Employee's Withholding Exemption Certificate (Ohio)

As of 12/7/20 this new version of the IT 4 combines and replaces the following forms: IT 4 (previous version) IT 4NR. IT 4 MIL. and IT MIL SP.

For IT 4 Instructions, please click here: https://tax.ohio.gov/static/forms/employer_withholding/generic/wth-it4-combined-fi.pdf

Employee's Withholding Exemption Certificate

Ohio Department of Taxation

Submit form IT 4 to your employer on or before the start date of employment so your employer will withhold and remit Ohio income tax from your compensation If applicable, your employer will also withhold school district income tax. You must file an updated IT 4 when any of the information listed below changes (including your marital status or number of dependents You should contact your employer for instructions on how to complete an updated IT 4. Your employer may require you to complete this form electronically.

Section I: Personal Information

Employee Name*

Employee SSN*

Address, city, state, ZIP code*

School district of residence (See The Finder at tax.ohio.gov)*

School district number (####)*

Section II: Claiming Withholding Exemptions

1. Enter "0" if you are a dependent on another individual's Ohio return; otherwise enter "1"*

2. Enter "0" if single or if your spouse files a separate Ohio return; otherwise enter "1"*

3. Number of dependents*

4. Total withholding exemptions (sum of line 1. 2, and 3)*

5. Additional Ohio income tax withholding per pay period (optional)

Section III: Withholding Waiver

I am a full-year resident of Indiana, Kentucky, Michigan, Pennsylvania, or West Virginia.I am a resident military servicemember who is stationed outside Ohio on active duty military orders.I am a nonresident military servicemember who is stationed in Ohio due to military orders.I am a nonresident civilian spouse of a military servicemember and I am present in Ohio solely due to my spouse's military orders.I am exempt from Ohio withholding under R.C. 5747.06(A1) through (6).

Section IV: Signature (required)

Under penalties of perjury, I declare that, to the best of my knowledge and belief, the information is true, correct and complete.

Signature*

Date*