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Pennsylvania rev 419 form

(EX) 09-20 (FI) 2026

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The document is the Employee's Nonwithholding Application Certificate (REV-419) used in Pennsylvania, allowing employees to claim exemption from state income tax withholding under specific conditions, such as qualifying for Tax Forgiveness or being a resident of a reciprocal state. It outlines eligibility criteria, responsibilities for both employees and employers, and instructions for filing the form annually or when personal circumstances change.

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Click ‘Get Form’ to open the (EX) 09-20 (FI) in the editor.
Begin by filling out Section I, which requires your Employee Name, Social Security Number, Street Address, City, State, Zip Code, and Telephone Number. Ensure all information is accurate and clearly printed or typed.
In Section II, select the appropriate exemption reason. If you qualify for Tax Forgiveness from last year or expect it this year, check Box a. For residents of reciprocal states like Indiana or New Jersey, check Box b and specify your state. If applicable under the Servicemembers Civil Relief Act, check Box c and provide your state of legal residence.
Proceed to Section III for certification. Sign and date the form to confirm that you did not incur any Pennsylvania personal income tax liability during the previous year.
Finally, ensure your employer's details are filled in correctly before submitting the completed form.

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Do I need to fill out a rev-419?

Who needs the Employees Nonwithholding Certificate Form REV-419? Employees expecting no tax liability need this form. Residents of reciprocal states applying for tax exemptions must use this form. Individuals eligible for tax forgiveness may need this certification.

What form do I give my employer to withhold PA state taxes?

Complete Form REV-419 so that your employer can with- hold the correct Pennsylvania personal income tax from your pay. Complete a new Form REV-419 every year or when your personal or financial situation changes. Photo- copies of this form are acceptable.

What forms do new employees need to fill out in PA?

Pennsylvania New Hire Paperwork I-9 form for employee eligibility requirements. W-4 form for federal tax reporting. Pennsylvania New Hire Reporting form. Disability Self-Identification (required for companies doing business with the government)

What is the new employee pay and fringe benefit notification in PA?

New Employee Pay and Fringe Benefit Notification (Pennsylvania) All Pennsylvania employers are required to notify new hires of their pay rate, the date and time of payments, and the amount of fringe benefits they will receive if any.