Minnesota Payroll Withholding

Your W4 Information
For Payroll in Tax Year:
Federal Withholding Status:
Federal Allowances:
Federal Additional Withholding Amount:
State Withholding Status:
Minnesota Claimed Allowances:
State Additional Withholding Amount:

Your Paycheck Information

Pay Periods per Year:

Gross Salary Per Pay Period:

Income to be taxed as supplemental income:

Before Tax Retirement Benefits:
(401(k), 403(b), etc)

Before Tax Cafeteria Plan Benefits:
(Medical, Child Care, etc)

After Tax Deduction:

Optional for FICA limit calculation

Gross Salary YTD
(Do not include this paycheck)

Data Storage Options