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Complete all worksheets that apply. However, you

payments using Form 1040-ES, Estimated Tax

Form W-4 (2010)

may claim fewer (or zero) allowances. For regular

for Individuals. Otherwise, you may owe

wages, withholding must be based on allowances

additional tax. If you have pension or annuity

you claimed and may not be a flat amount or

income, see Pub. 919 to find out if you should

Purpose. Complete Form W-4 so that your

adjust your withholding on Form W-4 or W-4P.

percentage of wages.

employer can withhold the correct federal income

tax from your pay. Consider completing a new

Two earners or multiple jobs. If you have a

Head of household. Generally, you may claim

Form W-4 each year and when your personal or

working spouse or more than one job, figure

head of household filing status on your tax

financial situation changes.

return only if you are unmarried and pay more

the total number of allowances you are entitled

than 50% of the costs of keeping up a home

to claim on all jobs using worksheets from only

Exemption from withholding. If you are

for yourself and your dependent(s) or other

one Form W-4. Your withholding usually will

exempt, complete only lines 1, 2, 3, 4, and 7

be most accurate when all allowances are

qualifying individuals. See Pub. 501,

and sign the form to validate it. Your exemption

claimed on the Form W-4 for the highest

Exemptions, Standard Deduction, and Filing

for 2010 expires February 16, 2011. See

paying job and zero allowances are claimed on

Information, for information.

Pub. 505, Tax Withholding and Estimated Tax.

the others. See Pub. 919 for details.

Note. You cannot claim exemption from

Tax credits. You can take projected tax

withholding if (a) your income exceeds $950

credits into account in figuring your allowable

Nonresident alien. If you are a nonresident

and includes more than $300 of unearned

number of withholding allowances. Credits for

alien, see Notice 1392, Supplemental Form

income (for example, interest and dividends)

child or dependent care expenses and the

W-4 Instructions for Nonresident Aliens, before

and (b) another person can claim you as a

child tax credit may be claimed using the

completing this form.

dependent on his or her tax return.

Personal Allowances Worksheet below. See

Check your withholding. After your Form W-4

Pub. 919, How Do I Adjust My Tax

Basic instructions. If you are not exempt,

takes effect, use Pub. 919 to see how the

Withholding, for information on converting

complete the Personal Allowances Worksheet

amount you are having withheld compares to

your other credits into withholding allowances.

below. The worksheets on page 2 further adjust

your projected total tax for 2010. See Pub.

your withholding allowances based on itemized

Nonwage income. If you have a large amount

919, especially if your earnings exceed

deductions, certain credits, adjustments to

of nonwage income, such as interest or

$130,000 (Single) or $180,000 (Married).

dividends, consider making estimated tax

income, or two-earners/multiple jobs situations.

Personal Allowances Worksheet (Keep for your records.)

Enter “1” for yourself if no one else can claim you as a dependent

● You are single and have only one job; or

● You are married, have only one job, and your spouse does not work; or

Enter “1” if:

● 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 “-0-” 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.)

Enter number of dependents (other than your spouse or yourself) you will claim on your tax return

Enter “1” if you will file as head of household on your tax return (see conditions under Head of household above)

Enter “1” if you have at least $1,800 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.)

G Child Tax Credit (including additional child tax credit). See Pub. 972, Child Tax Credit, for more information.

● If your total income will be less than $61,000 ($90,000 if married), enter “2” for each eligible child; then less “1” if you have three or more eligible children.

● If your total income will be between $61,000 and $84,000 ($90,000 and $119,000 if married), enter “1” for each eligible

child plus “1” additional if you have six or more eligible children.

Add lines A through G and enter total here. (Note. This may be different from the number of exemptions you claim on your tax return.)

● If you plan to itemize or claim adjustments to income and want to reduce your withholding, see the Deductions

For accuracy,

complete all

and Adjustments Worksheet on page 2.

● If you have more than one job or are married and you and your spouse both work and the combined earnings from all jobs exceed

worksheets

that apply.

$18,000 ($32,000 if married), see the Two-Earners/Multiple Jobs Worksheet on page 2 to avoid having too little tax withheld.

● If neither of the above situations applies, stop here and enter the number from line H on line 5 of Form W-4 below.

Cut here and give Form W-4 to your employer. Keep the top part for your records.

W-4

OMB No. 1545-0074

Employee’s Withholding Allowance Certificate

Form

2010

Whether you are entitled to claim a certain number of allowances or exemption from withholding is

Department of the Treasury

subject to review by the IRS. Your employer may be required to send a copy of this form to the IRS.

Internal Revenue Service

Type or print your first name and middle initial.

Last name

Your social security number

Home address (number and street or rural route)

Single

Married

Married, but withhold at higher Single rate.

Note. If married, but legally separated, or spouse is a nonresident alien, check the “Single” box.

City or town, state, and ZIP code

4 If your last name differs from that shown on your social security card,

check here. You must call 1-800-772-1213 for a replacement card.

Total number of allowances you are claiming (from line H above or from the applicable worksheet on page 2)

Additional amount, if any, you want withheld from each paycheck

I claim exemption from withholding for 2010, 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

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.

Employee’s signature

Date

(Form is not valid unless you sign it.)

Employer’s name and address (Employer: Complete lines 8 and 10 only if sending to the IRS.)

Office code (optional) 10

Employer identification number (EIN)

W-4

For Privacy Act and Paperwork Reduction Act Notice, see page 2.

Cat. No. 10220Q

Form

(2010)