IT MIL-SP
                                                                                                 Revised 10/12

               P.O. Box 2476
               Columbus, OH 43216-2476
               1-800-282-1780

              Exemption from Withholding – Military Spouse Employee

Ohio Employers: In November 2009, Congress passed the Federal Military Spouses Residency Relief Act, Public Law 
111-97. This new law says that the income of a civilian spouse of a military servicemember is not subject to state income 
tax of the state in which the spouse is present if the servicemember and spouse have the same state of residency, and their 
state of residency is in another state pursuant to the servicemember’s military orders. 

This new law allows a civilian spouse to be exempt from withholding for Ohio income tax purposes if their state of residency 
is not Ohio. Your employee should complete the information contained in this document and provide you with acceptable 
supporting documentation. That documentation must include a copy of the employee’s spousal military identifi cation card 
issued to the employee by the Department of Defense. The employer is then required to fax or mail this completed docu-
ment, and a copy of the employee’s spousal military identifi cation card within 30 days of receipt, to the address or fax number 
listed below.1

The employer is also required to have a copy of this form on fi le for each employee who is claiming to be a nonresident of 
Ohio because s/he is the spouse of a military servicemember and is in Ohio due to the military orders of the spouse. 

Declaration of Spouse of Servicemember: 
“I hereby declare, under penalty of perjury, that I am a resident of the state of                                           and that I am pres-
ent in Ohio solely due to the military orders of my spouse. I hereby claim exemption from withholding of Ohio income tax on 
my earnings in Ohio. I understand that my state of residency may tax the income I earn in Ohio.” 

Employee’s signature                                     Date (MM/DD/YYYY)

Employee – print full name                               Social Security number

Current mailing address, including ZIP

1Ohio Department of Taxation, IT MIL-SP Section, P.O. Box 2476, Columbus OH, 43216-2476. Fax (614) 466-1588.

                     Should you have questions, please contact us at 1-800-282-1780.