W-4eom
Form
The exceot.ons don t appty to
greater than $1.000 ooo
y::t|lfl.
on page 2 funt-er adjust your
wrmho.tdrng aliowances based on ,ter;iz;o
;"; i;._
oeOUCttOnS, cenarn credits. adjustments
or two-earners/multiple,obs
or
the cnild
:::"^"Ip^":,.-::
pss ona
"ld,t.Alowa n
s"
.
Will clajm adjustments to rncome; tax
creorts, or
rtemized deductiors. on his or l^e.lax
retJrn
Enter
"1"
for yourself if
to nco.e,
s,iuations.
Complete aJl worksheets that appty.
Howeve,, y6s
may clarrt fewer (or zero) allowances I-^t .6^, t-.
w^ages, withholding mr:sr be based
on tlo;;;c;.
may not Oe a trat amouni oi """
I9y-!l9lled ofand
percentage
wages.
Head of household. GererallV, you can
claim read
frting status on yijui tax ,"iu.9^.i.ro-']:eh9td
oniu'i"
you.are-unmarrjed
ard pay more tnaa SOZ" o.iie
costs of keeping up a home for yourserf
and
voul
dependen(s) or other qualifyinq'i"oi"iorifildJJ
qol Exemptions, stard"io O"ou-Jtil"",i"ni
:y?
F ttng trtormatjon, for infomatron.
Tax credits. You can take p.ojecred tax
credirs- inro
'account,.tn iiguring your allowable nurnber
oi
wftnnotdrn9 allowances. Credits for chilo
oioeperdent
Exemption from withholding. tt you are exenot.
comptete onty lines 1. 2. 3. al andl-a;J.;;; i["
t9 u4,_dulg j! y_our exemption toi zo: i
Lo-r,T
eioir""
February 15.2018. See pub. SOS far Witnniioini'
and Estimated Tax.
Note: lf anoil^er persol can cla,m you as a
deperdent '
p.l ! s 9f l ef l* return. you
t ira*
rron- withholding if you. iota"an
"rei.Eion""
ircone exceeds
S.1,050
more rl.an $350 of unearned ,ncor."-1ior.
ilgl9l_rq.:
examote,
tnteresr ard divide.tds).
Exc-e!!i9!1s. Ar.empioyee may oe abte to
cta.T
^
exemptton
trom withholding even if tl-e emptoyee ,s
a dependent, if the employ6e:
. Is age 65 or older,
r ls blind,
.rppt"rn"*JGfr
Basic instructions. lf you aren't exempt.
comDlete
the-P€rsonatAilowan6esWorf sf reeiLero-w.'iil'
Purpose. Comptete FormW-4 so rhat vdrrr
withhotd il-e co.recileoe'ril;nco.e
iI?l9yjl
!"" pay.
tax Jrom,your
Cons,dei-oiprei;;;
y:1^??9h y-?", and when your personai or financiat
srIUat on changes
!:I
I
l"
i.?3^Ii?;_19?
credits
into
tax creoir nay
b;;i;;;
w;;i; #,"i;"j;1 :'
j:lllo,Irgtjon ";"
on co"ue.t,ns yJu. oire,
ailowances.
person?t Rltowinces
WorGtrEE
n
tf you have a tars" anro*G
l^o1y^1s^:jl:l-".
income, such as inreresr
oi o,violnos,
l?!ygS"
il[il,&*.iH::''
i8i8',_?'d ?31 fiffi :"ffi,?S. iffi fl
you may owe addit.onal tax. lf you have pe"i
annJlty rncome. see puo. 505 to tirO out ri yoJon oi
sfriutO
- -"'"
adlust your witnholding on Forrn W_a
or W_,+pTw_o, earners or multiple jobs. lf you
have a
y?:lfS spouse or more than orelob, figure
rorar,nLmber of a'lowances you are entit"led rhe
to clarm'
r.ll g worksheers from onty one for-ni
p^l
?llJtb:
your,w,thholding usually
rv"-4.
w;ll be Tost accurate
wnen al ailowances are claimed on tne Form
tor the highest oaying rob ard zero altowanJesW_i'arecrarmed on tl-e otners. See pub. SOS tor
OJtarfs.
Nonresident alien. lf you are a norrestdent
allen, see
Notice 1392. Supprem'ertat form W-+ njiruiiion's"fii
Nonresident Aiiens. before compret ng inii;,;;. ' ''
f
;{"""::r'.""$;1?i:'ill."#Tf :'"'f :XLy#1i:"
J:il ?';1",",T ji". nT;
i", f $130,000
.."T"ff'!ss::..i:
exceed
{Singtei or
ii
$180,006jM;;6.""
Future_developments. Informar,on aboLt
anv fLture
-'"'"
oev^eropmerts affecting Form W_4 (su-ch;s*
l"pi:lgl:IqFq,"o irt& uu-" ,",euJe'itj"# riBe posteo
,
for
. yor,r. single and have only one job;
or
: [ . you're married, have onry one job, and your spouse
doesn,t work; or
i\ ' Your wages from a second job
or your spouse's wages (or the total
of both)
A
E
bnter "1"
c
are $1,500 o,' l.rr.
Enter "1" for your spouse' But' you may
choose to enter "-o-" if you-are married
and have either a working spouse or
than one job. (Entering "-o-" may herp you
more
avoid having too rit e iax
Fnter number of dependents (other than your
c
spouse or yourselD you will claim on your
tax return
Enter "1" if you will file as head of houseiold
your
on
tax return (see conditions under Head
of househord
Enter " l" if you have at least $2,000 of
child or dependent care expenses for
which you pran to crajm a
(Note: Do not include child support payments.
F
see Pub. 503, chird and Dependent care
Expenses, for detairs.)
child rax credit (including additional
D
E
F
G
if
t'- _-=-
withherd.)
*__D _-'--_E
.
above)
credit
child tax credit). see pub.972,chird rax
credit, for more information.
lf your total income, wjll be less than
$70,000 ($1 00,000 it marrieo;,1nt", "2,, rol.
eligible child; then less ,,1,, if you
have two to four erigible chirdren or ress ,.2,,
if you have five or more erigibre chirdren.
"""n
lf your total income will be between
$70,000 and $84,000 ($100,000 ano"$t t s,ooo
if married), enter ,,1,, for each eligibre
Add lines A through G and enter total here' (Note:
chird. G
This may be different from the number
of exemptions you craim on your tax return.)
>
.l
For accuracy, ' il:,f:ji'$ht:;l:Tj::*T#':lT""5i!"J1"*. to income and want to reduce your withhordins,
see the Deductions
'
H
t
I
'
H
comoleteall fI -,
ilil:"ffi: I[
#,j:['mru1jftij:f"wmh?t:d.",'il#si':;s,",.:i'*'""18t:"::Ji""s,?,;?:ffJ:
.
-.-.
-----
w:tl,T:"T:".;Tn?10
lf neither of ihe above situations aoolies ston hara rna
separate here and give Form w-4 to your emproyer.
Keep the top part for your records.
.",'
llU-4 I -)
'I
Deoanrerr of tne TreasLry
nteria Rev€r'e su*'"u
<
:
i
J-i
:,,
si iai;
I
a
Employee's withholding Allowance
certificate
-
whether you are entitled to claim a certain number
of allowancc< Ar avahh+r^subject to ieview ov ttre tni. vour emprov",
r"
-^-
-,
,-.q;:lffiGffYfi[1T#'l:T'".iR:
ilv
2
Your social
I
I
ourero
; ;
1545-0074
| 2017
number
Home address (number and street or rura-outej
City or town, state,
an6llp
"o6"
lf your last name differs trom that
shown on 1,ou,
5
o
7
*ffi"nd,
check here. You must call 1-gOO_722-1213rora "o"i"l
replacementcard.
) !
Additional amount, if any, you want withheld
from each paycheck
o LaSt Veaf I had a rinht
in e rof,,n.1
^+
-I {^r^-^J
"'ttl'n"i,
,n"", oo,n o, the fo'owing conditions
to,.
;;;;ffiil::="';
I rqu n9 tatx ilao
t This vear I Fyna^i ) r6+t t^A
^r r^r^--, income tax withhetd because
^{ afl,federal
r
expecr
to nave no tax
"t ,,Exempt,,
you meet both conditions, write
lf; l::::T_,tr1"^"^:r,:lr:o
here
Under penalties of perjury,
Employee's signature
ffhis form is not valid unless you sign it.). >
A"t Notr", see page
.;
Date >
Employer's name and address (Employe., Co
For Privac'y Aci and papei.work Reduclion
"*".no,ioifjl-
I
2.
office code (oprLonat)
Cat. No. 10220e
i0
Employer identif ication number (ElN)
Form
-4 eotn
Form W-4 (2017)
Pa1e2
Deductions and Adiustments Worksheet
Note: Use this worksheet only if you plan to itemize deductions or claim certain credits or adjustments to income.
1
Enter an estimate of your 2017 itemized deductions, These include qualifying home mortgage interest, chariiabie contributions, state
and local taxes, medical expenses in excess of 1 0% of your income, and miscellaneous deductions. For 201 7, you may have to reduce
your itemized deductions if your income is over $313,800 and you're manied filing loinily or you're a qualifying wrdow(er);
if you're head of household; $261 ,500 if you're singie, not head of household and not a qualifying widow(er): or
manied filing separately. See Pub. 505 for details
[
{
t
$12,700 rf married filing jointly or qualifying
$297,650
$156,900 if you,re
widow(er)
4
I
$9,350 if head of
I
)
$o.sSO if single or married filing
Subtract line 2 from line 1. lf zero or less, enter "-0-"
Enter an estimate ol your 2017 adjustments to income and any additional standard deduction (see pub. 505)
5
Add lines 3 and 4 and enter the total. (lnclude any amount for credits from the Converting Credits to
Enter:
3
household
separately
Withholding Allowances for 2017 Form W-4 worksheet in Pub. 505.)
6
7
8
9
't0
J
4
5
.
Enter an estimate of your 201 7 nonwage income (such as dividends or interest)
Subtract line 6 from line 5. lf zero or less, enter "-0-"
6
s
7
$
Divide the amount on line 7 by $4,050 and enter the result here. Drop any fraction
Enter the number from the Personal Allowances Worksheet, line H, page 1
Add lines 8 and g and enter the total here. lf you plan to use the Two-Earners/Multiple Jobs Worksheet,
also enter this total on line 1 below. Otherwise, stop here and enter this total on Form W-4, line 5, page 1
8
I
10
Two-Earners/Multiple Jobs Worksheet (See fwo earners or multipleiobs on oaoe
1
Note: Use this worksheet only it Ihe instructions under line H on page 1 direct you here.
1
2
Enter the number from line H, page 1 (or from line
1 0 above if you used the Deductions and Adjustments Worksheet)
Find the number in Table 1 below that applies to the LOWEST paying job and enter it here. However, if
you are married filing jointly and wages from the highest paying job are $65,000 or less, do not enter more
1
ihan "3"
lf line 1 is more than or equal to line 2, subtract line 2 from line 1. Enter the result here (if zero, enter
"-0-") and on Form W-4, line 5, page 1. Do not use the rest of this worksheet
Note: lf line 1 is less than line 2, enter "-0-" on Form W-4, line 5, page 1. Complete lines 4 through 9 below to
figure the additional withholding amount necessary to avoid a year-end tax bill.
2
3
.
4
5
6
7
8
9
Enter the number from line 2 of this worksheet
Enter the number from line 1 of this worksheet
Subtract line 5 from line 4 .
4
5
Find the amount in Table 2 below that applies to the HIGHEST paying job and enter it here
Multiply line 7 by line 6 and enter the result here. This is the additional annual withholding needed
Divide line 8 by the number of pay periods remaining in 2017. For example, divide by 25 if you are paid every two
weeks and you complete this form on a date in January when there are 25 pay periods remaining in 201 7. Enter
the result here and on Form W-4, line 6, page 1. This is the additional amount to be withheld from each paycheck
Table
- $7,000
- 14,000
14.001 - 22,000
22,4A1 - ?7,000
27,001 - 35,000
35,001 - 44,000
44,001 - 55,000
55,001 , 65,000
65,001 - 75,000
75,001 - 80,000
80,001 - 95,000
95,001 - 115,000
115,001 - 130,000
130,001 - 140,000
140,001 - 150,000
$0
7,001
150,001 and over
All Others
Enter on
line 2 above
0
1
2
J
4
6
7
8
I
10
9
$
Table 2
1
Married Filing Jointly
lf wages from LOWEST
paying 1ob are-
7$
8$
ll wages frorn LOWEST
payrng lob
are-
- $8,000
- 16,000
16,001 - 26,000
26,001 - 34,000
34,001 - 44,000
44,001 - 70,000
70,001 - 85,000
85,001 - 110,000
110.001 - 125,000
125,001 - 140,000
$0
8,001
140.00.1 and over
Married Filing Jointly
Enter on
line 2 above
lf wages trom HIGHEST
All Others
l{ wages from HIGHEST
are-
Enter on
line 7 above
$0
-
$61 0
$0
-
5
405.001 and over
,010
1,130
1,340
1,420
'1
.600
38,001
85,001
185.001
4
75,001
135,001
205.001
360.001
0
1
2
paying job
-
$75,000
135,000
205,000
360,000
405,000
1
payinq job
are-
-
s8,000
- 85,000
- 185,000
- 400.000
400.001 and over
Enter on
line 7 above
$61 o
'1
,010
,130
1,340
1,600
1
6
7
a
9
10
1't
12
13
14
15
Privacy Act and Paperwork Reduction
to cany out the lntemal Revenue laws of
3402{fl(2) and 610S and their regulations
uses it to determine your federal income
Act Notice, We ask for the information on this fom
the United States. Intemal Revenue Code sections
requtre you to provide this infonnation; your employer
tax withholding. Failure io provide a properly
completed form will result in your being treated as a single person who claims no withhoiding
allowances; providing traudulent infomation maysubject you to penalties. Routine uses of
this infomation include giving jt to the Department of Justice for civil and criminal litigation: to
cities, states, the District of Columbia, and U.S. commonwealths and possessions for use in
administenng their tax laws; and to the Department of Heallh and Human Servlces for use tn
the National Directory of New Hires. We may also disclose this information to oiher countries
under a tax treaty, to federal and state agencies to enforce federal nontax crimrnal laws, or to
federal law enforcement and !nielligence agencies to combat terrorism.
You are not required 1o provide the information requested on a form that is
subject to the Paperwork Reduction Act unless the iorm displays a valid OMB
control number. Books or records relating to a form or its
must be
retained as long as their contents may become material in'nstructions
the administratjon of
any lntemal Revenue law. Generally, tax returns and return informatjon are
confidentjal, as required by Code section 6103.
The average time and expenses .equired to complete and file this lorm
depending on individual circumstances. For estimated averages, see the
instructions for your income td return.
Vr'ill
vary
lf you have suggestions for making this form simpler, we would be happy to hear
trom you. See the instructions for your income tax return.