Revenue Form K-4 - Employee'S Withholding Exemption Certificate

INSTRUCTIONS

1. NUMBER OF EXEMPTIONS—Do not claim more than the correct

3. DEPENDENTS—To qualify as your dependent (line 4 on reverse), a person

number of exemptions. However, if you have unusually large amounts

(a) must receive more than one-half of his or her support from you for the year,

of itemized deductions, you may claim additional exemptions to avoid

and (b) must not be claimed as an exemption by such person’s spouse, and (c)

excess withholding. You may also claim an additional exemption if you

must be a citizen of the United States, or a resident of the United States, Canada,

will be a member of the Kentucky National Guard at the end of the year.

or Mexico, or (d) must have lived with you for the entire year as a member of

If you expect to owe more income tax for the year than will be withheld,

your household or be related to you as follows:

•

you may increase the withholding by claiming a smaller number of

your child, stepchild, legally adopted child, foster child (if he lived in your

exemptions or you may enter into an agreement with your employer to

home as a member of the family for the entire year), grandchild, son-in-law,

have additional amounts withheld. If you claim more than 10 exemptions

or daughter-in-law;

•

this information is sent to the Department of Revenue.

your father, mother, or ancestor of either, stepfather, stepmother, father-in-

2. CHANGES IN EXEMPTIONS—You may ﬁ le a new certiﬁ cate at

law, or mother-in-law;

•

any time if the number of your exemptions INCREASES.

your brother, sister, stepbrother, stepsister, brother-in-law, or sister-in-law;

•

You must ﬁ le a new certiﬁ cate within 10 days if the number of

your uncle, aunt, nephew, or niece (but only if related by blood).

exemptions previously claimed by you DECREASES for any of the

4. MILITARY SPOUSE—Under the Military Spouses Residency Relief Act, you

following reasons.

may be exempt from Kentucky tax on your wages if (a) your spouse is a member

(a) You are divorced or legally separated from your spouse for

of the armed forces present in Kentucky in compliance with military orders; (b)

whom you have been claiming an exemption or your spouse claims his

you are present in Kentucky solely to be with your spouse; and (c) you maintain

or her own exemption on a separate certiﬁ cate.

your domicile in another state. If you claim this exemption, please check the box

(b) The support of a dependent for whom you claimed exemption

on the front of the K-4 and attach a copy of your spousal military identiﬁ cation

is taken over by someone else, so that you no longer expect to furnish

card.

more than half the support for the year.

5. PENALTIES—Penalties are imposed for willfully supplying false information

or willful failure to supply information which would reduce the withholding

K-4A has previously been ﬁ led.

exemption.

OTHER DECREASES in exemption, such as the death of a spouse

or a dependent, do not affect your withholding until the next year, but

require the ﬁ ling of a new certiﬁ cate by December 1 of the year in which

they occur.

Revenue Form K-4 - Employee'S Withholding Exemption Certificate - 2009 Page 2

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