2016                                             DELAWARE  SCHEDULE W                                                                                               Page 1
                                                             APPORTIONMENT WORKSHEET

NAME                                                                                           SOCIAL SECURITY NUMBER

If income of non-resident taxpayers derived from Delaware sourced employment includes income earned while working outside of the State of Delaware, an
allowancewillbepermittedforthosedaysworkedoutsideoftheState. TheallowancewillbeequivalenttotheratioofdaysworkedoutsideoftheStateversus
the total number of Delaware sourced employment working days. Any allowance claimed must be based on necessity of work outside the State of Delaware in
performanceofdutiesfortheemployer,asopposedtosolelyfortheconvenienceoftheemployee.Workingfromanof ceoutofyourhomedoesnotsatisfyfi
therequirementsof“necessity”ofdutiesforyouremployerandisconsideredfortheconvenienceoftheemployeeunlessworkingfromhomeisarequirementof
employment with your employer.
SEVERANCEPAY
SeverancePayispaymentforthecancellation(involuntaryseparation)ofanemployee’semploymentcontractbytheemployer.  Severancepaycanbepaidina
lump sum or in payments over a period of time.
Severancepayistaxableintheyearitisreceivedandmustbeincludedinyourgrossincome.  Itisbasedonthetotalservicetimerenderedtotheemployer. Ifyour
totalservicetimefortheemployerinpreviouscalendaryearswasconductedinmorethanonestate,yourseverancepaymaybeprorated.  Ifinpreviousyearsyou
were not assigned to work outside the State of Delaware by your employer, Schedule W does not apply and you cannot prorate your severance pay.  Employer 
veri cationfimust be submitted to prorate your severance pay.
Example1:IfJohnWhiteworkedforXYZCompanyfor10years-5yearsinMarylandand5yearsinDelaware-thenonly50%ofhisseverancepaywouldbe
included as Delaware Source Income.
Example 2: If John White was a non-resident of Delaware, had worked for a Delaware employer andfi                                     led his previous years’ returns using a Schedule W to determine 
the portion of his wages that were Delaware source income, John White may be eligible to prorate his severance pay. If your situation is similar to Example 2, 
please contact the Division of Revenue at  (302) 577-8170 to discuss the rules speci c tofiyour situation with one of our representatives.

1. Wages, Salaries,Tips, etc (to be apportioned)..............................................................................................................                             1
2. Total Days inYear Employed by Employer
      (365 or actual number of days employed).....................................................................................................................                         2
3. Non-Working Days

            Saturdays and Sundays........................................................................................                                             3a

            Holidays................................................................................................................                                  3b

            Sick Leave............................................................................................................                                    3c

            Vacation................................................................................................................                                  3d

            Other Non-Working Days......................................................................................                                              3e

            Total Non-Working Days (sum of lines 3a through 3e above)...............................                                                                  3
                                                                                                                                                                                           4
4. Total Days Worked inYear (subtract Line 3 from  Line 2)..............................................................................................
                                                                                                                                                                                           5
5. Total Days Worked Outside Delaware (from page 2 of this form)..................................................................................
                                                                                                                                                                                           6
6. Total Days Worked in Delaware (subtract Line 5 from Line 4)...................................................................................

7. Delaware Sourced Income:

                                                                                                                                                                     =
                                ÷                            = (               %)       X                                                                                                  7
             Line 6                             Line 4                                                Line 1
Ifyouonlyhaveone(1)sourceofemploymentinDelaware,entertheDelawareSourcedIncome(Line7)ontoForm200-02,page2,column2,Line1.  Ifyouhave
morethanone(1)sourceofemploymentinDelaware,addtheDelawareSourcedIncomeamountsfromLines7(oneformperDelawaresource),andenterthe
       TotalDelaware Sourced income on Form 200-02, Page 2, Column 2, Line 1.
                                                                                                                                     *DF31216019999*
                                                                                       Page 1                                                                      DF31216019999

     2016                           DELAWARE SCHEDULE W                                                 Page 2
                                   DAYS WORKED OUTSIDE DELAWARE
NAME                                                                 SOCIAL SECURITY NUMBER

The location of employment must be identified with City and State. If the location is outside the U.S., then identify the country.
List the purpose of the out-of-state business for each day. (For example: client meeting, seminar, etc.)

     DATE                          LOCATION                                          PURPOSE OF OUT-OF-STATE BUSINESS

                                             Total Number of Days    Worked Outside Delaware =

                                                                         *DF31216029999*
     (REV.  09/2016)                                       Page 2                    DF31216029999