Reset                           Print Form

     State of Delaware                         Form W-4DE                                                Division of Revenue 
                                                                                
                   Annual Withholding Tax Exemption Certification  
                                             for Military Spouse 
 
             Read the instructions before completing this form. Except for signature you must print. 
                                                                                                                                                                          .  
 
             Employee Name                                                          Employee Social Security Number 
              
             Military Servicemember Spouse’s Name                               Spouse’s Social Security Number 
              
             Street address where you both currently reside                     City                           State    Zip code 
              
             Name of Military Servicemember’s Station                           City                           State    Zip code 
              
FORM W- 4DE is to be used only for Employees claiming exemption from Delaware’s Income Tax Withholding 
requirements because they meet the conditions set forth under the Servicemembers Civil Relief Act, as amended 
by the Military Spouses Residency Relief Act (P.L. 111-97). 
 
In order to qualify you must complete this form in full, meet all the conditions below and certify that you are not subject to 
Delaware withholding tax because you meet these conditions.  
 
  My spouse is a military servicemember …….….……………..……….…..... (check one)                                                 …  YES          …NO  
   
  I am NOT a military servicemember............................................................ (check one)              …  YES          …NO 
   
  My military servicemember spouse has current military orders assigning him or her to a military location near 
  Delaware…………....................................................................................... (check one)        …  YES          …NO 
   
  My domicile is a state other than Delaware ….…....................................… (check one)                        …  YES          …NO 
  If yes, give name of State of Domicile                                                              . 
   
  …  Start Exemption.  Check here if you answered “YES” to ALL of the above questions, note the start date here 
  and sign below;                             
   
  …  Terminate Exemption.  Check here if the answer to one of four questions above is “NO” to start having 
  Delaware tax withheld, note the start date here and sign below;                                               
                                                                                                                                                                                    
                                                                                                               (       )                                  
Employee’s Signature                         Date                                                              Phone Number 
 
Employer’s Name    Employe ’s Signature                                      r                           Date 
 
Under penalties of perjury, I certify that I am not subject to Delaware withholding tax because l meet the conditions set 
forth under the Servicemembers Civil Relief Act, as amended by the Military Spouses Residency Relief Act (P.L. 111-97)  
 
Give the certificate to your Employer.  Keep a copy for your records. 

NOTICE TO EMPLOYERS 
Employers are not exempt from withholding tax liability for failing to withhold the proper Delaware tax on any Employee 
unless they have a Federal Form W-4 and, if applicable, a Delaware Form W-4DE that is fully completed and signed by 
the Employee. 
 
REQUIREMENTS OF EMPLOYER 
 •  The Employee must show the Employer an original of his or her military spouse’s latest Leave and Earning 
    Statement (LES). The Employer must retain a copy with the Employees’ personnel records.  The Employer must 
    ensure the Employee’s military spouse’s LES assignment location matches the location the Employee indicated 
    on the Form W-4DE and is within the four state area of DE; PA; NJ or MD. 
 •  The Employee must show the Employer an original of the Employee’s current Military ID.  The Employer must 
    ensure that the ID denotes the Employee as a current Military Spouse and retain a copy with the Employees’ 
    personnel records. These IDs are reissued every four years; accordingly, the Employer may not accept a Military 
    ID that is dated more than four years before the date on which it is given to the Employer. 
 •  The Employer must keep the Delaware withholding tax exemption certificate with the Employee’s personnel 
    records. If the Employer believes the Employee has claimed too many exemptions or improperly claimed the 
    Military Spouse Residency Exemption, the Employer must contact the Division of Revenue immediately at, P.O. 
    Box 8995, Wilmington, Delaware 19801-8995, or telephone (302) 577-8200. 
 •  A representative of Employer, with responsibility for Personnel matters, must certify that you have completed the 
    three requirements of the employer above by certifying the employee’s ‘Withholding Tax Exemption Certification 
    for Military Spouse by completing the employer’s section at the bottom of that form. 
 
DOMICILE 
In order to claim domicile in a state other than the state in which you currently reside you must have proof that you meet 
one or more of the criteria listed below.  If you previously were not a domiciliary of another state you can not claim that 
state as your domicile merely by making an election. 
 
Domicile is a place where a person has established permanent residence with an intention to dwell in that place 
permanently and to return to it after absence. One has only one state of domicile at any time and loses one’s current 
domicile only when one establishes a new domicile. In order to change domicile one normally has to be a resident of that 
new state for at least six months. The domicile is created based on performing one or more of the following actions. 
 
CRITERIA USED TO DETERMINE DOMICILE 
The following is a summary of the criteria used to determine ‘State of Domicile’: 
                                                             homestead status; 
                                                             the location of permanent home; 
                   Property Ownership and Residence: 
                                                             mailing address; 
                                                             amount of time spent in a state. 
                                                             location of bank accounts; 
                                                             where taxpayer qualifies for unemployment benefits; 
                    Financial Data: 
                                                             state where prior resident tax returns were filed; 
                                                             state where wages are earned. 
                                                             where taxpayer is registered to vote; 
                                                             state driver’s license; 
                   Licenses and Registrations: 
                                                             state where vehicles are registered; 
                                                             state where professional licenses are maintained. 
                                                             location of fraternal, social or athletic memberships; 
                           Affiliations:                     union membership location; 
                                                             place of worship 
                   Higher Education:                         where taxpayer qualifies for in-state tuition 
                                                             return and that person’s state of residence; 
                   Family and Dependents: 
                                                             where taxpayer’s spouse and dependents reside 
  
SINGLE DOMICILE FACTOR NOT SUFFICIENT 
No single factor determines a person’s State of Domicile; all factors must be evaluated together. Some factors, such as 
where a person makes his or her charitable contributions, play no part in domiciliary determination at all.  
 
A person’s permanent residence, once established, continues as their ‘State of Domicile’ until they take steps to establish 
a new domicile in another state.             
 
             (Revised 01/25/10)