compliance with military or naval orders of the United States? .................................................Yes
No
If you checked “Yes,” enclose a true copy of your military or naval orders.
21. Are you in Hawaii while engaged in aviation or navigation? .......................................................................................Yes
No
If you checked “Yes,” enclose a true copy of a letter from your employer describing your services
performed in aviation or navigation.
22. Are you in Hawaii while a student at any institution of learning? ................................................................................Yes
No
If you checked “Yes,” enclose a true copy of a document certified by the officials of the
school, college, or university, evidencing your enrollment in their class or course.
23. Are you the spouse of a nonresident service member, crew member, or student who came to Hawaii;
your principal reason for moving to Hawaii was to accompany your spouse; and it is your intention to
leave Hawaii when your spouse is transferred, discharged, or graduates? ................................................................Yes
No
If you checked “Yes,” enclose true copies of your spouse’s military or naval orders and Leave and Earning
Statement, and your unexpired military spouse identification card; a letter from your spouse’s employer
describing your spouse’s services performed in aviation or navigation; or document certified by
the officials of the school, college, or university evidencing your spouse’s enrollment in their class or course.
Note:
If you checked “No” to question 2, stop here. If you checked “Yes” to question 2, answer questions 24 through 34.
24. List the years you were a resident of Hawaii.
25. Explain why you gave up your Hawaii residency.
26. If you were domiciled in Hawaii, on what date did you terminate your Hawaii domicile?
27. Did you move out of Hawaii to your new domicile? ....................................................................................................Yes
No
If you checked “Yes,” on what date? (Note: This date may be different than the date in number 26.)
28. What specific steps did you take to terminate your Hawaii domicile and on what date did you take such steps?
29. In what state or country did you establish your new domicile?
30. When did you begin working in that state or country?
31. Did your family move out of Hawaii to your new domicile? .........................................................................................Yes
No
If you checked “Yes,” on what date? ____________________________
32. In the state or country you are now claiming as your new domicile, have you:
a.
Purchased a home? ............................................................................................................................................Yes
No
If you checked “Yes,” on what date was it purchased?__________________________
b.
Sent your children to schools in that state or country? .......................................................................................Yes
No
c.
Joined any social, business, or church groups in that state or country? .............................................................Yes
No
d.
Registered to vote in that state or country? ........................................................................................................Yes
No
33. What other specific steps did you take to establish your new domicile?
34. Please enter any other facts or circumstances relating to your change of domicile that you feel should be
considered.
I declare under the penalties of section 231-36 of the Hawaii Revised Statutes, that I have answered all the above questions which I
am required to answer, and that my answers are true and correct.
Employee’s Signature:
Date:
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