UPAY 830 Instructions

UPAY 830 - Out-of-State Income Tax Withholding Form

A. Purpose of Form

This form assists Payroll Services in determining the tax withholding for an individual who works and lives in a state other than California. Employees are categorized as one of the following:

California tax residents - subject to tax withholding on their world wide income regardless of where the work is performed.
California nonresidents who work in California - subject to tax withholding on their portion of income that is earned in the state of California.
Nonresidents working and living outside California - not subject to California tax withholding. They may be subject to state income tax withholding in the state in which they are working.

B. When to Complete a UPAY 830 Form

The UPAY 830 must be completed whenever an employee is hired by UCLA, UCOP, or UCM to perform services while living outside the state of California. The completed form should be submitted to UCLA Payroll Services as soon as possible to insure correct income tax withholding.

C. Instructions for Completing the UPAY 830 Form

Personal Information Section

Name: Enter name as last, first, middle.
Campus: Enter UCLA, UCOP, or UCM.
Employee No.: Enter University identification number of the individual.
Work Address: Address where the work will be performed.
Campus Dept.: Hiring department.
Social Security number: A valid US Social Security number.
Work Phone: Enter the phone number where the employee will be performing services.

Nonresident Section

This section should only be completed by employees who are nonresidents of California.

Resident Section

This section should only be completed by employees who are tax residents of California.

Cancel Out-of-State Withholding

Completed when an individual no longer works out of state or wishes to cancel a previous state’s withholding due to a change in location or liabilities.

Employee's Certification

The employee must sign and date the form.

D. Other State Income Tax Withholding Obligation

Employees who live and work in a state other than California may be subject to income tax withholding in that state. Consult the related article on States Withholding Requirements and Withholding Forms to determine if the employee is subject to state income tax withholding. If required, have the employee submit a certificate of withholding for that state.