Form 9N "Nebraska Nonresident Employee Certificate for Allocation of Income Tax Withholding" - Nebraska

What Is Form 9N?

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

Form Details:

  • Released on November 1, 2017;
  • The latest edition provided by the Nebraska Department of Revenue;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;

Download a fillable version of Form 9N by clicking the link below or browse more documents and templates provided by the Nebraska Department of Revenue.

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Download Form 9N "Nebraska Nonresident Employee Certificate for Allocation of Income Tax Withholding" - Nebraska

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Nebraska Nonresident Employee Certificate
FORM
9N
for Allocation of Income Tax Withholding
Employee’s Name
Percent of Compensation Subject to
Social Security Number
Withholding
%
Home Address (Number and Street, or Rural Route and Box Number)
Employer’s Name
*
City
State
Zip Code
Check this box if you are a nonresident military spouse whose income is not subject
to Nebraska tax.
Under penalties of perjury, I declare that I reside at the address shown above. I estimate that the above percentage of my
compensation from the employer with whom I file this certificate is for services subject to Nebraska income tax withholding. I will notify
my employer by filing another Form 9N within ten days of any substantial change in the proportion of my services subject to Nebraska
income tax withholding.
I also understand that a nonresident individual who provides false information on Form 9N or an employer who knowingly
uses such false information may be penalized. Furthermore, penalties may be imposed if the false information results in an
amount withheld of less than 75 percent of the employee’s tax liability on the wages. This penalty may equal the total tax
evaded, and an additional penalty of up to $1,000 may be imposed.
RESET
PRINT
sign
here
Signature of Employee
Date
Employee:
File this certificate with your employer. Do not send it to the Nebraska Department of Revenue.
Employer:
Retain this certificate with your withholding tax records. You may withhold on the basis of this certificate,
but you must make any necessary adjustments during the year so that the proper amount is withheld
from the employee. The percentage indicated on Form 9N does not determine the amount of Nebraska
wages or other compensation to be reported on Form W-2.
* Note: For tax year 2009 and after, the wages of a nonresident military spouse (with the same legal
residence in another state as the servicemember) are not subject to Nebraska tax.
revenue.nebraska.gov, 800-742-7474 (NE and IA), 402-471-5729
8-011-1967 Rev. 11-2017
Supersedes 8-011-1967 Rev. 12-2013
Nebraska Nonresident Employee Certificate
FORM
9N
for Allocation of Income Tax Withholding
Employee’s Name
Percent of Compensation Subject to
Social Security Number
Withholding
%
Home Address (Number and Street, or Rural Route and Box Number)
Employer’s Name
*
City
State
Zip Code
Check this box if you are a nonresident military spouse whose income is not subject
to Nebraska tax.
Under penalties of perjury, I declare that I reside at the address shown above. I estimate that the above percentage of my
compensation from the employer with whom I file this certificate is for services subject to Nebraska income tax withholding. I will notify
my employer by filing another Form 9N within ten days of any substantial change in the proportion of my services subject to Nebraska
income tax withholding.
I also understand that a nonresident individual who provides false information on Form 9N or an employer who knowingly
uses such false information may be penalized. Furthermore, penalties may be imposed if the false information results in an
amount withheld of less than 75 percent of the employee’s tax liability on the wages. This penalty may equal the total tax
evaded, and an additional penalty of up to $1,000 may be imposed.
RESET
PRINT
sign
here
Signature of Employee
Date
Employee:
File this certificate with your employer. Do not send it to the Nebraska Department of Revenue.
Employer:
Retain this certificate with your withholding tax records. You may withhold on the basis of this certificate,
but you must make any necessary adjustments during the year so that the proper amount is withheld
from the employee. The percentage indicated on Form 9N does not determine the amount of Nebraska
wages or other compensation to be reported on Form W-2.
* Note: For tax year 2009 and after, the wages of a nonresident military spouse (with the same legal
residence in another state as the servicemember) are not subject to Nebraska tax.
revenue.nebraska.gov, 800-742-7474 (NE and IA), 402-471-5729
8-011-1967 Rev. 11-2017
Supersedes 8-011-1967 Rev. 12-2013