Employee’s Withholding Certificate

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.

Your withholding is subject to review by the IRS.
Step 1: Personal Information
Name*

First Name Last Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Marital Status*

Single or Married filing separatelyMarried filing jointly or Qualifying widow(er)Head 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.
Step 2: Multiple Jobs or Spouse Works

Complete this step if you (1) hold more than one job at a time, or (2) are married filing jointly and your spouse also works. The correct amount of withholding depends on income earned from all of these jobs.
Do only one of the following

Use the estimator at www.irs.gov/W4App for most accurate withholding for this step (and Steps 3 - 4)Use the Multiple Jobs Worksheet and enter the result in Step 4(c) below for roughly accurate withholdingIf there are only two jobs total, you may check this box. Do the same on Form W-4 of the other job. This option is accurate for jobs with similar pay; otherwise, more tax than necessary may be withheld
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
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
Multiply the number of other dependents by $500
Total ($)
Step 4: Other Adjustments (optional)
(a) Other income not from jobs($):
If you want tax withheld for other income you expect this year that won't have withholding, enter the amount of other income here. This may inclide interest, dividends, and retirement income.
(b) Deductions($):
If you expect to claim deductions other than the standard deduction and want to reduce your withholding, use the Deductions Worksheet and enter the result here. https://www.irs.gov/pub/irs-pdf/fw4.pdf
(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.
Date

MonthDayYear
Date
Employee's Signature

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Employers Only
Employer's Name
Employer's Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
First date of employment

MonthDayYear
Date
Employer identification number (EIN)
Should be Empty:

Employee’s Withholding Certificate

Step 1: Personal Information

Step 2: Multiple Jobs or Spouse Works

Step 3: Claim Dependents

Step 4: Other Adjustments (optional)

Step 5: Sign Here

Employers Only