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                                                                                                                           Instructions
               Arizona Form 
                              Withholding Exemption Certificate for Military Spouses
              WECM                                                                                                         2016

    For use by an employee, who is a spouse of a servicemember, to claim an exemption from Arizona withholding on 
    wages because:  (i) your spouse is a member of the armed forces present in Arizona in compliance with military 
    orders; (ii) you are present in Arizona solely to be with your spouse; and (iii) you maintain a domicile in another state, 
    which is the same state that is the domicile of the servicemember.

    Arizona income tax returns will still be required if the nonresident employee meets Arizona filing requirements.

                                                SeeSeeinstructionsinstructionsononreversenext page.side.
 Type or print your Full Name                                                                                 Your Social Security Number

 Home Address – number and street or rural route

 City or Town                                                                                           State ZIP Code

  1.  I am a resident of the State of                                                         .

  2.  My servicemember spouse is a resident of the State of                                                           .

      Are the states listed in lines 1 and 2 identical?
    Yes. Complete the Employee’s Certification below.
    No. STOP!  You do not qualify to file Form WECM.

  3.  Employee’s Certification:  I declare that I am present in Arizona solely to be with my servicemember spouse who is 
    present in Arizona in compliance with military orders.

    SPOUSE’S NAME                                                                                              SPOUSE’S SSN

      My military spouse identification number is:  
      Date issued:  M M D D YYYY

 4.  By checking this box, I am notifying my employer to terminate this exemption, as I no longer qualify to be exempt 
    from withholding as the spouse of a servicemember.

EMPLOYEE’S SIGNATURE                                                                                          DATE

 •  Employee:  Include a copy of your military spouse identification and your spouse’s last Leave and Earnings Statement 
    (LES) and file the completed certificate with your employer.  Keep a copy of this certificate for your records.
  •  Employer:  Keep this certificate and documents for your records.                  Please do not mail this form to the Arizona 
    Department of Revenue unless requested to do so.

Employer:  I have inspected the employee’s original military spouse identification, and verified the number and date in 
line 3 above.

EMPLOYER’S SIGNATURE                                                                                          DATE

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ADOR 10760 (15)
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                                                                                                            ARIZONA FORM
Withholding Exemption Certificate for Military Spouses                                                      WECM

Obtain additional information or assistance by calling                 How to Claim an Exemption From  Arizona 
one of the numbers listed below:                                       Income Tax Withholding for Military Spouses
                                                                       You must complete  Arizona Form WECM to claim an 
Phoenix.............................................. (602) 255-3381
                                                                       exemption from Arizona income tax withholding. Complete 
                                                                       this form and give it to your employer.  Attach a copy of 
From area codes 520 and 928,
                                                                       your military spouse identification and your spouse’s last 
toll-free............................................... (800) 352-4090
                                                                       Leave and Earnings Statement (LES).

                 www.azdor.gov                                        Be sure to keep a copy of this certificate for your records.

                                                                       The employer must keep this certificate and attachments 
               General Instructions                                    for its records. You only need to provide a copy to the 
                                                                       department upon request.
Who May Use Form WECM
An employee who performs services for an employer within               Does the Employee Have to File an Arizona 
Arizona is exempt from Arizona income tax withholding                  Nonresident Individual Income Tax Return?
provided the following three requirements are met:
                                                                       Although an employee may be exempt from  Arizona 
                                                                       income tax withholding on income earned for services 
 1.  Your spouse is a member of the armed forces 
                                                                       performed in Arizona, the employee may be required to 
 present in  Arizona in compliance with military 
                                                                       file Arizona Form 140NR,  Nonresident Personal Income 
 orders;
                                                                       Tax Return, if the employee has any other income subject 
                                                                       to Arizona income tax and:
 2.  You are present in Arizona solely to be with your 
 spouse; and
                                                                        1.  The employee’s gross income is $15,000 or more; 
                                                                        or
 3.  You maintain a domicile in another state, which 
 is the same state that is the domicile of the 
                                                                        2.  The employee’s  Arizona adjusted gross income 
 servicemember.
                                                                        is $5,500 or more if single, head of household, or 
                                                                        married filing a separate return; or
When to File Form WECM
File Form WECM as soon as you qualify for the exemption.                3.  The employee’s Arizona adjusted gross income is 
                                                                        $11,000 or more if married filing a joint return.
 TO CONTINUE  TO BE EXEMPT FROM  ARIZONA 
 WITHHOLDING:  A new Form WECM, with a copy of                         For purposes of the filing requirement, “gross income” is 
 your military spouse identification and your spouse’s                 gross income as defined under the Internal Revenue Code 
 last Leave and Earnings Statement (LES), must be filed                less income included in gross income that is excluded 
 with your employer every calendar year.                               from Arizona taxation.

If the employee’s situation changes and the employee 
no longer qualifies for the withholding exemption, the 
employee must file a revised Form WECM with their 
employer to terminate the exemption.

ADOR 10760 (15)
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