Form D-40wh - Withholding Tax Schedule - 2016 Page 2
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*16040W120002*
D-40WH PAGE 2
Last name and SSN
4
A - Employer or Payor Information
B - Employee or Taxpayer Information
C - DC Tax Withheld
Employer ID or Payor ID from W-2 or 1099
Name
DC Withholding from Box #17 of W-2 or
the appropriate box from 1099
$
.00
Employer or Payor Name
Social Security Number
Check the appropriate box
Address
Income Subject to DC Withholding
W-2
1099
$
.00
City
Enter State Abbreviation
from Box #1 of W-2 or the
from Box #15 of W-2 or the
appropriate box from 1099
appropriate box from 1099
State
Zip Code + 4
Enter DC Withholding Only
5
A - Employer or Payor Information
B - Employee or Taxpayer Information
C - DC Tax Withheld
Employer ID or Payor ID from W-2 or 1099
Name
DC Withholding from Box #17 of W-2 or
the appropriate box from 1099
$
.00
Employer or Payor Name
Social Security Number
Check the appropriate box
Address
Income Subject to DC Withholding
W-2
1099
$
.00
City
Enter State Abbreviation
from Box #1 of W-2 or the
from Box #15 of W-2 or the
appropriate box from 1099
appropriate box from 1099
State
Zip Code + 4
Enter DC Withholding Only
6
A - Employer or Payor Information
B - Employee or Taxpayer Information
C - DC Tax Withheld
Employer ID or Payor ID from W-2 or 1099
Name
DC Withholding from Box #17 of W-2 or
the appropriate box from 1099
$
.00
Employer or Payor Name
Social Security Number
Check the appropriate box
Address
Income Subject to DC Withholding
W-2
1099
$
.00
City
Enter State Abbreviation
from Box #1 of W-2 or the
appropriate box from 1099
from Box #15 of W-2 or the
appropriate box from 1099
State
Zip Code + 4
Enter DC Withholding Only
Total DC tax withheld from column C above..............................
$
.00
If you have DC withholding on multiple pages, add the totals together
and enter the GRAND total on Form D-40EZ, Line 11 or D-40, Line 30.
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2016 D-40WH P2
Withholding Tax Schedule
Revised 06/2016
File order 4a
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