City of Detroit Withholding Certificate for Income Tax
LINE 3 INSTRUCTIONS — If you work for this employer in more than two cities or communities, print names of
the two Michigan cities or communities where you perform the greatest percentage of your work. Circle the closest percent
of total earnings for work done or services rendered in each city or community listed. The estimated percent of total earn-
ings from this employer for work done or services performed within taxing cities (line 3 on other side) is for withholding
purposes only. In determining final tax liability this estimate is subject to substantiation and audit.
RENAISSANCE ZONE EXEMPTION — Attach copy of Certification of Qualification.
EXEMPTIONS — An employee is allowed the same number of exemptions for himself and dependents as for fed-
eral income tax purposes, except that additional withholding allowances claimed on Schedule A of Federal Form W-4 are
not allowed for City of Detroit income tax purposes.
CHANGES IN EXEMPTIONS — You should file a new certificate with your employer at any time the number of
your exemptions changes.
CHANGE OF RESIDENCE — You must file a new certificate within 10 days after you change your residence from
or to a taxing city.
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 done or services to be rendered in cities levying an income tax will change for the ensuing
year.
FC-65948-O
10021BR-O
REV.2-99
O-8148-1054B