Edit, Download, and Sign the State of Legal Residence Certificate for Tax Purposes
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How do I fill this out?
To fill out this form, gather necessary personal information such as your legal residence and social security number. Ensure accuracy as it determines your income tax withholding state. Review the instructions thoroughly before signing.

How to fill out the State of Legal Residence Certificate for Tax Purposes?
1
Gather your personal information including name and SSN.
2
Identify your legal residence by city or county and state.
3
Read the instructions carefully to understand all legal implications.
4
Fill out the form with accurate and truthful data.
5
Sign the form to certify that the information is correct.
Who needs the State of Legal Residence Certificate for Tax Purposes?
1
Military personnel filing state taxes.
2
Families relocating due to military orders.
3
Enlisted members needing a home of record change.
4
Retention and transition specialists in military HR.
5
Tax consultants assisting military clients.
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What are the instructions for submitting this form?
To submit this form, send it to your local state tax authority, and ensure you include all required information accurately. You can submit it via email, fax, or by mailing a hard copy to the appropriate address provided on the form. Always keep a copy of the submitted form for your records and reference.
What are the important dates for this form in 2024 and 2025?
Important dates for submission vary by state, but generally, the form needs to be submitted whenever there is a change in your legal residence. Ensure to check for state-specific deadlines. It’s advisable to submit this form promptly after relocating to avoid withholding issues.

What is the purpose of this form?
The purpose of this form is to certify your legal residence for state taxation. This is particularly important for military personnel who often relocate due to service obligations. Completing this form ensures that your state income tax withholding aligns with your actual legal residence.

Tell me about this form and its components and fields line-by-line.

- 1. Name: Your full legal name, including last, first, and middle initials.
- 2. Social Security Number (SSN): Your unique SSN for identification purposes.
- 3. Legal Residence/Domicile: Your current city or county and state of legal residence.
- 4. Signature: Your signature to certify the accuracy of the information provided.
- 5. Current Mailing Address: Your present mailing address including ZIP code.
- 6. Date: The date on which you are signing the form.
What happens if I fail to submit this form?
If you fail to submit this form, your state income taxes may be withheld based on your previous legal residence. This might lead to overpayment or underpayment of taxes, causing future complications with tax authorities. It is essential to submit this certificate promptly to avoid any legal or financial issues.
- Incorrect Tax Withholding: Failure to submit may lead to withholding at the wrong state rate.
- Legal Complications: Potential legal issues arise if your residence is incorrectly established.
- Lack of Benefits: Inability to access certain state benefits associated with your legal residence.
How do I know when to use this form?

- 1. Relocating: When moving to a new state as per military orders.
- 2. Establishing Legal Residence: When you intend to establish your legal residence in a new location.
- 3. Tax Purposes: To ensure correct tax withholding related to your military pay.
Frequently Asked Questions
What is the purpose of this form?
This form helps establish your legal residence for state tax purposes.
Who should fill out this certificate?
Military members and their families should fill out this certificate.
How do I edit this PDF?
You can load it into the PrintFriendly editor and modify the text as needed.
Can I share the PDF after editing?
Yes, you can share your edited PDF directly from PrintFriendly.
What if I make a mistake on this form?
You can easily correct it by editing the PDF before submission.
How do I submit this form?
Follow the submission instructions outlined on the form.
Is this form mandatory?
Yes, if you are required to determine your legal residence for tax withholding.
What happens if I don’t submit it?
Your state income tax withholding may be based on your last certified residence.
When do I need to fill out this form?
Fill it out whenever you relocate or change your legal residence.
What information is required?
You need to provide your name, SSN, and current legal residence.
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