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After printing the form, forward the first page to your Business Office.
Ensure timely filing of the University Federal and State tax returns, reports and payments.
Use this form if employee is eligible for advance earned income credit. Form W-5 [PDF]
Certificate of Residence—For Reciprocal States: Michigan, Ohio, Pennsylvania, Kentucky, and Wisconsin. Payroll Form 52 [Excel]
Certificate of Residence: For Employees Who Neither Work Nor Reside In Indiana. Payroll Form 52A [Excel]
Cancellation of Reciprocal Exemption From Withholding of Indiana Adjusted Gross Income Tax. Payroll Form 52C [Excel]
After printing the form, forward to your Business Office.
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