Form K-4 - Kansas Employee'S Withholding Allowance Certificate

Download a blank fillable Form K-4 - Kansas Employee'S Withholding Allowance Certificate in PDF format just by clicking the "DOWNLOAD PDF" button.

Open the file in any PDF-viewing software. Adobe Reader or any alternative for Windows or MacOS are required to access and complete fillable content.

Complete Form K-4 - Kansas Employee'S Withholding Allowance Certificate with your personal data - all interactive fields are highlighted in places where you should type, access drop-down lists or select multiple-choice options.

Some fillable PDF-files have the option of saving the completed form that contains your own data for later use or sending it out straight away.

K-4

KANSAS

EMPLOYEE'S WITHHOLDING ALLOWANCE CERTIFICATE

(Rev. 8-15)

Use the following instructions to accurately

withheld because you had no tax liability;

receive a K-4 form from you, they must

complete your K-4 form, then detach

and 2) this year you will receive a full

withhold Kansas income tax from your

the lower portion and give it to your

refund of all STATE income tax withheld

wages without exemption at the “Single”

employer. For assistance, call the Kansas

because you will have no tax liability.

allowance rate.

Department of Revenue at 785-368-8222.

Head of household: Generally, you may

Basic Instructions: If you are not exempt,

Purpose of the K-4 form: A completed

complete

the

Personal

Allowance

claim head of household filing status on

withholding allowance certificate will let

your tax return only if you are unmarried

Worksheet that follows. The total on line

and pay more than 50% of the cost of

your employer know how much Kansas

F should not exceed the total exemptions

income tax should be withheld from your

you

claim

under

“Exemptions

and

keeping up a home for yourself and for

pay on income you earn from Kansas

Dependents” on your Kansas income tax

your dependent(s).

sources. Because your tax situation may

return.

Non-wage income: If you have a large

change, you may want to re-figure your

NOTE: Your status of “Single” or “Joint”

amount of non-wage Kansas source

withholding each year.

may differ from your status claimed on

income, such as interest or dividends,

your federal Form W-4).

consider making Kansas estimated tax

Exemption from Kansas withholding:

Using the information from your Personal

payments on Form K-40ES. Without

To qualify for exempt status you must

these payments, you may owe additional

verify with the Kansas Department of

Allowance Worksheet, complete the

Revenue that: 1) last year you had the

K-4 form below, sign it and provide it to

Kansas tax when you file your state

your employer. If your employer does not

income tax return.

right to a refund of all STATE income tax

Personal Allowance Worksheet (Keep for your records)

A Allowance Rate: If you are a single filer mark “Single”

Single

If you are married and your spouse has income mark “Single”

Joint

If you are married and your spouse does not work mark “Joint”

B Enter “0” or “1” if you are married or single and no one else can claim you as a dependent (entering “0” may help

you avoid having too little tax withheld).......................................................................................................................... B _________

C Enter “0” or “1” if you are married and only have one job, and your spouse does not work (entering “0” may help

you avoid having too little tax withheld).......................................................................................................................... C _________

D Enter “2” if you will file head of household on your tax return (see conditions under Head of household above) ......... D _________

E Enter the number of dependents you will claim on your tax return. Do not claim yourself or your spouse or

dependents that your spouse has already claimed on their form K-4. ........................................................................... E _________

F Add lines B through E and enter the total here ........................................................................................................... F _________



Cut here and give the lower portion to your employer. Keep the top portion for your records.

K-4

Kansas Employee’s Withholding Allowance Certificate

Whether you are entitled to claim a certain number of allowances or exemption from withholding is subject to review by the

(Rev. 9-12)

Kansas Department of Revenue. Your employer may be required to send a copy of this form to the Department of Revenue.

Print your First Name and Middle Initial

Last Name

Social Security Number

Mailing Address

Allowance Rate

Mark the allowance rate selected in line A above.

City or Town, State and Zip Code

Single

Joint

Total number of allowances you are claiming (from line F above) .....................................................................................

Enter any additional amount you want withheld from each paycheck (this is optional) .....................................................

I claim exemption from withholding. (You must meet the conditions explained in the "Exemption from withholding"

instructions above.) If you meet the conditions above, write "Exempt" on this line

............................................................

Note: The Kansas Department of Revenue will receive your federal W-2 forms for all years claimed Exempt.

Under penalties of perjury, I declare that I have examined this certificate and to the best of my knowledge and belief it is true, correct, and complete.

SIGN



HERE

DATE

Employer's name and address

8 EIN (Employer ID Number)