State Of Louisiana Exemption From Withholding Louisiana Income Tax

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R-1307 (7/02)
L-4E
State of Louisiana
Form
State of Louisiana
Exemption from Withholding
Department of Revenue
Louisiana Income Tax
TAX YEAR 20______
For use by employees who incurred no tax liability in the prior year and anticipate no
tax liability for the current year
Type or print full name
Social Security Number
Home address (Number and Street)
City, State, and ZIP
-
EMPLOYEE
Employee’s certification-Under penalties of perjury, I certify that I incurred no liability for Louisiana income tax for
File this certificate with your
the prior year and that I anticipate that I will incur no liability for Louisiana income tax for the current year.
employer. Otherwise he must withhold Louisiana
income tax from your wages.
Signature
-
EMPLOYER
Keep this certificate with
your records. This certificate may be used
instead of Form L-4 by those employees quali-
Date
fied to claim the exemption.
INSTRUCTIONS
Multiple employers:
Who may claim exemption from withholding of
income tax:
If you are employed by more than one employer,
you may claim the exemption from withholding with
You may be entitled to claim exemption from with-
holding Louisiana income tax if you incurred no lia-
each employer, provided that the total of your antic-
ipated income will not cause you to incur any liabil-
bility for Louisiana income tax for the prior year and
you anticipate that you will incur no liability for such
ity for Louisiana income tax for the current year and
you incurred no liability for Louisiana income tax for
income tax for the current year. For this purpose,
you incur tax liability if your joint or separate return
the previous year.
shows tax before the allowance of any credit for
income tax withheld. If you claim this exemption,
When you must revoke this exemption:
You must revoke this exemption certificate:
your employer will not withhold Louisiana income
(1) within 10 days from the day you anticipate you
tax from your wages.
will incur Louisiana income tax liability for the cur-
rent year, or (2) if you anticipate you will incur
When to claim exemption:
Louisiana income tax liability for the following year
File this certificate with your employer as soon as
(if a fiscal year taxpayer, within 10 days after you so
you determine you are entitled to claim this exemp-
anticipate, or by the first day of the last month of
tion. You must file a certificate each year if you wish
your current taxable year, whichever is later.) If you
to continue to claim the exemption.
want to discontinue, or are required to revoke this
exemption, you must file a new Employee’s
Withholding Exemption Certificate (Form L-4) with
your employer.
For assistance, call the
Department of Revenue
at (225) 219-0102

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