Form W-4 Complete Form W-4 so that your employer can withhold the correct federal income tax from your pay. Your withholding is subject to reivew by the IRS. Step 1: Enter Personal Information First Name and Middle Initial Last Name Social security number * Address Address Address Address City City State/Province Alabama Alaska Arkansas Arizona California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming State/Province Zip/Postal Zip/Postal Filing Status * Single or Married filing separately Married filiing 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. See page 2 for more information on each step, who can claim exemption from withholding, when to use the online estimator, and privacy. 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: 2 (a) Use the estimator at www.irs.gov/W4app for most accurate withholding for this step (and Steps 3–4); or 2 (b) Use the Multiple Jobs Worksheet on page 3 and enter the result in Step 4(c) below for roughly accurate withholding; or 2 (c) 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 accurate for jobs with similar pay; otherwise, more tax than necessary may be withheld. 2(c) TIP: To be accurate, submit a 2020 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 income will be $200,000 or less ($400,000 or less if married filing jointly): Qualifying children Multiply the number of qualifying children under age 17 by $2,000 Other Dependents Multiply the number of other dependents by $500 Step 3 Total Add the amounts together and enter the total here Step 4: (optional): Other Adjustments (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 (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 . (c) Extra withholding Enter any additional tax you want withheld each pay period Step 5: Sign Here Signature Clear Under penalties of perjury, I declare that this certificate, to the best of my knowledge and belief, is true, correct, and complete. Date Submit