DECLARATION OF PERMANENT TAX HOME

IMPORTANT INSTRUCTIONS

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The IRS requires that Nebraska Care withhold taxes on travel expense reimbursements and housing benefits, unless you are maintaining a permanent tax home which is different from where you are incurring living expenses while on assignment.  The attached form and instructions will provide you with the needed documentation about your permanent tax home.  If you do not return this completed form, the IRS requires that we treat your travel and lodging benefits as income and must withhold taxes accordingly.

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To determine whether you maintain a permanent tax home and are eligible for travel expense reimbursements, the following IRS requirements must be met:

• You have living expenses at your main home (ie. Rent, mortgage) that you duplicate because you are away from that home on assignment.

• There must be a realistic expectation that you will return to live at your permanent tax home.

• You often use your permanent tax home for lodging or you have a family member living there while you are away.

If you satisfy ALL three factors you have a permanent tax home and it is the home where you regularly live.

 

NOTE: Failure to return this form will require that we treat your travel and housing benefits as income and will withhold taxes accordingly.  This form must be completed for the assignments worked.

 

The following other factors are also considered in determining whether you are maintaining a permanent tax home.

1. On what date was this permanent address established?

2. Do you anticipate leaving your personal effects (furniture, personal records, clothing etc. ) at your permanent tax home?

3. Do you have family, financial, or social ties with your community at your permanent home?

4. Are you registered to vote at your permanent tax home?

5. Where did you file your resident state and local tax returns last year?

6. In what stat are you licensed to drive?

7. In what state is your vehicle registered?

 

 

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