Form G-4 - Employee'S Withholding Allowance Certificate January 2000 Page 2
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1
2SCHEDULE A
WORKSHEET FOR FIGURING YOUR WITHHOLDING ALLOWANCES TO BE ENTERED ON LINE 5 OF FORM G-4.
1. COMPLETE THIS LINE ONLY IF USING STANDARD DEDUCTION:
Yourself:
Age 65 [
]
Blind [
]
Spouse:
Age 65 [
]
Blind [
]
Number of blocks checked ____ X 1300 =
$
2. ADDITIONAL ALLOWANCES FOR DEDUCTIONS:
(A) Federal Estimated Itemized Deductions............................................................................$
(B)
GEORGIA STANDARD DEDUCTION - This adjustment is necessary if itemized deductions are included
in line (A) above, since the standard deduction is built in the Georgia Withholding Tax Tables, and both
standard and itemized deductions cannot be claimed. (see below)...............................$
ENTER ONE
Single/Head of Household
$2300
Married Filing Joint
$3000
Married Filing Separate
$1500
(C)
SUBTRACT LINE B FROM LINE A................................................................................................ $
(D)
ALLOWABLE DEDUCTIONS TO FEDERAL ADJUSTED GROSS INCOME....................................$
(Such as Retirement Income Exclusion, U.S. Obligations,Social Security and other allowable
deductions per Georgia Law)
(E)
ADD THE AMOUNTS ON LINES 1, 2C, AND 2D............................................................................$
(F)
ENTER AN ESTIMATE OF YOUR TAXABLE INCOME NOT SUBJECT TO WITHHOLDING ..........$
(Such as interest, dividends and lump sum distributions)
(G)
SUBTRACT LINE F FROM E AND ENTER RESULT ......................................................................$
IF LESS THAN ZERO (0) STOP HERE.
(H)
DIVIDE THE AMOUNT ON LINE G BY $2700 TO GET THE NUMBER OF PERSONAL ALLOWANCES
(If the remainder is over $1350 round up). ENTER HERE AND ON LINE 5 OF FORM G-4...................
ADDITIONAL WITHHOLDING:
If you have income other than salaries and wages you can authorize your employer to withhold an additional amount. You can figure 6% of the
other income, then divide by the yearly number of pay periods (Weekly, Monthly, Etc.), or whatever you feel will be needed.
I authorize additional withholding per pay period of $__________.
(Signed) ______________________________
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