CT-W4 Fillable

Employees: See Employee General Instructions on Page 2. Sign and return Form CT-W4 to your employer. Keep a copy for your records.
1.
Withholding Code: Enter Withholding Code letter chosen from above.........................1. 
2.
Additional withholding amount per pay period: If any, see instructions. .......................2. $
3.
Reduced withholding amount per pay period: If any, see instructions..........................3. $
Form CT-W4
Employee’s Withholding Certificate
Department of Revenue Services
State of Connecticut
(Rev. 12/23)
Effective January 1, 2024
Employee Instructions
• Read the instructions on Page 2 before completing this form.
• Select the filing status you expect to report on your Connecticut
income tax return.
• Choose the statement that best describes your gross income.
• Enter the Withholding Code on Line 1 below.
Check if you are claiming
the MSRRA exemption 
and enter state of legal 
residence/domicile:
_____________________

Employers: See Employer Instructions, on Page 2.
Declaration: I declare under penalty of law that I have examined this certificate and, to the best of my knowledge and belief, it is true, complete, and 
correct. I understand the penalty for reporting false information is a fine of not more than $5,000, imprisonment for not more than five years, or both.
Is this a new or rehired employee?	
 No	
 Yes  Enter date hired:
mm/dd/yyyy
* If you are claiming the Military Spouses Residency Relief Act (MSRRA) exemption, see instructions on Page 2.
Our expected combined annual gross income is less than or
equal to $24,000 or I am claiming exemption under the Military	
E
Spouses Residency Relief Act (MSRRA)* and no withholding 
is necessary.
My spouse is employed and our expected combined annual 
gross income is greater than $24,000 and less than or equal	
A
to $100,500. See Certain Married Individuals, Page 2.
My spouse is not employed and our expected combined	
C
annual gross income is greater than $24,000.
My spouse is employed and our expected combined	
D
annual gross income is greater than $100,500.
I have significant nonwage income and wish to avoid having	
D
too little tax withheld.
I am a nonresident of Connecticut with substantial other income.	
D
Withholding 
Code
My expected annual gross income is less than or equal to
$24,000 or I am claiming exemption under the MSRRA* and	
E
no withholding is necessary.
My expected annual gross income is greater than $24,000.	
C
I have significant nonwage income and wish to avoid having too	
D
little tax withheld.
I am a nonresident of Connecticut with substantial other income.	
D
Withholding 
Code
Qualifying Surviving Spouse
Married Filing Jointly
My expected annual gross income is less than or equal to 
$12,000 or I am claiming exemption under the MSRRA* and	
E
no withholding is necessary.
My expected annual gross income is greater than $12,000.	
A
I have significant nonwage income and wish to avoid having	
D
too little tax withheld.
I am a nonresident of Connecticut with substantial other income.	
D
Withholding 
Code
My expected annual gross income is less than or equal to	
E
$15,000 and no withholding is necessary.
My expected annual gross income is greater than $15,000.	
F
I have significant nonwage income and wish to avoid having	
D
too little tax withheld.
I am a nonresident of Connecticut with substantial other income.	
D
Withholding 
Code
My expected annual gross income is less than or equal to	
E
$19,000 and no withholding is necessary.
My expected annual gross income is greater than $19,000.	
B
I have significant nonwage income and wish to avoid having	
D
too little tax withheld.
I am a nonresident of Connecticut with substantial other income.	
D
Withholding 
Code
Married Filing Separately
Single
Head of Household
First name	
Ml	
Last name	
Social Security Number
Home address (number and street, apartment number, suite number, PO Box)
City/town	
State	
ZIP code 
Employee’s signature	
Date
Employer’s business name			
Federal Employer Identification Number
Employer’s business address
City/town	
State	
ZIP code
Contact person			
Telephone number
	
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Visit us at portal.ct.gov/DRS for more information.
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Form CT-W4 (Rev. 12/23)
Page 2 of 2
Form CT-W4 Instructions 
Employee General Instructions
Form CT‑W4, Employee’s Withholding Certificate, provides your 
employer with the necessary information to withhold the correct 
amount of Connecticut income tax from your wages to ensure that 
you will not be underwithheld or overwithheld.
You are required to pay Connecticut income tax as income is earned 
or received during the year. You should complete a new Form CT‑W4 
at least once a year or if your tax situation changes.
If your circumstances change, such as you receive a bonus or your 
filing status changes, you must furnish your employer with a new 
Form CT‑W4 within ten days of the change.
Gross Income
For Form CT-W4 purposes, gross income means all income from 
all sources, whether received in the form of money, goods, property, 
or services, not exempt from federal income tax, and includes any 
additions to income from Schedule 1 of Form CT‑1040, Connecticut 
Resident Income Tax Return, or Form CT‑1040NR/PY, Connecticut 
Nonresident and Part‑Year Resident Income Tax Return.
Filing Status
Generally, the filing status you expect to report on your Connecticut 
income tax return is the same as the filing status you expect to report 
on your federal income tax return. However, special rules apply to 
married individuals who file a joint federal return but have a different 
residency status. Nonresidents and part‑year residents should see 
the instructions to Form CT‑1040NR/PY. 
Check Your Withholding
You may be underwithheld if any of the following apply:
•	
You have more than one job;
•	
You qualify under Certain Married Individuals; or
•	
You have substantial nonwage income.
If you are underwithheld, you should consider adjusting your 
withholding or making estimated payments using Form CT‑1040ES, 
Estimated Connecticut Income Tax Payment Coupon for Individuals. 
You may also select Withholding Code “D” to elect the highest level 
of withholding.
If you owe $1,000 or more, after subtracting from your Connecticut 
income tax the amount withheld from your income for the prior 
taxable year, and any PE Tax Credit, you may be subject to interest 
on the underpayment at the rate of 1% per month or fraction of a 
month. 
Certain Married Individuals
If you are a married individual filing jointly and you and your spouse 
both select Withholding Code “A,” you may have too much or too 
little Connecticut income tax withheld from your pay. This is because 
the phase-out of the personal exemption and credit is based on your 
combined incomes. The withholding tables cannot reflect your exact 
withholding requirement without considering the income of your 
spouse. 
To minimize this problem and determine if you need to adjust your 
withholding using Line 2 or Line 3, see Supplemental Tables in 
Informational Publication 2024(7), Is My Connecticut Withholding 
Correct?
Nonresident Employees Working Partly Within and Partly 
Outside of Connecticut
If you work partly within and partly outside of Connecticut for 
the same employer, you should also complete Form CT‑W4NA, 
Employee’s Withholding or Exemption Certificate - Nonresident 
Apportionment, and provide it to your employer. The information on 
Form CT‑W4NA and Form CT‑W4 will help your employer determine 
how much to withhold from your wages for services performed 
within Connecticut. Residents of states with a “convenience of the 
employer” test will be subject to similar rules for work performed for 
a Connecticut employer. Any nonresident who expects to have no 
Connecticut income tax liability should choose Withholding Code “E.”
Armed Forces Personnel and Veterans
If you are a Connecticut resident, your armed forces pay is subject 
to Connecticut income tax withholding unless you qualify as a 
nonresident for Connecticut income tax purposes. If you qualify as 
a nonresident, you may request that no Connecticut income tax 
be withheld from your armed forces pay by entering Withholding 
Code “E” on Line 1.
Military Spouses Residency Relief Act (MSRRA)
If you are claiming an exemption from Connecticut income tax under 
the MSRRA, you must provide your employer with a copy of your 
military spouse’s Leave and Earnings Statement (LES) and a copy 
of your military dependent ID card.
See Informational Publication 2019(5), Connecticut Income Tax 
Information for Armed Forces Personnel and Veterans.
Employer Instructions
For any employee who does not complete Form CT‑W4, you are 
required to withhold at the highest marginal rate of 6.99% without 
allowance for exemption. You are required to keep Form CT‑W4 in 
your files for each employee.
Report Certain Employees Claiming Exemption From 
Withholding to DRS
Employers are required to file copies of Form CT‑W4 with DRS for 
certain employees claiming “E” (no withholding is necessary). Mail 
copies of Forms CT‑W4 to: 
	
Department of Revenue Services
	
PO Box 2931
	
Hartford CT 06104-2931
Report New and Rehired Employees to the Department of Labor 
New employees are workers not previously employed by your 
business, or workers rehired after having been separated from your 
business for more than sixty consecutive days.
Employers with offices in Connecticut or transacting business in 
Connecticut are required to report new hires to the Department of 
Labor (DOL) within 20 days of the date of hire. 
New hires can be reported by:
•	 Using the Connecticut New Hire Reporting website at
www1.ctdol.state.ct.us/newhires;
•	 Faxing copies of completed Forms CT‑W4 to 800-816-1108; or 
•	 Mailing copies of completed Forms CT‑W4 to:
	
Connecticut Department of Labor
	
Office of Research, CT‑W4 
	
200 Folly Brook Blvd
	
Wethersfield CT 06109
For more information on DOL requirements or for alternative 
reporting options, visit the DOL website at portal.ct.gov/dol or call 
DOL at 860-263-6310.