Mississippi Employees Withholding Certificate
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Enter $6,000 as exemption . . . . f
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Spouse 127 employed: Enter $12,000
(a)
f
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Otherwise, you
Spouse ,6 employed: Enter that part of
must withhold Mississippi
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income tax from the full
(b)
$12,000 claimed by you in multiples of
amount of your wages.
$500.
See instructions 2(b) below
.f
Enter $9,500 as exemption.
To qualify
as head of family, you must be single
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and have a dependent living in the
home with you.
See instructions 2(c)
and 2(d)below . . . . . . . . . . . .f
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You may claim $1,500 for each dependent
, other than
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for taxpayer and spouse, who receives chief support
from you and who qualifies as a dependent for Federal
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If the
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income tax purposes.
employee is believed to
* A head of family may claim $1,500 for each
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have claimed excess
dependents excluding the one which qualifies you
exemption, the Department
0
as head of family. Multiply number of dependents
f
claimed by you by $1,500. Enter amount claimed . . .
of Revenue should be
1
advised.
Age 65 or older
Husband
Wife
Single
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Blind
Husband
Wife
Single
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Multiply the number of blocks checked by $1,500.
Enter the amount claimed
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No exemption allowed for age or blindness
No exemption allowed for age or blindness
for dependents.
for dependents.
727$/ $02817 2) (;(037,21 &/$,0(' /LQHV WKURXJK f
Additional dollar amount of withholding per pay period if
agreed to by your employer . . . . . .
. . . . . . . . . . .f
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If you meet the conditions set forth under the Service Member
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Civil Relief, as amended by the Military Spouses Residency
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Relief Act, and have no Mississippi tax liability, write
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:LWKKROGLQJ
on Line 8.
You must attach a copy of the Federal
Form DD-2058 and a copy of your Military Spouse ID Card to
this form so your employer can validate the exemption claim..f
I declare under the penalties imposed for filing false reports that the amount of exemption claimed on this
certificate does not exceed the amount to which I am entitled or I am entitled to claim exempt status.
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INSTRUCTIONS
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VKRXOG QRW include themselves or their spouse. Married taxpayers may divide the number of their
dependents between them in any manner they choose; for example, a married couple has 3 children
(a) Single Individuals
$6,000
(d) Dependents
$1,500
who qualify as dependents. The taxpayer may claim 2 dependents and the spouse 1; or the taxpayer
(b) Married Individuals (Jointly)
$12,000
(e) Age 65 and Over
$1,500
may claim 3 dependents and the spouse none. Enter the amount of dependent exemption on Line 4.
(c) Head of family
$9,500
(f) Blindness
$1,500
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(e) An additional exemption of $1,500 may be claimed by either taxpayer or spouse or both if
either or both have reached the DJH RI before the close of the taxable year. No
(a) Single Individuals enter $6,000 on Line 1.
additional exemption is authorized for dependents by reason of age. Check applicable
blocks on Line 5.
(b) Married individuals are allowed a joint exemption of $12,000.
(f) An additional exemption of $1,500 may be claimed by either taxpayer or spouse or both if
If the spouse is not employed, enter $12,000 on Line 2(a). If the spouse is employed, the
either or both are EOLQG. No additional exemption is authorized for dependents by reason of
exemption of $12,000 may be divided between taxpayer and spouse in any manner they
blindness. Check applicable blocks on Line 5. Multiply number of blocks checked on Line 5
choose - in multiples of $500. For example, the taxpayer may claim $6,500 and the spouse
by $1,500 and enter amount of exemption claimed.
claims $5,500; or the taxpayer may claim $8,000 and the spouse claims $4,000. The total
claimed by the taxpayer and spouse may not exceed $12,000. Enter amount claimed by
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you on Line 2(b).
Add the amount of exemptions claimed in each category and enter the total on Line 6. This
(c) Head of Family
amount will be used as a basis for withholding income tax under the appropriate withholding
tables.
A head of family is a single individual who maintains a home which is the principal place of
$ 1(: (;(037,21 &(57,),&$7( 0867 %( ),/(' :,7+ <285 (03/2<(5 :,7+,1
abode for himself and at least one other dependent. Single individuals qualifying as a head
'$<6 $)7(5 $1< &+$1*( ,1 <285 (;(037,21 67$786.
of family enter $9,500 on Line 3. If the taxpayer has more than one dependent, additional
exemptions are applicable. See item (d).
3(1$/7,(6 $5( ,0326(' )25 :,//)8//< 6833/<,1* )$/6( ,1)250$7,21
(d) An additional exemption of $1,500 may generally be claimed for each dependent of the
taxpayer. A dependent is any relative who receives chief support from the taxpayer and
,) 7+( (03/2<(( )$,/6 72 ),/( $1 (;(037,21 &(57,),&$7( :,7+ +,6
who qualifies as a dependent for Federal income tax purposes. Head of family individuals
q
p
p p
y
(03/2<(5 ,1&20( 7$; 0867 %( :,7++(/' %< 7+( (03/2<(5 21 727$/
(03/2<(5 ,1&20( 7$; 0867 %( :,7++(/' %< 7+( (03/2<(5 21 727$/
may claim an additional exemption for each dependent excluding the one which is required
may claim an additional exemption for each dependent excluding the one which is required
:$*(6 :,7+287 7+( %(1(),7 2) (;(037,21.
:$*(6 :,7+287 7+( %(1(),7 2) (;(037,21.
for head of family status. For example, a head of family taxpayer has 2 dependent children
for head of family status. For example, a head of family taxpayer has 2 dependent children
. To comply with the Military Spouse Residency Relief Act (PL111-97) signed on November
. To comply with the Military Spouse Residency Relief Act (PL111-97) signed on November
and his dependent mother living with him. The taxpayer may claim 2 additional exemptions.
and his dependent mother living with him. The taxpayer may claim 2 additional exemptions.
11, 2009.
11, 2009.
Married or single individuals may claim an additional exemption for each dependent, but
Married or single individuals may claim an additional exemption for each dependent, but
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