Form W4 CDS

Form W4 - Employee's Withholding Certificate

Complete Form W-4 so that your employer can withhold the correct federal income tax from your pay. Your withholding is subject to review by the IRS. IF YOU HAVE QUESTIONS ABOUT HOW TO COMPLETE YOUR W4 PLEASE CONSULT A TAX PROFESSIONAL.
Step 1: Enter Personal Information
Employee First name and middle initial
Employee Last name
Client Name

First NameLast Name
Employee Social security number
*Does your name match the name on your social security card? If not, to ensure you get credit for your earnings, contact SSA at 800-772-1213 or go to www.ssa.gov.
Employee Address

Street Address

Street Address Line 2

CityState

Zip Code
Email address where you would like confirmation sent:
example@example.com
To download a copy of the W4 with instructions for reference, CLICK HERE. See page 2 for more information on each step, who can claim exemption from withholding, when to use the estimator at www.irs.gov/W4App, and privacy.
Please select:
Which of these apply to you? Please select all that apply.
Retired***Step 2: Multiple Jobs or Spouse
Step 2 - Multiple Jobs

The correct amount of withholding depends on income earned from all of these jobs.
Which of the following will you do (select only one)?
TIP: To be accurate, submit a Form W-4 for all other jobs. If you (or your spouse) have self-employment income, including as an independent contractor, use the estimator.

Complete Steps 3-4(b) on Form W-4 for only ONE of these jobs. Leave those steps blank for the other jobs. (Your withholding will be most accurate if you complete Steps 3-4(b) on the Form W-4 for the highest paying job.
Step 3 - Claim Dependents
Dependents Select:
Type number of qualifying children under age 17
Type number of other dependents
Multiply the number of qualifying children under age 17 by $2,000
Enter the number only.
Multiply the number of other dependents by $500
Enter the number only.
Step 3 total:
Step 4 - Other Adjustments
Other adjustments selector (optional)
(a) Other income (not from jobs). If you want tax withheld for other income you expect this year that won't have withholding, enter the amount of other income here. This may include interest, dividends, and retirement income.
Enter number only
(b) Deductions. If you expect to claim deductions other than the standard deduction and want to reduce your withholding, use the Deductions Worksheet on page 3 and enter the result here.
Enter number only
(c) Extra withholding. Enter any additional tax you want withheld each pay period.
Enter number only
Step 5 - Signature

Under penalties of perjury, I declare that this certificate, to the best of my knowledge and belief, is true, correct, and complete.
Employee's signature (This form is not valid unless you sign it.)
Date

MonthDayYear
Date
Please "preview PDF" below before submitting to ensure that the Form W4 appears as-expected.
Submit Date

MonthDayYear
Date
Hour MinutesAM/PM Option
Should be Empty:

Form W4 - Employee's Withholding Certificate

Step 1: Enter Personal Information

Step 2 - Multiple Jobs

Step 3 - Claim Dependents

Step 4 - Other Adjustments

Step 5 - Signature