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Download DD Form 2058 "State of Legal Residence Certificate"
STATE OF LEGAL RESIDENCE CERTIFICATE
PRIVACY ACT STATEMENT
AUTHORITY: 50 U.S.C 571, Residence for tax purposes and 37 U.S.C., Pay and Allowances of the Uniformed Services.
PURPOSE: Information is required for determining the correct State of legal residence for purposes of withholding State income taxes from military
pay.
ROUTINE USES: Additional routine uses are listed in the applicable system of records notices, T7340, Defense Joint Military Pay System-Active
Component, and T7344, Defense Joint Military Pay System-Reserve Component are located at: http://dpcld.defense.gov/Privacy/SORNsIndex/DOD-
Component-Notices/DFAS-Article-List/. M01040-3, Marine Corps Manpower Management Information System Records, located at http://
dpcld.defense.gov/Privacy/SORNsIndex/DOD-Component-Notices/.
DISCLOSURE: Voluntary, however, if not provided, State income taxes will be withheld based on the tax laws of the applicable State, based on your
home of record.
1. NAME (Last, First, Middle Initial)
2. DOD ID NUMBER
3. LEGAL RESIDENCE/DOMICILE (City or county and State)
INSTRUCTIONS FOR CERTIFICATION OF STATE OF LEGAL RESIDENCE
The purpose of this certificate is to obtain information with respect to your legal residence/domicile for the purpose of determining the State for which income
taxes are to be withheld from your "wages" as defined by Section 3401(a) of the Internal Revenue Code of 1954. PLEASE READ INSTRUCTIONS CAREFULLY
BEFORE SIGNING.
The terms "legal residence" and "domicile" are essentially interchangeable. In brief, they are used to denote that place where you have your permanent home
and to which, whenever you are absent, you have the intention of returning. The Soldiers’ and Sailors’ Civil Relief Act protects your military pay from the income
taxes of the State in which you reside by reason of military orders unless that is also your legal residence/domicile. The Act further provides that no change in
your State of legal residence/domicile will occur solely as a result of your being ordered to a new duty station.
You should not confuse the State which is your "home of record" with your State of legal residence/domicile. Your "home of record" is used for fixing travel and
transportation allowances. A "home of record" must be changed if it was erroneously or fraudulently recorded initially.
Enlisted members may change their "home of record" at the time they sign a new enlistment contract. Officers may not change their "home of record" except to
correct an error, or after a break in service. The State which is your "home of record" may be your State of legal residence/domicile only if it meets certain
criteria.
The formula for changing your State of legal residence/domicile is simply stated as follows: physical presence in the new State with the simultaneous intent of
making it your permanent home and abandonment of the old State of legal residence/domicile. In most cases, you must actually reside in the new State at the
time you form the intent to make it your permanent home. Such intent must be clearly indicated. Your intent to make the new State your permanent home may
be indicated by certain actions such as: (1) registering to vote; (2) purchasing residential property or an unimproved residential lot; (3) titling and registering your
automobile(s); (4) notifying the State of your previous legal residence/domicile of the change in your State of legal residence/domicile; and (5) preparing a new
last will and testament which indicates your new State of legal residence/domicile. Finally, you must comply with the applicable tax laws of the State which is
your new legal residence/domicile.
Generally, unless these steps have been taken, it is doubtful that your State of legal residence/domicile has changed. Failure to resolve any doubts as to your
State of legal residence/domicile may adversely impact on certain legal privileges which depend on legal residence/domicile including among others, eligibility
for resident tuition rates at State universities, eligibility to vote or be a candidate for public office, and eligibility for various welfare benefits. If you have any doubt
with regard to your State of legal residence/domicile, you are advised to see your Legal Assistance Officer (JAG Representative) for advice prior to completing
this form.
I certify that to the best of my knowledge and belief, I have met all the requirements for legal residence/domicile in the State claimed above and that the
information provided is correct.
I understand that the tax authorities of my former State of legal residence/domicile will be notified of this certificate.
5.CURRENT MAILING ADDRESS (Include Zip Code)
4. SIGNATURE OF APPLICANT
6. DATE (YYMMDD)
DD FORM 2058, JAN 2018
AEM Designer
PREVIOUS EDITION IS OBSOLETE.
STATE OF LEGAL RESIDENCE CERTIFICATE
PRIVACY ACT STATEMENT
AUTHORITY: 50 U.S.C 571, Residence for tax purposes and 37 U.S.C., Pay and Allowances of the Uniformed Services.
PURPOSE: Information is required for determining the correct State of legal residence for purposes of withholding State income taxes from military
pay.
ROUTINE USES: Additional routine uses are listed in the applicable system of records notices, T7340, Defense Joint Military Pay System-Active
Component, and T7344, Defense Joint Military Pay System-Reserve Component are located at: http://dpcld.defense.gov/Privacy/SORNsIndex/DOD-
Component-Notices/DFAS-Article-List/. M01040-3, Marine Corps Manpower Management Information System Records, located at http://
dpcld.defense.gov/Privacy/SORNsIndex/DOD-Component-Notices/.
DISCLOSURE: Voluntary, however, if not provided, State income taxes will be withheld based on the tax laws of the applicable State, based on your
home of record.
1. NAME (Last, First, Middle Initial)
2. DOD ID NUMBER
3. LEGAL RESIDENCE/DOMICILE (City or county and State)
INSTRUCTIONS FOR CERTIFICATION OF STATE OF LEGAL RESIDENCE
The purpose of this certificate is to obtain information with respect to your legal residence/domicile for the purpose of determining the State for which income
taxes are to be withheld from your "wages" as defined by Section 3401(a) of the Internal Revenue Code of 1954. PLEASE READ INSTRUCTIONS CAREFULLY
BEFORE SIGNING.
The terms "legal residence" and "domicile" are essentially interchangeable. In brief, they are used to denote that place where you have your permanent home
and to which, whenever you are absent, you have the intention of returning. The Soldiers’ and Sailors’ Civil Relief Act protects your military pay from the income
taxes of the State in which you reside by reason of military orders unless that is also your legal residence/domicile. The Act further provides that no change in
your State of legal residence/domicile will occur solely as a result of your being ordered to a new duty station.
You should not confuse the State which is your "home of record" with your State of legal residence/domicile. Your "home of record" is used for fixing travel and
transportation allowances. A "home of record" must be changed if it was erroneously or fraudulently recorded initially.
Enlisted members may change their "home of record" at the time they sign a new enlistment contract. Officers may not change their "home of record" except to
correct an error, or after a break in service. The State which is your "home of record" may be your State of legal residence/domicile only if it meets certain
criteria.
The formula for changing your State of legal residence/domicile is simply stated as follows: physical presence in the new State with the simultaneous intent of
making it your permanent home and abandonment of the old State of legal residence/domicile. In most cases, you must actually reside in the new State at the
time you form the intent to make it your permanent home. Such intent must be clearly indicated. Your intent to make the new State your permanent home may
be indicated by certain actions such as: (1) registering to vote; (2) purchasing residential property or an unimproved residential lot; (3) titling and registering your
automobile(s); (4) notifying the State of your previous legal residence/domicile of the change in your State of legal residence/domicile; and (5) preparing a new
last will and testament which indicates your new State of legal residence/domicile. Finally, you must comply with the applicable tax laws of the State which is
your new legal residence/domicile.
Generally, unless these steps have been taken, it is doubtful that your State of legal residence/domicile has changed. Failure to resolve any doubts as to your
State of legal residence/domicile may adversely impact on certain legal privileges which depend on legal residence/domicile including among others, eligibility
for resident tuition rates at State universities, eligibility to vote or be a candidate for public office, and eligibility for various welfare benefits. If you have any doubt
with regard to your State of legal residence/domicile, you are advised to see your Legal Assistance Officer (JAG Representative) for advice prior to completing
this form.
I certify that to the best of my knowledge and belief, I have met all the requirements for legal residence/domicile in the State claimed above and that the
information provided is correct.
I understand that the tax authorities of my former State of legal residence/domicile will be notified of this certificate.
5.CURRENT MAILING ADDRESS (Include Zip Code)
4. SIGNATURE OF APPLICANT
6. DATE (YYMMDD)
DD FORM 2058, JAN 2018
AEM Designer
PREVIOUS EDITION IS OBSOLETE.
DD Form 2058 Instructions
Carefully read and review the step-by-step instructions attached to the form before filing.
- Note the difference between the State of Legal Residence and Home of Record.
- Your State of Legal Residence (SLR) is the place you permanently live in and have the intention to return to when leaving.
- A Home of Record (HOR) is a military-exclusive term that determines certain service-related benefits. The HOR does not apply to military spouses. It refers to the state where you originally enlisted or from where you received a commission from the Army.
- Your Home of Record can change when signing a new enlistment contract. In some cases, your State of Legal Residence and Home of Record can be the same place.
- In order to officially change their legal domicile the individual must be physically present at the new address, must intend to treat the location as a place of permanent residence and must intend to abandon the previous SLR. The intent to change your SLR can be shown through some of the following:
- Registering to vote or voting;
- Purchasing residential property;
- Obtaining a driver's license or registering your vehicle through the DMV;
- Paying state tax;
- Preparing a new last will and testament which indicates the new domicile as your new State of Legal Residence.
- File the DD 2058 after you have taken the steps to establish a new domicile. Fill in the form with your name and social security number, state your new SLR and sign the form. If you have any questions, contact your Legal Assistance Officer (JAG Representative) for advice on filling this form.
- Remember that failure to resolve your case may have an impact on certain military privileges.
DD 2058 Related Forms
- DD Form 2058-1, State Income Tax Exemption Test Certificate is a document filed by residents of those states that exclude military pay from income taxes. This form will stop your taxes from being withheld for the year the form was submitted.
- DD Form 2058-2, Native American State Income Tax Withholding Exemption Certificate is used by Native American servicemen and women to claim exemption from income tax withholding on their pay.
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