W-4 Employee’s Withholding Certificate

W-4 Employee’s Withholding Certificate
Step 1: Enter Personal Information
(a) First name and middle initial*
Last name*
(b) Social security number*
Address*
City or town, state, and ZIP code*
(c) Status*

Single or Married filing separatelyMarried filing jointly or Qualifying surviving spouseHead of household (Check only if you’re unmarried and pay more than half the costs of keeping up a home for yourself and a qualifying individual)
Complete Steps 2–4 ONLY if they apply to you; otherwise, skip to Step 5. See page 2 for more information on each step, who can claim exemption from withholding, and when to use the estimator at www.irs.gov/W4App.
Step 2: Multiple Jobs or Spouse Works
Do only one of the following.
1. Use the estimator at www.irs.gov/W4App for most accurate withholding for this step and Steps 3–4 If you or your spouse have self-employment income, use this option; or
2. Use the Multiple Jobs Worksheet on page 3 and enter the result in Step 4c below; or
3. If there are only two jobs total, you may check this box. Do the same on Form W-4 for the other job. This option is generally more accurate than b if pay at the lower paying job is more than half of the pay at the higher paying job. Otherwise, (b) is more accurate....
(b) is more accurate
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 Dependent and Other Credits
If your total income will be $200,000 or less ($400,000 or less if married filing jointly):
Multiply the number of qualifying children under age 17 by $2,000
$ Amount
Multiply the number of other dependents by $500
$ Amount
Add the amounts above for qualifying children and other dependents. You may add to this the amount of any other credits. Enter the total here
$ Amount
Step 4 (optional): Other Adjustments
4(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.
4(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.
4(c)Extra withholding- Enter any additional tax you want withheld each pay period .
Step 5: Sign Here
Under penalties of perjury, I declare that this certificate, to the best of my knowledge and belief, is true, correct, and complete. (This form is not valid unless you sign it)
Employees' Signature *

Clear
Date*

MonthDayYear
Date
First Date of Employment*

MonthDayYear
Date
Employer's name and Address
EIN*
Should be Empty:

W-4 Employee’s Withholding Certificate

Step 1: Enter Personal Information

Step 2: Multiple Jobs or Spouse Works

Step 3: Claim Dependent and Other Credits

Step 4 (optional): Other Adjustments

Step 5: Sign Here