Form 501N – Fill Out and Use This PDF

Nebraska Monthly Withholding Deposit

FORM

501N

Nebraska ID Number

Deposit for Month of

Due Date

Nebraska income tax withheld this period. (Do not file this form if you are making

payments electronically.) Please pay this amount.....................................................

$

sign here

	(			)			(		)
Authorized Signature			Daytime Phone			Signature of Preparer Other Than Taxpayer		Daytime Phone
Title			Date			Address		Date
Email Address
	INSTRUCTIONS

You must be licensed for Nebraska withholding with the Nebraska Department of Revenue (Department) prior to filing this deposit. Complete Nebraska Tax Application, Form 20, to apply for this license and mail it together with the Form 501N.

WHO MUST FILE. Monthly deposits are required when the amount withheld exceeds $500 for either the first or second month of a calendar quarter.

Certain taxpayers are required to make payments electronically. Electronic payments can be made using ACH Debit, ACH Credit, or by credit card. See www.revenue.ne.gov for additional information. If you are required to make withholding payments electronically, Form 501N will not be mailed.

For m 501N will not be mailed to taxpayers making electronic payments.

Payments for the third month of a calendar quarter are made by filing the Nebraska Withholding Return, Form 941N. Form 941N and payment may be filed electronically or on a preidentified form. Taxpayers required to make payments electronically should not send a check with Form 941N.

WHEN AND WHERE TO FILE. The payment is due on or before the 15th day of the month following the calendar month covered by the deposit. If not paying electronically, mail to the Nebraska Department of Revenue, PO Box 98915, Lincoln, Nebraska 68509-8915. Checks written to the Department of Revenue may be presented for payment electronically.

PREIDENTIFIED RETURN. This Form 501N is to be used only by the employer or payor whose name is printed on it. Contact the Department if:

1.You need to file a deposit but are currently not receiving this form;

2.You did not receive a Form 501N for the current period;

3.You lost/misplaced your Form 501N for the current period; or

4.Your business name, location, or mailing address listed on the Form 501N are not correct.

Do not file Forms 501N which are photocopies, which are from another period, or which have not been preidentified.

PENALTY AND INTEREST. Penalty and interest may be imposed for failure to timely remit income tax withheld.

TAXPAYER ASSISTANCE. See the Department’s website at www.revenue.ne.gov or call 800-742-7474 (NE and IA) or 402-471-5729.

SPECIFIC INSTRUCTIONS

NEBRASKA INCOME TAX WITHHELD THIS PERIOD. Enter the amount of Nebraska income tax withheld during the calendar month for which this deposit is being filed. If a deposit is not required until the second month, all tax withheld for the first and second months must be remitted.

SIGNATURES. If filing a paper return, Form 501N must be signed by the taxpayer, partner, member, or corporate officer. If the taxpayer authorizes another person to sign this deposit, there must be a power of attorney on file with the Department.

Any person who is paid for preparing a taxpayer’s Form 501N must also sign the deposit as preparer.