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Run: W-4 Federal Tax Withholding Form

The W-4 Federal Tax Withholding Form collects an employee’s filing status, dependents, extra withholding, and certification in one place. Use it to set feder...

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Employee Information

Full Name (required)

Employee ID (required)

Home Address (required)

SSN Last 4 Digits

Only collect if needed by your payroll process. Do not enter a full SSN.

Federal Withholding Election

Filing Status (required)

Do you have multiple jobs or does your spouse work? (required)

Total Credit for Dependents

Enter the total amount of dependent credit you are claiming, if any.

Other Income

Enter additional income amount, if you want extra withholding based on other income.

Deductions

Enter deduction amount, if applicable.

Extra Withholding per Pay Period

Enter any additional amount you want withheld from each paycheck.

Employee Certification

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

Yes No N/A

Employee Signature (required)

Date Signed (required)

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Email (required)

Your name (optional)

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