Form W-4 - Employee's Withholding Allowance Certificate - 2015

Form W-4 (2015)
The exceptions do not 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 are not exempt, complete
1040-ES, Estimated Tax for Individuals. Otherwise, you
Purpose. Complete Form W-4 so that your employer
the Personal Allowances Worksheet below. The
may owe additional tax. If you have pension or annuity
can withhold the correct federal income tax from your
worksheets on page 2 further adjust your
income, see Pub. 505 to find out if you should adjust
pay. Consider completing a new Form W-4 each year
withholding allowances based on itemized
your withholding on Form W-4 or W-4P.
and when your personal or financial situation changes.
deductions, certain credits, adjustments to income,
or two-earners/multiple jobs situations.
Two earners or multiple jobs. If you have a
Exemption from withholding. If you are exempt,
working spouse or more than one job, figure the
complete only lines 1, 2, 3, 4, and 7 and sign the form
Complete all worksheets that apply. However, you
total number of allowances you are entitled to claim
to validate it. Your exemption for 2015 expires
may claim fewer (or zero) allowances. For regular
on all jobs using worksheets from only one Form
February 16, 2016. See Pub. 505, Tax Withholding
wages, withholding must be based on allowances
W-4. Your withholding usually will be most accurate
and Estimated Tax.
you claimed and may not be a flat amount or
when all allowances are claimed on the Form W-4
percentage of wages.
Note. If another person can claim you as a dependent
for the highest paying job and zero allowances are
on his or her tax return, you cannot claim exemption
Head of household. Generally, you can claim head
claimed on the others. See Pub. 505 for details.
from withholding if your income exceeds $1,050 and
of household filing status on your tax return only if
Nonresident alien. If you are a nonresident alien,
includes more than $350 of unearned income (for
you are unmarried and pay more than 50% of the
see Notice 1392, Supplemental Form W-4
example, interest and dividends).
costs of keeping up a home for yourself and your
Instructions for Nonresident Aliens, before
dependent(s) or other qualifying individuals. See
Exceptions. An employee may be able to claim
completing this form.
Pub. 501, Exemptions, Standard Deduction, and
exemption from withholding even if the employee is a
Check your withholding. After your Form W-4 takes
Filing Information, for information.
dependent, if the employee:
effect, use Pub. 505 to see how the amount you are
Tax credits. You can take projected tax credits into account
• Is age 65 or older,
having withheld compares to your projected total tax
in figuring your allowable number of withholding allowances.
for 2015. See Pub. 505, especially if your earnings
Credits for child or dependent care expenses and the child
• Is blind, or
exceed $130,000 (Single) or $180,000 (Married).
tax credit may be claimed using the Personal Allowances
• Will claim adjustments to income; tax credits; or
Worksheet below. See Pub. 505 for information on
Future developments. Information about any future
itemized deductions, on his or her tax return.
developments affecting Form W-4 (such as legislation
converting your other credits into withholding allowances.
enacted after we release it) will be posted at
Personal Allowances Worksheet (Keep for your records.)
A
Enter “1” for yourself if no one else can claim you as a dependent .
A
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• You are single and have only one job; or
B
Enter “1” if:
• You are married, have only one job, and your spouse does not work; or
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B
• 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)
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E
F
Enter “1” if you have at least $2,000 of child or dependent care expenses for which you plan to claim a credit
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F
(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 $65,000 ($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 $65,000 and $84,000 ($100,000 and $119,000 if married), enter “1” for each eligible child .
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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
earnings from all jobs exceed $50,000 ($20,000 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
2015
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
Your first name and middle initial
Last name
2
Your social security number
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
$
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6
Additional amount, if any, you want withheld from each paycheck
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7
I claim exemption from withholding for 2015, 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
Employer’s name and address (Employer: Complete lines 8 and 10 only if sending to the IRS.)
9 Office code (optional)
10
Employer identification number (EIN)
W-4
For Privacy Act and Paperwork Reduction Act Notice, see page 2.
Form
(2015)
Cat. No. 10220Q

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