W4-2025

Employee's Withholding Certificate

Department of the Treasury Internal Revenue Service

Complete Form W-4 so that your employer can withhold the correct federal income tax from your pay. Give Form W-4 to your employer. Your withholding is subject to review by the IRS.

First name and middle initial*

Last name*

Social security number*

Street Address* Address Line 2* City* State* Zip*

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.

Filing 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 qualifying individuals)

Filing 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 qualifying individuals)

Multiply the number of qualifying children under age 17 by $2,000

Multiply the number of other dependents by $500

Add the amounts above and enter the total here

(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(a)

(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(b)

(c) Extra withholding. Enter any additional tax you want withheld each pay period 4(c)

If you meet the criteria for Exempt status, Type Exempt here

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*

Date

W-4 2025