- Paper: Letter (8.5in x 11in)
- Copies to print: 2
- The completed form must be submitted to the employer by the later of the following:
- February 28
- 30 days after you begin working or change your permanent residence.
- Employers must keep this form for five years from the date received.
- Mail to:
Mail Station 6501
St Paul MN 55146-6501
- Employees are eligible to claim this exemption if:
- The employee is a resident of Michigan or North Dakota.
- The employee returns to their residence in that state at least once a month.
- The employee doesn't want Minnesota income tax withheld from their wages.
- Employees who live in other states, including Minnesota, can't use this form.
- Employers may be assessed a $50 penalty for each form they're required to submit but don't.
- If the form isn't filled out completely, employers must withhold Minnesota income tax.
- To be used by nonresidents to file exemption from state withholding tax.
- Minnesota Dept. of Revenue
- Withholding Tax: (651) 282-9999
- Toll-free: (800) 657-3594
- Email: [email protected]