Detailed Questionnare - Tax at Source - EN

Questionnaire
Withholding tax information
Class C1 / Öffentlich
Version V1.0
Datum 20.06.2024
Diese Unterlagen sind urheberrechtlich geschützt.
Insbesondere das Recht, die Unterlagen mittels irgendeines Mediums (grafisch, technisch, elektronisch und/oder
digital, einschliesslich Fotokopie und Download) ganz oder teilweise zu vervielfältigen, vorzutragen, zu verbreiten, zu
bearbeiten, zu übersetzen, zu übertragen oder zu speichern, liegt ausschliesslich bei Abacus Research AG. Jede
Verwertung in den genannten oder in anderen als den gesetzlich zugelassenen Fällen, namentlich jede kommerzielle
Nutzung, bedarf der vorherigen schriftlichen Einwilligung von Abacus Research AG. Diese Unterlagen stehen nur
berechtigten Teilnehmerinnen und Teilnehmern der Schulungen / Kurse und den Vertriebspartnern zur eigenen
Nutzung zur Verfügung.
Die gewerbsmässige Verletzung der Urheberrechte kann gemäss Art. 67 Abs. 2 URG bestraft werden.
Copyright © 2020 by Abacus Research AG, 9300 Wittenbach SG
Information
Please fill out the following questions and return the signed questionnaire to the HR department. The
information is used to determine the new withholding tax as of January 01, 2021.
Personal Information:
Personnel number _______________________________________________________________
Last name _______________________________________________________________
First name _______________________________________________________________
Social insurance number _______________________________________________________________
Address valid from _______________________________________________________________
Street _______________________________________________________________
Supplement _______________________________________________________________
Postcode / City _______________________________________________________________
Information: For the following information, the status on the last day of the month is relevant.
Information valid from _______________________________________________________________

(Month/year)
Nationality _______________________________________________________________
Permit type _______________________________________________________________
Class: C1 / Öffentlich Copyright © 2020 by Abacus Research AG, 9300 Wittenbach SG Seite 2 von 8
Civil status single
divorced
widowed
married
registered partnership
dissolved registered partnership
separated
Civil status valid from _______________________________________________________________
Do you live in a cohabitation? Yes

The information is required for the No
tariff classification; if you are single,
divorced or widowed and have
children entitled to deduction
Are you a single parent? Yes

No
Do you draw a pension? Yes

No
Denomination Evangelical-Reformed church

The denomination is required in Roman-Catholic church
some cantons for the tariff classifi- Christian-Catholic church
cation. Jewish Community
None / Other
Single Parent / Head of Household:
Information: This information is intended for single persons living together with children or persons
responsible for dependants in the same household for whose maintenance they are mainly
responsible (SP/HoH)
Do you live in the same house- Yes

hold with children entitled to No
deduction (sole custody)?
Do you cohabitate with your Yes

partner in the same household? No
Do you live in the same house- Yes
hold with the deductible children No
and the cohabiting partner?
Do you exercise sole custody Yes

over children living in the same No
household?
Do you exercise joint custody Yes

over children living in the same No
household and do you earn the
higher gross income than the
other parent?
Do you live with an adult child in Yes

the same household and do you No
earn the higher gross income
than the other parent?
Partner information:
Information: Only fill in if you are married or in a registered partnership
Last name _______________________________________________________________
First name _______________________________________________________________
Date of birth _______________________________________________________________
Social insurance number _______________________________________________________________

(optional)
Address _______________________________________________________________
Only fill in if the address of the
partner differs.
Nationality(ies) _______________________________________________________________
Permit type _______________________________________________________________
Does your partner draw a Yes

pension? No
Is your partner employed? Yes

No
If yes: Main occupation

What is the employment type Secondary occupationo
of your partner?
Place of work _______________________________________________________________
When was the start of the _______________________________________________________________

employment or the beginning of
the entitlement to substitute
income (or the date of entry)
End of employment or entitle- _______________________________________________________________

ment to substitute income
Children:
Information: If you have children for whom you do not receive child allowances from your employer, you
can list them below. This information is required to confirm the children eligible for deduction
Example: Your employed partner receives child allowances for the children you have together. Conse-
quently, you do not receive child allowances from your employer. In this case, you must report the child
information to the withholding tax office for the tariff classification.
Child 1 Child 2 Child 3 Child 4
Last name _____________ _____________ _____________ _____________
First name _____________ _____________ _____________ _____________
Date of birth _____________ _____________ _____________ _____________
Sex _____________ _____________ _____________ _____________
Nationality _____________ _____________ _____________ _____________
SI number _____________ _____________ _____________ _____________
Start of entitlement to
child deduction _____________ _____________ _____________ _____________
End of entitlement
to child deduction
(optional) _____________ _____________ _____________ _____________
Cross-border commuter information:
Information: Only fill in if your place of residence is not in Switzerland.
Type of stay in Switzerland Daily return home

Weekly return home
For weekly return home:: _______________________________________________________________

Residential address in Switzer-
land
Other / Additional employment:
Information: These questions refer to other/additional employment..
Are you pursuing any other gain- Yes
ful employment? No
Refers to Switzerland and abroad
If yes::
How high is your level of _________%
employment in this occupation?
Mein Arbeitspensum ist nicht ermittelbar
What gross monthly wage _______________________________________________________________

amount do you receive for your
other employment?
(optional)
Job title/function with the _______________________________________________________________

other employer
(optional)
Name(s) and address(es) of _______________________________________________________________

other employer
(optional)
Substitute income:
Information: For the correct tax rate determination, substitute income must be indicated. In order to de-
termine the correct tax rate, the following must be stated: daily allowances (IS, AI, UI, BVG, etc.) compen-
sation from liable third parties, partial pensions due to disability (IS, AI, occupational benefits, etc.) and
capital payments that replace them.
Do you receive a substitute in- Yes

come? No
Refers to Switzerland and abroad
If yes:
How much per month? _______________________________________________________________
Please sign the document here:

I hereby confirm that I have correctly filled in all the information.
Place and date First and Last name Signature of employeen

__________________________
__________________________ _________________________
General information: Employees subject to withholding tax are responsible for providing the person
liable for withholding tax with all information relevant for the collection of the withholding tax. They must
do everything possible to enable a complete and correct assessment and, if requested by the relevant tax
authority, provide information or submit supporting documents orally or in writing (see Art. 136 DBG and
Art. 5 para. 3 QStV). The basis for the withholding tax on earned income was newly regulated by the Fe-
deral Law of 16 December 2016. The new provisions will come into force on 1 January 2021. For a cor-
rect calculation of the withholding tax, additional information is required from the employee. The part-time
employee must inform the employer(s) whether he/she is engaged in one or more other gainful
activity(ies) or whether he/she is receiving additional/supplementary income. If the employee discloses
neither the workload nor the salary earned from the other activity, each employment relationship is
converted to a 100 percent workload for the income determining the rate. Any changes relevant to with-
holding tax, e.g. the commencement of further employment (personal and partner's employment) must be
reported immediately to the personnel department.

Detailed Questionnare - Tax at Source - EN

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Questionnaire

Withholding tax information

Diese Unterlagen sind urheberrechtlich geschützt.

Personnel number _______________________________________________________________

Last name _______________________________________________________________

First name _______________________________________________________________

Social insurance number _______________________________________________________________

Address valid from _______________________________________________________________

Postcode / City _______________________________________________________________

Information valid from _______________________________________________________________

Permit type _______________________________________________________________

Civil status valid from _______________________________________________________________

Do you live in a cohabitation? Yes

Are you a single parent? Yes

Do you draw a pension? Yes

Denomination Evangelical-Reformed church

Single Parent / Head of Household:

Do you live in the same house- Yes

Do you cohabitate with your Yes

Do you exercise sole custody Yes

Do you exercise joint custody Yes

Do you live with an adult child in Yes

Information: Only fill in if you are married or in a registered partnership

Last name _______________________________________________________________

First name _______________________________________________________________

Date of birth _______________________________________________________________

Social insurance number _______________________________________________________________

Does your partner draw a Yes

Is your partner employed? Yes

If yes: Main occupation

Place of work _______________________________________________________________

When was the start of the _______________________________________________________________

End of employment or entitle- _______________________________________________________________

Child 1 Child 2 Child 3 Child 4

Last name _____________ _____________ _____________ _____________

First name _____________ _____________ _____________ _____________

Date of birth _____________ _____________ _____________ _____________

Sex _____________ _____________ _____________ _____________

Nationality _____________ _____________ _____________ _____________

SI number _____________ _____________ _____________ _____________

Cross-border commuter information:

Information: Only fill in if your place of residence is not in Switzerland.

Type of stay in Switzerland Daily return home

For weekly return home:: _______________________________________________________________

Other / Additional employment:

Information: These questions refer to other/additional employment..

What gross monthly wage _______________________________________________________________

Job title/function with the _______________________________________________________________

Name(s) and address(es) of _______________________________________________________________

Do you receive a substitute in- Yes

Please sign the document here:

Place and date First and Last name Signature of employeen

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Last name _______ _ _ _______

First name _______ _ _ _______

Date of birth _______ _ _ _______

Sex _______ _ _ _______

Nationality _______ _ _ _______

SI number _______ _ _ _______