Form 3147 (Al-W4) - Employee'S Withholding Certificate - City Of Albion - 1999
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1Michigan Department of Treasury - CTU
3147 (Rev. 9-99)
AL-W4
EMPLOYEE'S WITHHOLDING CERTIFICATE FOR CITY OF ALBION INCOME TAX
1. Print Full Name
Social Security No.
Office, Plant, Dept.
Employee Identification No.
2. Address (Number and Street)
City, Township or Village
State
ZIP Code
3.
Predominant Place of Employment.
City
Under
25%
40%
60%
80%
100%
Print name of each city where you work for this employer
and circle the closest percent (%) of total earnings in each.
City
Under
25%
40%
60%
80%
100%
4.
Exemptions
YOUR WITHHOLDING
Regular $600
Additional $600 exemption
Enter number of
}
Check
for yourself
EXEMPTIONS:
exemption
if 65 or over at end of year
boxes checked
blocks
(See instructions on
which
5.
Exemptions
Enter number of
Regular $600
Additional $600 exemption
reverse side.)
apply
for your wife (husband)
boxes checked
exemption
if 65 or over at end of year
6.
(a) No. of exemptions for
6. (b) No. of exemptions for
Enter total of line 6
EMPLOYEE: File this form with your
your children
your other dependents
(a plus b)
employer. Otherwise City of Albion income
tax must be withheld 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 total
EMPLOYER: Keep this certificate with
your records.
I certify that the information submitted on this certificate is true and complete to the best of my knowledge.
8. Date
Signature
FRONT
LINE 3 INSTRUCTIONS - If you work for this employer
CHANGES IN EXEMPTIONS - You should file a new
in more than two cities or communities, print names of the
certificate at any time if the number of exemptions
two Michigan cities or communities where you perform the
INCREASES.
greatest percent of your work. Circle the closest percent of
You must file a new certificate within 10 days if the number
total earnings for work done or services rendered in each city
of exemptions previously claimed by you DECREASES for
or community listed. The estimated percent of total earnings
any of the following reasons:
from this employer for work done or services performed
within taxing cities (line 3) is for withholding purposes only. In
(a)
Your spouse for whom you have been claiming exemption is
determining final tax liability this estimate is subject to audit.
divorced or legally separated, or claims her/his own exemption on a
separate certificate.
(b)
The support of a dependent for whom you claimed exemption is
DEPENDENTS - To qualify as your dependent (line 6), a
taken over by someone else, so that you no longer expect to
person (a) must receive more than one-half of his/her
furnish more than half the support for the year.
support from you for the year, (b) must have less than $600
(c)
You find that a dependent for whom you claimed exemption will
gross income during the year (except your child who is a
receive $600 or more of income during the year (except your child
student or who is under 19 years of age), (c) must not be
who is a student or who is under 19 years of age).
claimed as an exemption by such person's husband or wife,
OTHER DECREASES in exemption, such as the death
(d) must be a citizen or resident of the United States or a
resident of Canada, Mexico, the Republic of Panama or the
of a spouse or a dependent, do not affect your withholding
Canal Zone (this does not apply to an alien child legally
until the next year, but require the filing of a new certificate
adopted and living with a United States citizen abroad), and
by December 1 of the year in which they occur.
(e) must (1) have your home as his/her principal residence
CHANGE OF RESIDENCE - You must file a new
and be a member of your household for the entire year, or (2)
certificate within 10 days after you change your residence
be related to you as follows:
from or to a taxing city.
Your son or daughter (including legally adopted children), grandchild,
CHANGES IN EMPLOYMENT - You must file a new
stepchildren, son-in-law, or daughter-in-law;
certificate by December 1 of each year if your estimate of
Your father, mother, grandparent, stepparent, father-in-law, or
mother-in-law;
the percent of work done or services rendered in cities
Your brother, sister, stepbrother, stepsister, half brother, half sister,
levying an income tax (line 3) will change for the next year.
brother-in-law, or sister-in-law;
Your uncle, aunt, or nephew, or niece (but only if related by blood).
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