Federal Tax Withholding

Employee onboarding

Step 13 of 14

Federal tax withholding form W-4

Name*

View W-4 completion instructions

Phone*

Format: (000) 000-0000.

Email*

Location*

Position*

Start date*

Street address*

Apartment or unit

City*

State*

Zip code*

Social security number*

Single or Married filing separatelyMarried filing jointly or Qualifying surviving spouseHead of household (if you are unmarried and pay more than half the costs of keeping up a home)

Multiple jobs or working spouses

Complete this section if you hold more than one job at a time, or are married filing jointly and your spouse also works. The correct amount of withholding depends on income earned from all jobs. Do only ONE of the following:

(2a) Use the withholding estimator on the IRS website

Go to the estimator

(2b) Use the multiple job worksheet in the instructions

View the worksheet

(2c) Check this box if there are only two jobs total

x

Dependent and other credits

Complete this section for only ONE job. Leave this section blank for the other jobs. Your withholding will be most accurate if you complete this form W-4 for your highest paying job.

Rows	xxx	x
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, and enter it here
Multiply the number of other dependents by $500, and enter it here
<span style="font-weight:600;">(3)</span> Add the amounts above for qualifying children and dependents, and enter the total here

Other adjustments

Complete this section for only ONE job. Leave this section blank for the other jobs. Your withholding will be most accurate if you complete this form W-4 for your highest paying job.

Rows	xxx	x
<span style="font-weight:600;">(4a)</span> Other income: If you want tax withheld for other income you expect this year that won't have withholding, enter the number here
<span style="font-weight:600;">(4b)</span> Deductions: If you expect to claim deductions other than the standard deduction and want to reduce your withholding, enter the number here
<span style="font-weight:600;">(4c)</span> Extra withholding: If you want any additional tax withheld from your paycheck each pay period, enter the number here

Declaration and signature

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

Date*

Employee signature*