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Run: W-4 Federal Tax Withholding Form

Collect federal withholding details in one place so payroll can calculate the right tax amount and employees can update elections without paper chase.

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Employee Information

Employee Full Name (required)

Employee ID (required)

Work Email (required)

Department

Tax Filing Status

Filing Status (required)

Multiple Jobs or Spouse Works

Check if you have more than one job or if your spouse also works.

Yes No N/A

Claim Exempt From Federal Income Tax Withholding

Only select if you meet the IRS exemption requirements.

Yes No N/A

Dependents and Credits

Number of Qualifying Children Under Age 17

Number of Other Dependents

Total Dependent Tax Credit Amount

Enter the total amount of dependent credits you are claiming, if applicable.

Other Credits Amount

Enter any additional tax credits you want considered in withholding.

Additional Withholding Adjustments

Other Income Amount

Enter income not subject to withholding, if applicable.

Deductions Amount

Enter estimated deductions to reduce withholding, if applicable.

Extra Withholding Per Pay Period

Additional federal tax to withhold from each paycheck.

Multiple Jobs Adjustment Method

Employee Certification

Certification Acknowledgement (required)

I certify that the information provided is true, correct, and complete to the best of my knowledge.

Yes No N/A

Employee Signature (required)

Signature Date (required)

Additional Notes

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Email (required)

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