Form W-4 - Employee'S Withholding Allowance Certificate - 2017

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Form W-4 (2017)
The exceptions don’t apply to supplemental wages
Nonwage income. If you have a large amount of
greater than $1,000,000.
nonwage income, such as interest or dividends,
consider making estimated tax payments using Form
Basic instructions. If you aren’t exempt, complete
1040-ES, Estimated Tax for Individuals. Otherwise,
Purpose. Complete Form W-4 so that your
the Personal Allowances Worksheet below. The
you may owe additional tax. If you have pension or
employer can withhold the correct federal income
worksheets on page 2 further adjust your
annuity income, see Pub. 505 to find out if you should
tax from your pay. Consider completing a new Form
withholding allowances based on itemized
adjust your withholding on Form W-4 or W-4P.
W-4 each year and when your personal or financial
deductions, certain credits, adjustments to income,
situation changes.
or two-earners/multiple jobs situations.
Two earners or multiple jobs. If you have a
working spouse or more than one job, figure the
Exemption from withholding. If you are exempt,
Complete all worksheets that apply. However, you
total number of allowances you are entitled to claim
complete only lines 1, 2, 3, 4, and 7 and sign the
may claim fewer (or zero) allowances. For regular
on all jobs using worksheets from only one Form
form to validate it. Your exemption for 2017 expires
wages, withholding must be based on allowances
W-4. Your withholding usually will be most accurate
February 15, 2018. See Pub. 505, Tax Withholding
you claimed and may not be a flat amount or
when all allowances are claimed on the Form W-4
and Estimated Tax.
percentage of wages.
for the highest paying job and zero allowances are
Note: If another person can claim you as a dependent
Head of household. Generally, you can claim head
claimed on the others. See Pub. 505 for details.
on his or her tax return, you can’t claim exemption
of household filing status on your tax return only if
Nonresident alien. If you are a nonresident alien, see
from withholding if your total income exceeds $1,050
you are unmarried and pay more than 50% of the
Notice 1392, Supplemental Form W-4 Instructions for
and includes more than $350 of unearned income (for
costs of keeping up a home for yourself and your
Nonresident Aliens, before completing this form.
example, interest and dividends).
dependent(s) or other qualifying individuals. See
Pub. 501, Exemptions, Standard Deduction, and
Check your withholding. After your Form W-4 takes
Exceptions. An employee may be able to claim
Filing Information, for information.
effect, use Pub. 505 to see how the amount you are
exemption from withholding even if the employee is
having withheld compares to your projected total tax
Tax credits. You can take projected tax credits into
a dependent, if the employee:
for 2017. See Pub. 505, especially if your earnings
account in figuring your allowable number of
• Is age 65 or older,
exceed $130,000 (Single) or $180,000 (Married).
withholding allowances. Credits for child or dependent
care expenses and the child tax credit may be claimed
• Is blind, or
Future developments. Information about any future
using the Personal Allowances Worksheet below.
developments affecting Form W-4 (such as
• Will claim adjustments to income; tax credits; or
legislation enacted after we release it) will be posted
See Pub. 505 for information on converting your other
itemized deductions, on his or her tax return.
at
credits into withholding allowances.
Personal Allowances Worksheet (Keep for your records.)
A
Enter “1” for yourself if no one else can claim you as a dependent .
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A
{
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• You’re single and have only one job; or
B
B
Enter “1” if:
• You’re married, have only one job, and your spouse doesn’t work; or
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• Your wages from a second job or your spouse’s wages (or the total of both) are $1,500 or less.
Enter “1” for your spouse. But, you may choose to enter “-0-” if you are married and have either a working spouse or more
C
than one job. (Entering “-0-” may help you avoid having too little tax withheld.) .
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C
D
Enter number of dependents (other than your spouse or yourself) you will claim on your tax return .
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D
E
Enter “1” if you will file as head of household on your tax return (see conditions under Head of household above)
E
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F
Enter “1” if you have at least $2,000 of child or dependent care expenses for which you plan to claim a credit
F
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(Note: Do not include child support payments. See Pub. 503, Child and Dependent Care Expenses, for details.)
G
Child Tax Credit (including additional child tax credit). See Pub. 972, Child Tax Credit, for more information.
• If your total income will be less than $70,000 ($100,000 if married), enter “2” for each eligible child; then less “1” if you
have two to four eligible children or less “2” if you have five or more eligible children.
• If your total income will be between $70,000 and $84,000 ($100,000 and $119,000 if married), enter “1” for each eligible child.
G
H
Add lines A through G and enter total here. (Note: This may be different from the number of exemptions you claim on your tax return.)
H
{
If you plan to itemize or claim adjustments to income and want to reduce your withholding, see the Deductions
For accuracy,
and Adjustments Worksheet on page 2.
complete all
If you are single and have more than one job or are married and you and your spouse both work and the combined
worksheets
$50,000 ($20,000
earnings from all jobs exceed
if married), see the Two-Earners/Multiple Jobs Worksheet on page 2
to avoid having too little tax withheld.
that apply.
If neither of the above situations applies, stop here and enter the number from line H on line 5 of Form W-4 below.
Separate here and give Form W-4 to your employer. Keep the top part for your records.
W-4
Employee’s Withholding Allowance Certificate
OMB No. 1545-0074
2017
Form
Whether you are entitled to claim a certain number of allowances or exemption from withholding is
Department of the Treasury
subject to review by the IRS. Your employer may be required to send a copy of this form to the IRS.
Internal Revenue Service
1
2
Your social security number
Your first name and middle initial
Last name
Home address (number and street or rural route)
3
Single
Married
Married, but withhold at higher Single rate.
Note: If married, but legally separated, or spouse is a nonresident alien, check the “Single” box.
City or town, state, and ZIP code
4 If your last name differs from that shown on your social security card,
check here. You must call 1-800-772-1213 for a replacement card.
5
Total number of allowances you are claiming (from line H above or from the applicable worksheet on page 2)
5
$
6
Additional amount, if any, you want withheld from each paycheck
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6
7
I claim exemption from withholding for 2017, and I certify that I meet both of the following conditions for exemption.
• Last year I had a right to a refund of all federal income tax withheld because I had no tax liability, and
• This year I expect a refund of all federal income tax withheld because I expect to have no tax liability.
If you meet both conditions, write “Exempt” here .
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7
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.
Employee’s signature
Date
(This form is not valid unless you sign it.)
8
9 Office code (optional)
10
Employer’s name and address (Employer: Complete lines 8 and 10 only if sending to the IRS.)
Employer identification number (EIN)
W-4
For Privacy Act and Paperwork Reduction Act Notice, see page 2.
Form
(2017)
Cat. No. 10220Q

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