It-4, 2011, Employee'S Withholding Exemption Certificate printable pdf download

Form IT-4

State of Ohio

(11-90)

Department of Taxation

Employee's Withholding Exemption Certificate

Name

Social Security No.

Address

Public School District of Residence

School District No.

Personal exemption for yourself, enter "1" if claimed

If married, personal exemption for your spouse if not separately claimed

(enter "1" if claimed)

Exemptions for dependents

Add the exemptions which you have claimed above and enter total

Additional withholding per pay period under agreement with Employer

Under the penalties of perjury, I certify that the number of exemptions claimed on this certificate does not exceed the number to which I am entitled.

Signature

Date

Notice to Employee

For state purposes an individual may claim only natural dependency

The death of a spouse or a dependent does not affect your withhold-

exemptions. This would include himself, his spouse and each depen-

ing until the next year but requires the filing of a new certificate. If

dent. Dependents are the same as defined in the Internal Revenue

possible, file a new certificate by December 1st of the year in which

Code and as claimed in the Taxpayer's federal income tax return for

the death occurs.

the taxable year or which the taxpayer would have been permitted to

claim had he filed such a return.

For further information consult the Ohio Department of Taxation, In-

come Tax Division, or your employer.

You may file a new certificate at any time if the number of your ex-

emptions INCREASES.

IF YOU EXPECT TO OWE MORE OHIO INCOME TAX THAN WILL BE

WITHHELD, YOU MAY CLAIM A SMALLER NUMBER OF EXEMPTIONS;

You must file a new certificate within 10 days if the number of exemp-

OR UNDER AN AGREEMENT WITH YOUR EMPLOYER, YOU MAY HAVE

tions previously claimed by you DECREASES because:

AN ADDITIONAL AMOUNT WITHHELD EACH PAY PERIOD.

(a)

Your spouse for whom you have been claiming exemptions is

A married couple with both spouses working and filing a joint return

divorced or legally separated, or claims her (or his) own exemp-

will in many cases be required to file a Declaration of Estimated Indi-

tion on a separate certificate.

vidual Income Tax even though Ohio Income Tax is being withheld

from their wages. This is due to the fact that the tax on their com-

(b)

The suppport of a dependent for whom you claimed exemption

bined income will be greater than the sum of the taxes withheld from

is taken over by someone else.

the husband's wages and the wife's wages. This requirement to file a

Declaration of Estimated Individual Income Tax may also apply to an

(c)

You find that a dependent for whom you claimed exemption must

individual who has two jobs, both of which are subject to withhold-

be dropped for Federal purposes.

ing. In lieu of filing the Declaration of Estimated Individual Income

Tax, the individual may provide for additional withholding under an

agreement with his employer by use of line 5.

It-4, 2011, Employee'S Withholding Exemption Certificate

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