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2023 M1W, page 2
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Complete lines 5 and 6 to report Minnesota income tax withheld if you received more than five Forms W-2 or more than four Forms
1099, W-2G, and 1042-S. Complete line 7 to report Minnesota tax withheld on Schedules KPI, KS, and KF.
5 Minnesota wages and Minnesota tax withheld on additional Forms W-2 (other than W-2G).
A B—Box 13 C—Box 15 D—Box 16 E—Box 17
If the Form W-2 is for: If Retirement Plan Employer’s seven-digit Minnesota State wages, tips, etc. Minnesota tax withheld
• you, enter 1 box is checked, Tax ID Number (round to nearest whole dollar) (round to nearest whole dollar)
• spouse, enter 2 mark an X below.
a1 b1 c1 MN d1 e1
a2 b2 c2 MN d2 e2
a3 b3 c3 MN d3 e3
a4 b4 c4 MN d4 e4
Subtotal for additional Forms W-2 (add amounts in line 5, column E) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .5. .
Enter the result here and include on line 1 on the front of this schedule.
6 Minnesota tax withheld on additional Forms 1099, W-2G, and 1042-S.
A B C D
If the Form 1099 or W-2G is for: Payer’s seven-digit Minnesota Tax ID Income amount (see the table at the Minnesota tax withheld
• you, enter 1 Number (if unknown, contact the payer) bottom of this page for amounts to include) (round to nearest whole dollar)
• spouse, enter 2
a1 b1 MN c1 d1
a2 b2 MN c2 d2
a3 b3 MN c3 d3
a4 b4 MN c4 d4
Subtotal for additional Forms 1099, W-2G, and 1042-S (add amounts in line 6, column D) .. ...... ..... .... 6
Enter the result here and include on line 2 on the front of this schedule.
7 Minnesota income and tax withheld by partnerships, S corporations, and fiduciaries, if any.
A B—Minnesota Income Amount C—Minnesota Tax Withheld
Entity’s seven-digit Minnesota Tax ID (from line 50 of Schedule KPI, (the sum of lines 31 and 52 of Schedule KPI,
Number (if unknown, contact the entity) line 48 of KS, or line 46 of KF) lines 31 and 50 of KS, or lines 30 and 40 of KF)
a1 MN b1 c1
a2 MN b2 c2
a3 MN b3 c3
a4 MN b4 c4
Subtotal of Minnesota tax withheld by any partnerships, S corporations, and fiduciaries (add amounts in
line 7, column C). Enter the result here and on line 3 on the front of this schedule... ...... ..... ....... .. 7
Table for Column C, Lines 2 and 6
Use to determine which amounts from your Form 1099 and 1042-S you must include as income on column C, lines 2 and 6.
Form Include the Sum of Boxes: Form Include the Sum of Boxes: Form Include the Sum of Boxes:
1099-G . ..... ..... 1, 2, 5–7 1099-INT ... ...... ..... . 1 1099-K .... ..... ..... 1a
1099-MISC ... ..... 1–3, 5, 6, 8–11, 14, 15 1099-OID ..... ...... ... 1, 2 1099-R ... ...... ..... 16, 2a or 1
1099-DIV . ...... ... 1a, 2a 1042-S ... ...... ..... ... 2 1099-NEC ... ...... ... 1
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