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The Rhode Island Tx 16 form is an essential document for individuals seeking a refund of overpaid Temporary Disability Insurance (TDI) taxes. This form is specifically designed for those who have worked for multiple Rhode Island employers within a calendar year and have exceeded the taxable wage base. The process requires you to provide personal details such as your name, Social Security number, and address. Additionally, you must indicate the calendar year for which you are claiming a refund and include your signature and contact number. It's crucial to attach a copy of your Federal Form W-2 from each employer listed, as these documents serve as proof of the wages earned. The form is applicable only for specific years—2007, 2008, and 2009—and mandates that each spouse file separately, as combined wages are not permitted. Refund requests under one dollar cannot be processed, emphasizing the need for accuracy in your submission. Completing the Tx 16 form accurately ensures that you can reclaim the excess taxes paid to the Rhode Island Temporary Disability Insurance Fund.
Rhode Island Tx 16 Example
STATE OF RHODE ISLAND
DIVISION OF TAXATION - EMPLOYER TAX SECTION
1 Capitol Hill - Suite 36
Providence, Rhode Island 02908
(401)
CLAIM FOR REFUND OF TEMPORARY DISABILITY INSURANCE TAX
IMPORTANT - Please read instructions before completing
1. Enter your Name, Social Security Number, and Address.
YOUR NAME (First, Middle Initial and Last) |
SOCIAL SECURITY NUMBER |
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ZIP CODE |
2. Enter the calendar year for which a refund is being claimed, filing date, your signature , and telephone number.
I hereby apply for a refund of taxes paid in excess during the calendar year _________ to the
R.I. Temporary Disability Insurance Fund. I certify that the facts presented including the attached
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Signature: |
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Telephone : |
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3. IMPORTANT - ATTACH A COPY OF FEDERAL FORM |
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COMPANY TELEPHONE NUMBER: |
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COMPANY TELEPHONE NUMBER: |
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FIRM NAME OF |
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FIRM NAME OF |
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EMPLOYER |
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EMPLOYER |
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CITY STATE & ZIP |
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WAGE |
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WAGE |
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COMPANY TELEPHONE NUMBER: |
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COMPANY TELEPHONE NUMBER: |
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FIRM NAME OF |
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FIRM NAME OF |
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EMPLOYER |
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EMPLOYER |
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CITY STATE & ZIP |
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WAGE |
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CITY STATE & ZIP |
WAGE |
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COMPANY TELEPHONE NUMBER: |
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COMPANY TELEPHONE NUMBER: |
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FIRM NAME OF |
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FIRM NAME OF |
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EMPLOYER |
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EMPLOYER |
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STREET & NUMBER |
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CITY STATE & ZIP |
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WAGE |
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WAGE |
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Page 1
IMPORTANT INFORMATION
1.Refunds can only be requested for the calendar years of 2007, 2008, and 2009.
2.This form should only be completed if during a prior calendar year you worked for two or more Rhode Island registered employers. The refund will be based on the amount of wages in excess of the taxable wage base to the Rhode Island Temporary Disability Insurance Fund. Those wage bases are as follows:
2007- $ 52,100.00, and 2008 - $ 54,400.00, and 2009 - $ 56,000.00
3.A separate Claim For Refund Form must be completed for each year a refund is requested.
4.Spouses cannot combine wages and must file a separate Claim For Refund Form.
5.The Rhode Island Temporary Disability Insurance Act does not allow a refund of under one dollar to be processed.
IMPORTANT INSTRUCTIONS
1.Complete all of the information in section 1 and section 2. The Claim For Refund Form cannot be processed without this information.
2.Check to make sure the calendar year and your telephone number is correct.
3.List each employer for whom you worked during the calendar year in section 3. Enter the employer name, address, employer telephone number and wages paid. List only Rhode Island registered employers from whom you received wages on which Rhode Island Temporary Disability Taxes were paid.
4.Attach a copy of Federal Form
of
5.Please review your Claim For Refund Form and sign before mailing.
6.Return completed form to:
DIVISION OF TAXATION - EMPLOYER TAX SECTION
ONE CAPITOL HILL SUITE 36
PROVIDENCE, RI 02908 - 5829
Page 2
Form Specifications
| Fact Name | Description |
|---|---|
| Purpose | The Rhode Island TX-16 form is used to claim a refund for overpaid Temporary Disability Insurance taxes. |
| Eligible Years | Refunds can only be requested for the calendar years 2007, 2008, and 2009. |
| Employer Requirements | The form must be completed only if the individual worked for two or more Rhode Island registered employers in a prior calendar year. |
| Wage Base Limits | The taxable wage bases for the relevant years are: 2007 - $52,100; 2008 - $54,400; 2009 - $56,000. |
| Refund Minimum | According to the Rhode Island Temporary Disability Insurance Act, refunds under one dollar cannot be processed. |
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