W4 Withholdings - Allowance Certificate and Worksheet
Social Security Number
Enter "1" for yourself if no one else can claim you as a dependent
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1
0
Enter "1" if: You are single and only have one job; or You are married, have only one job, and your spouse does not work; or Your wages from a second job or your spouse's wages (or the total of both) are $1,500 or less.
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1
0
Enter "1" for your spouse. But, you may choose to enter "-0-" if you are married and have either a working spouse or more than one job. (Entering "-0-" may help you avoid having to little tax withheld.)
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1
0
Enter number of dependents (other than your spouse or yourself) you will claim on your tax return
Enter "1" if you will file as head of household on your tax return
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1
0
Enter "1" if you have at least $1,900 of child or dependent care expenses for which you plan to claim a credit
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1
0
Child Tax Credit (including additional child tax credit): If your total income will be less than $65,000 ($95,000 if married), enter "2" for each eligible child; then less "1" if you have three to six eligible children or less "2" if you have seven or more eligible children
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2
1
0
Add above lines and enter the total here. (Note: This may be different from the number of exemptions you claim on your tax return.)
Marital Status
Select....
Single
Married
Married, but withhold a higher Single rate
Last name differs from what is shown on social security card?
Total number of allowances you are claiming
Additional amount, if any, you want withheld from each paycheck
I claim exemption from withholding for 2013 , and I certify that I meet BOTH of the following conditions for exemption; Last year I had a right to a refund of all federal income tax withheld because I had no tax liability AND this year I expect a refund of all federal income tax withheld because I expect to have no tax liability. If you meet both conditions write "Exempt" here.