STATE INCOME TAX WITHHOLDING FORMS

1 STATE INCOME TAX WITHHOLDING FORMS . Please click on either the electronic or paper form link below in order to access the tax WITHHOLDING form you need. If completing a paper form , please send to or fax it to 858-565-8406. If submitted prior to the close of the bi-weekly pay period, changes in tax withholdings will be reflected in the following pay check. Changes for faxed or emailed FORMS will be visible in UltiPro within 1 business day. If you do not see the changes entered or if they are incorrect, please contact If you have difficulty logging in to UltiPro to access the electronic tax form , contact for assistance. STATE Electronic Tax form Paper Tax form Alabama (11_10).pdf Alaska If you reside in this STATE , you are not required to submit a STATE tax WITHHOLDING form . Arizona &tabid=265&mid=921. Arkansas California (This STATE uses the Colorado Federal W4 form for STATE taxes. To indicate separate STATE tax allowances, write STATE across the top of the form .)

2 Connecticut (This STATE uses the Delaware Federal W4 form for STATE taxes. To indicate separate STATE tax allowances, write STATE across the top of the form .). District of Not currently available Columbia electronically; please use paper form Florida If you reside in this STATE , you are not required to submit a STATE tax WITHHOLDING form . Georgia ument/TSD_Employees_Withholding_Allowanc e_Certificate_G- Hawaii df (This STATE uses the Idaho Federal W4 form for STATE taxes. To indicate separate STATE tax allowances, write STATE across the top of the form .). Illinois Indiana Iowa Kansas Kentucky 6C70D441A8E0/0 Page 1 of 3 Revised March 30, 2015. STATE INCOME TAX WITHHOLDING FORMS . STATE Electronic Tax form Paper Tax form Louisiana .pdf Maine Maryland Massachusetts Michigan (This STATE uses the Minnesota Federal W4 form for STATE taxes. To indicate separate STATE tax allowances, write STATE across the top of the form .)

3 Mississippi Missouri (This STATE uses the Montana Federal W4 form for STATE taxes. To indicate separate STATE tax allowances, write STATE across the top of the form .). (This STATE uses the Nebraska Federal W4 form for STATE taxes. To indicate separate STATE tax allowances, write STATE across the top of the form .). Nevada If you reside in this STATE , you are not required to submit a STATE tax WITHHOLDING form . New If you reside in this STATE , you are not required to submit a STATE tax WITHHOLDING form . Hampshire New Jersey (This STATE uses the New Mexico Federal W4 form for STATE taxes. To indicate separate STATE tax allowances, write STATE across the top of the form .). New York North Carolina (This STATE uses the North Dakota Federal W4 form for STATE taxes. To indicate separate STATE tax allowances, write STATE across the top of the form .). Ohio / (This STATE uses the Oklahoma Federal W4 form for STATE taxes.)

4 To indicate separate STATE tax allowances, write STATE across the top of the form .). Page 2 of 3 Revised March 30, 2015. STATE INCOME TAX WITHHOLDING FORMS . STATE Electronic Tax form Paper Tax form (This STATE uses the Oregon Federal W4 form for STATE taxes. To indicate separate STATE tax allowances, write STATE across the top of the form .). Pennsylvania Not currently available (Residency (Local Taxes) electronically; please use paper form Certification form : Local Earned INCOME Tax WITHHOLDING ). (This STATE uses the Pennsylvania Not currently available Federal W4 form for STATE taxes. To indicate separate STATE tax ( STATE Taxes) electronically; please use paper form allowances, write STATE across the top of the form .). Rhode Island 4% (This STATE uses the South Carolina Federal W4 form for STATE taxes. To indicate separate STATE tax allowances, write STATE across the top of the form .). South Dakota If you reside in this STATE , you are not required to submit a STATE tax WITHHOLDING form .

5 Tennessee If you reside in this STATE , you are not required to submit a STATE tax WITHHOLDING form . Texas If you reside in this STATE , you are not required to submit a STATE tax WITHHOLDING form . (This STATE uses the Utah Federal W4 form for STATE taxes. To indicate separate STATE tax allowances, write STATE across the top of the form .). Vermont .pdf Virginia Washington If you reside in this STATE , you are not required to submit a STATE tax WITHHOLDING form . (This STATE uses the West Virginia Federal W4 form for STATE taxes. To indicate separate STATE tax allowances, write STATE across the top of the form .). (This STATE uses the Wisconsin Federal W4 form for STATE taxes. To indicate separate STATE tax allowances, write STATE across the top of the form .). Wyoming If you reside in this STATE , you are not required to submit a STATE tax WITHHOLDING form . Page 3 of 3 Revised March 30, 2015.