Form Iw-4 - Employee'S Withholding Certificate For City Of Ionia Income Tax

EMPLOYEE'S WITHHOLDING CERTIFICATE FOR CITY OF IONIA INCOME TAX

Resident

IW-4

Non-Resident

1. Print Full Name

Social Security Number

Office, Plant, Dept.

Employer Identification No.

2. Address, Number and Street

City, Township or Village where you reside

State

Zip Code

City

Under

3. Predominant Place of Employment

25%

40%

60%

80%

100%

Print name of each city where you work for this employer

City

Under

and circle closest % of total earnings in each.

25%

40%

60%

80%

100%

4. Exemptions

Regular $700

Additional $700 exemption

Additional $700

Enter number of

YOUR WITHHOLDING Check

exemptions

EXEMPTIONS:

for yourself

exemptions

if 65 or over at end of year

exemption if blind

blocks

checked ------>

Enter number of

5. Exemptions for

Regular $700

Additional $700 exemption

Additional $700

(See instructions on

which

exemptions

your wife (husband)

exemptions

if 65 or over at end of year

exemption if blind

bottom half of form.)

apply

checked ------>

number

number

Enter Total of

EMPLOYEE:

6.(a) Exemptions for your

6.(b) Exemptions for your other

line 6 (a plus b)

If you fail or refuse to file this form,

children

dependents

--------->

your employer must withhold City of

Ionia income tax from your wages

7. Add the number of exemptions which you have claimed on lines 4, 5 and 6 above and write total -------->

without allowance for any

exemptions.

I certify that the information submitted on this certificate is true, correct and complete to the best of my knowledge and belief.

EMPLOYER:

Keep this certificate with your

records. If the employee is

8. Date

Signature

claiming more than personal and

dependency exemptions or claims

a status exempting the employee

from withholding, you must inform

the Income Tax Division.

- - - - - - - - - - - - - - - - - - -- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -- - - - - - - - - - - - -

LINE 3 INSTRUCTIONS - If you work for this employer in more

CHANGES IN EXEMPTIONS - You should file a new certificate

than three cities or communities, print names of the three Michigan

at any time if the number of your exemptions INCREASES.

cities or communities where you perform the greatest percent of

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

your work. Circle the closest percent of total earnings for work done

or services rendered in each city or community listed. The

exemptions previously claimed by you DECREASES for any of the

estimated percent of total earnings from this employer is for

following reasons:

withholding purposes only. In determining final tax liability this

(a) Your wife (or husband) for whom you have been claiming exemption is

estimate is subject to substantiation and audit.

divorced or legally separated, or claims her (or his) own exemption on a

separate certificate.

DEPENDENTS - To qualify as your dependent (line 6 above), a

(b) The support of a dependent for whom you claim exemption is taken over by

person (a) must receive more than one-half of his or her support

someone else, so that you no longer expect to furnish more than half the

from you for the year, and (b) must have less than $600 gross

support for the year.

income during the year (except your child who is a student or who is

(c) You find that a dependent for whom you claimed exemption will receive $600

under 19 years of age), and (c) must not be claimed as an

or more of income of his own during the year (except your child who is a student

exemption by such person's husband or wife, and (d) must be a

who is under 19 years of age.)

citizen or resident of the United States or a resident of Canada,

Mexico, the Republic of Panama or the Canal Zone (this does not

OTHER DECREASES in exemptions, such as the death of a wife or a

apply to an alien child legally adopted by and living with a United

dependent, do not affect your withholding until the next year, but require the

States citizen abroad), and (e) must (1) have your home as his

filing of a new certificate by December 1 of the year in which they occur.

principal residence and be a member of your household for the

entire year, or (2) be related to you as follows:

CHANGE OF RESIDENCE - You must file a new certificate within 10

Your son or daughter (including legally adopted

days after you change your residence from or to a taxing city.

children), grandchild, stepson, stepdaughter, son-

in-law, or daughter-in-law;

CHANGES IN EMPLOYMENT - You must file a new certificate by

December 1 of each year if your Line 3 estimate of the percent of work

Your father, mother, grandparent, stepfather,

stepmother, father-in-law, or mother-in-law;

done or services rendered in cities levying an income tax will change for the

ensuing year.

Your brother, sister, stepbrother, stepsister, half

brother, half sister, brother-in-law, or sister-in-law;

Your uncle, aunt, nephew, or niece (but only if

related by blood).