Form Dw-4 - Employee'S Withholding Certificate Income Tax - City Of Detroit
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1
2EMPLOYEE’S WITHHOLDING CERTIFICATE FOR CITY OF DETROIT INCOME TAX
DW -4
1. Print Full Nam e
S ocial Security No.
Of fice, Plant, Dept.
Employee Identification No.
2. Address, Number and Street
City , To wnship or V illage where you reside
State
Zip Code
3. Predominant Place of Employment
City
Under
Renaissance Zone Exemptio n
25%
40%
60%
80% 100%
Print name of each city where you work for this
employer and circle closest % of total earnings
City
Under
Renaissance Zone Exemptio n
25%
40%
60%
80% 100%
in each.
Enter number o f
4. Exemptions
Regular
Additional exemption if
Additional
YOUR WITHHOLDING
Check
exemptions checked
for yourself
exemption
65 or over at end of year
exemption if blin d
EXEMPTIONS:
blocks
which
(See instructions on
Enter number o f
5. Exemptions for
Regular
Additional exemption if
Additional
reverse side. )
appl y
exemptions checked
your wife (husband)
exemption
65 or over at end of year
exemption if blin d
Number
Number
Enter total o f
Exemptions for your other
EMPLOYEE: F ile t h is form w ith y our
6. (a) Exemptions for your childre n
6. (b )
line 6 (a plus b)
dependent s
employer . Otherwise he must w ithhol d
CITY OF DETROI T income tax from your
earnings without exemption.
7. Add the number of exemptions which you have claimed on lines 4, 5 and 6 above and write the tota l
EMPLOYER: K eep this certificate w ith
I certify that the information submitted on this certificate is true, correct and complete to the best o f
your records. If the information submitted
my knowledge and belie f
by the employee is not believed to be true,
correct and complete, the INCOME TA X
8. Dat e
S ignatur e
DIRECT OR m ust be so advised.
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Parent category: Financial