WT-4
Employee’s Wisconsin Withholding Exemption Certificate/New Hire Reporting
Employee’s Section
Employee’s Name (last, first, middle initial
Social Security Number
Date of Birth
Employee’s address (number and street)
City
State
Zip Code
Date of Hire
Single
Married
Married, but withhold at higher Single rate. Note: If married, but legally separated, check the Single box.
FIGURE YOUR TOTAL WITHHOLDING EXEMPTIONS BELOW
Complete Lines 1 through 3 only if your Wisconsin exemptions are different than your federal allowances.
1. (a) Exemption for yourself – enter 1 .........................................................................................................
(b) Exemption for your spouse – enter 1 .................................................................................................
(c) Exemption(s) for dependent(s) – you are entitled to claim an exemption for each dependent .......
(d) Total – add lines (a) through (c) ..........................................................................................................
2. Additional amount per pay period you want deducted (if your employer agrees) ....................................
3. I claim complete exemption from withholding (see instructions). Enter “Exempt” ..................................
I CERTIFY that the number of withholding exemptions claimed on this certificate does not exceed the number to which I am entitled. If claiming complete exemption from
withholding, I certify that I incurred no liability for Wisconsin income tax for last year and that I anticipate that I will incur no liability for Wisconsin income tax for this year.
Signature
Date Signed
,
• HOW TO COMPLETE FORM WT-4
EMPLOYEE INSTRUCTIONS:
Clearly print your full name (last, first, middle initial), address, social security
• WHO MUST FILE:
number and date of birth.
Every Employee is required to file a completed Form WT-4 with each of his or her
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employers unless the Employee claims the same number of withholding exemp-
• LINE 1:
tions for Wisconsin withholding tax purpose as for federal withholding tax purpose.
(a)-(c) Number of exemptions — Do not claim more than the correct number of
Form WT-4 (or federal Form W-4 if a Form WT-4 is not filed) will be used by your
exemptions. If you expect to owe more income tax for the year than will be with-
employer to determine the amount of Wisconsin income tax to be withheld from
held if you claim every exemption to which you are entitled, you may increase your
your paychecks. If you have more than one employer, you should claim a smaller
withholding by claiming a smaller number of exemptions on lines 1(a)-(c) or you
number or no exemptions on each Form WT-4 filed with employers other than
may enter into an agreement with your employer to have additional amounts
your principal employer so that the total amount withheld will be closer to your
withheld (see instruction for line 2).
actual income tax liability.
(c) Dependents — Those persons who qualify as your dependents for federal
Your employer may also require you to complete this form to report your hiring to
income tax purposes may also be claimed as dependents for Wisconsin purposes.
the Department of Workforce Development.
The term “dependents” does not include you or your spouse. Indicate the number
You may file a new Form WT-4 any time you wish to change the amount of with-
of dependents that you are claiming in the space provided.
holding from your paychecks, providing the number of exemptions you claim does
not exceed the number you are entitled to claim.
• LINE 2:
Additional withholding — If you have claimed “zero” exemptions on line 1, but still
• UNDER WITHHOLDING:
expect to have a balance due on your tax return for the year, you may wish to
If sufficient tax is not withheld from your wages, you may incur additional interest
request your employer to withhold an additional amount of tax for each pay period.
charges under the tax laws. In general, 90% of the net tax shown on your income
If your employer agrees to this additional withholding, enter the additional amount
tax return should be withheld.
you want deducted from each of your paychecks on line 2.
• OVER WITHHOLDING:
• LINE 3:
If you are using Form WT-4 to claim the maximum number of exemptions to which
Exemption from withholding — You may claim exemption from withholding of
you are entitled and your withholding exceeds your expected income tax liability,
Wisconsin income tax if you had no liability for income tax for last year, and you
you may use Form WT-4A to minimize the over withholding.
anticipate that you will incur no liability for income tax for this year. You may not
claim exemption if your return shows tax liability before the allowance of any credit
• WHEN TO FILE IF YOUR EXEMPTIONS CHANGE:
for income tax withheld. If you are exempt, your employer will not withhold Wis-
consin income tax from your wages.
You must file a new certificate within 10 days if the number of exemptions previously
claimed by you DECREASES.
You must revoke this exemption (1) within 10 days from the time you anticipate
you will incur income tax liability for the year or (2) on or before December 1 if you
You may file a new certificate at any time if the number of your exemptions
anticipate you will incur Wisconsin income tax liabilities for the next year. If you
INCREASES.
want to stop or are required to revoke this exemption, you must file a new Form
WT-4 with your employer showing the number of withholding exemption you are
entitled to claim. This certificate for exemption from withholding will expire on April
30 of next year unless a new Form WT-4 is filed before that date.
Employer’s Section
Employer’s Name
Federal Employer ID Number
Employer’s payroll address (number and street)
City
State
Zip Code
EMPLOYER INSTRUCTIONS for Department of Revenue:
EMPLOYER INSTRUCTIONS for New Hire Reporting:
• If you do not have a Federal Employer Identification Number (FEIN), contact the
• This report contains the required information for reporting New Hire to Wisconsin.
Internal Revenue Service to obtain a FEIN.
Mail the original form to the Department of Workforce Development, New
Hire Reporting, PO Box 14431, Madison, WI 53708-0431 or fax toll free to
• If the Employee has claimed more than 10 exemptions OR has claimed complete
1-800-277-8075.
exemption from withholding and earns more than $200.00 a week or is believed
to have claimed more exemptions than he or she is entitled to, mail a copy of this
• If you are reporting New Hires electronically, you do not need to forward a copy of
certificate to: Wisconsin Department of Revenue, Audit Bureau, P.O. Box 8906,
this report to Department of Workforce Development.
Madison, WI 53708 or fax (608)-267-0834.
• If you have questions about New Hire requirements, call toll free (888) 300-HIRE
• Keep a copy of this certificate with your records. If you have questions about the
(888-300-4473).
Department of Revenue requirements, call (608) 266-8646 or (608) 266-2776.
W-204 (R. 11-04)
Wisconsin Department of Revenue