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EFTA00316431 | EFTA00316435 Form W-4 (2017) Purpose. Complete Form W-4 so that your employer can wthhoki the correct federal income tax from your pay. Consider 4 anew Form W-4 each year and when your or financial 'Mahon changes. Exemption from withholding. II you are exempt. complete only fines 1.2.3,4.3nd 7 and sign the form to vadat. n. You Son for 2017 expires February 15.2018. See Pub. , Tax Wertholdng and Estimated Tax. Note: II another person can dam you as a dependent on Ns Or her lax return, you Can't clam exemption from withholding if you, total income exceeds 21,050 and include, mire than 5350 ol unearned :mom, (for example, interest and dvidends). may be able to claim &captions. An engto exemption from wit mg even if the employee is a dependant, il the employee: • Is age es welder. • Is Win& or • WI claim adjustments to income; tax credits: or Iternad asuman'', on Ns or her tax tram. The exceptions don't apply to supplemental wages greater than 31.000.000. Bask Instructions. If you anal exempt. complete the Personal Allowances Worksheet below. The worksheets at page 2 further adjust your vAthholding allowances bawd on itemized deductions. certain credits, actustments to Income, or two.earners/nxitiple jobs situations. Complete all worksheets that apps.. Ho ever, you may claim fewer for zero) allowances. For regular wages, withholding must be based on allowances you claimed and may not be a Dal amount or Percentage of wages. Head of household. Genomay. you can claim head of househed ng status on your tax retum only if You are UnnianiC4 and pay more than 50% of the oasts of keeping up 0 home for yourself and your dependent(s) or other .qualify:re indrAdvals. See Pub. 601, Exe mason 5. Standard Deduction, and Filing Information, for Information. Tex credits. You can take Protected tax credits into account In !goring your 1.10Wable number of withhold atokrxxes. Credits for aid or dependent care expenses and the Child tax credit may be claimed 'AIN the Persona: Allowances Worksheet below. See Pub. 505 for nformation on converting your other erodes Into withholding allowance& Nonwago Incense If you have a largearnount of nonwage Income, such es interest or 6vIderets, cosider making estimated tax payments uskg Form 040.ES, Estimated Tax kr Individuals OthervAse you may owe see Pal tax. Ilse hanponsion or annuity Income, see Pub. 505 to find out if you shoed &gust your withholding an Font W-4 orW-CP. Two earners or multiple jobs.11you tan a working spouse or more than me jOb. Nun) the total number of allowances you ale eraUS to claim on all lobs usng worksheets from on& one Form vi-4. Your w:thhold.ag usually wis be most accurate when el allowances are claimed on tee Form W.s for the highest payng job and :aro alcwances are claimed on the others. See Pub 505 for octets. Nonresident alien, II you are a nonresdent alien, see Nalco 1392. Supplemental Form W-4 instructions tor Nonresident Aliens, before correlating alis Check your withholding. After howyour Form W.4 takes the Whaunt you are effect, use Pub. 505 to see having withheldcompares to your preeleted total tax Sot 2017. Se* Pub. 5.•speaelly itwur earnings exceed 5130.000 (Singe) or Future developments. Information about any future developments affecting Form W.4 (such as legislation enacted after we release le mll be Posted at mvw.ara.gcrelw4. Personal Allowances Worksheet (Keep for your records.) A Enter "1" for yourself if no one else can claim you as a dependent { • You're single and have only one job; or Enter "1" if: • You're married, have only one job, and your spouse doesn't work; or • Your wages from a second job or your spouse's wages (or the total of both) are $1,500 or less. Enter "1" for your spouse. But, you may choose to enter --O." if you are married and have either a working spouse or more than one job. (Entering *-0-- may help you avoid having too little tax withheld ) C 0 Enter number of dependents (other than your spouse or yourself) you will claim on your tax return E Enter "1' if you will file as head of household on your tax return (see conditions under Head of household above) . . . F Enter "1" If you have at least $2,000 of child or dependent care expenses for which you plan to claim a credit (Note: Do not include child support payments. See Pub. 503, Child and Dependent Care Expenses, for details.) Child Tax Credit cncluding additional child tax credit). See Pub. 972. Child Tax Credit, for more information. • II your total income will be less than $70,000 ($100,000 if married), enter "2" for each eligible child; then less "1" if you have two to four eligible children or less "2' if you have five or more eligible ctildren. G • If your total income wal be between $70,000 and $84,000 ($100,000 and $119,000 if married), enter -1- for each ellgtle chid. Add linos A through 0 and enter total here. (Note: This may bo afferent from the number of exemptions you claim on your tax robin.) * H • If you plan to itemize or claim adjustments to Income and want to reduce your withholding, see the Deductions For accuracy. and Adjustments Worksheet on page 2. complete all • If you ere single and have more than one job or are married and you and your spouse both work and the combined worksheets earnings from all lobs exceed $50,000 ($20,000 if married), see the Two-Earners/Multiple Jobs Worksheet on page 2 to avoid having too tittle tax withheld. that apply. • II neither of the above situations applies, atop hero and enter the number from line H on line 5 of Form IN-4 below. A B C D E F G H Separate hero and give Form W-4 to your employer. Keep the top part for your records. W-4 Fenn ofeeetnstro el the UMW( Internet pane Sete 1 Your first an Employee's Withholding Allowance Certificate OMB N0.1645-0074 li. Whether you are entitled to claim a certain number of allowances or exemption from withholding is subject to review by the WS. Your employer may be required to send a copy of this form to the IRS. ad middle Initial last name Home address ( umber and street or rural route) 2 3 O Slop O Maned O 2017 Vow social security number Married, but withhold at riper Stele nate. Note: IlmaMed. NA leg* separated, or spouse is a norresiderl alitncheck to 'Sip' box. City or town, state, and DP code 4 If your last name differs from that shown on your social security card, chock here. You must call 1.900.772.1213 fora replacement card. IP O 5 Total number of allowances you are claiming (from line H above or from the applicable worksheet on page 2) 8 $ Additional amount, if any, you want withheld from each paycheck I claim exemption from withholding for 2017, 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 * I 71 Under penalties of perjury. I declare that I have examined this certificate and, to the best of my knowledge and belief, it Is true, correct, and complete. 5 6 7 Employee's signature (This form is not valid unless you sign it.) ► 8 Employees name and address (Employer. Complete lines 8 and 10 only if sending to the IRS.) For Privacy Act and Paperwork Reduction Act Notice, see page 2. Date ► 9 Offas coda Options) Cat. No. 102200 10 Employer kleaticalion number (OM Fonts W-4 (2017) EFTA00316435
April 27, 2026 at 7:15 AM