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| | Form W-4 | | Employee's Withholding Certificate | OMB No. 1545-0074 | |
| Department of the Treasury Internal Revenue Service | Complete Form W-4 so that your employer can withhold the correct federal income tax from your pay. Give Form W-4 to your employer. Your withholding is subject to review by the IRS. | 2022 |
| Step 1: Enter Personal Information | (a) | First name and middle initial | Last name | (b) | Social security number |
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| Address | | Does your name match the name on your social security card? If not, to ensure you get credit for your earnings, contact SSA at 800-772-1213 or go to www.ssa.gov. |
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| City or town, state, and ZIP code | |
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| (c) | Single or Married filing separatelyradio button unchecked1 of 3 |
| | Married filing jointly or Qualifying widow(er)radio button unchecked2 of 3 |
| | Head of household (Check only if youre unmarried and pay more than half the costs of keeping up a home for yourself and a qualifying individual.)radio button unchecked3 of 3 |
| Complete Steps 24 ONLY if they apply to you; otherwise, skip to Step 5. | See page 2 for more information on each step, who can claim exemption from |
| withholding, when to use the estimator at www.irs.gov/w4App, and privacy. |
| Step 2: Multiple Jobs or Spouse Works | Complete this step if you (1) hold more than one job at a time, or (2) are married filing jointly and your spouse also works. The correct amount of withholding depends on income earned from all of these jobs. |
| Do only one of the following. |
| (a) | Use the estimator at www.irs.gov/W4App for most accurate withholding for this step (and Steps 34); or |
| (b) | Use the Multiple Jobs Worksheet on page 3 and enter the result in Step 4(c) below for roughly accurate withholding; or |
| | (c) | If there are only two jobs total, you may check this box. Do the same on Form W-4 for the other job. This option is accurate |
| | | for jobs with similar pay; otherwise, more tax than necessary may be withheld . . . . . . . . . . . . . | | checkbox unchecked1 of 1 |
| | Tip: To be accurate, submit a 2022 Form W-4 for all other jobs. If you (or your spouse) have self-employment income, including as an independent contractor, use the estimator. |
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| Complete Steps 34(b) on Form W-4 for only ONE of these jobs. | Leave those steps blank for the other jobs. (Your withholding will be most accurate if you complete |
| Steps 34(b) on the Form W-4 for the highest paying job.) |
| Step 3: Claim Dependents | If your income will be $200,000 or less ($400,000 or less if married filing jointly): | | |
| | Multiply the number of qualifying children under age 17 by $2,000 | $ | | |
| | Multiply the number of other dependents by $500 . . . . . . . . . | $ | | |
| | Add the amounts above and enter the total here . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . | 3 | $ |
| Step 4 (optional): Other Adjustments | (a) | Other income (not from jobs). | If you want tax withheld for other income you expect | | |
| | this year that wont have withholding, enter the amount of other income here. This may | | |
| | include interest, dividends, and retirement income . . . . . . . . . . . . . . . . . . . . . . . . . . . . . | 4(a) | $ |
| | (b) | Deductions. | If you expect to claim deductions other than the standard deduction | | |
| | | and want to reduce your withholding, use the Deductions Worksheet on page 3 and | | |
| | | enter the result here . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . | 4(b) | $ |
| | (c) | Extra withholding. | Enter any additional tax you want withheld each pay period. | 4(c) | $ |
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| Step 5: Sign Here | Under penalties of perjury, I declare that this certificate, to the best of my knowledge and belief, is true, correct, and complete. |
| Terence Noren | | |
| | Employee's signature | (This form is not valid unless you sign it.) | Date |
| Employers Only | Employer's name and address | First date of employment | Employer identification number (EIN) |
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| | For Privacy Act and Paperwork Reduction Act Notice, see page 3. | Cat. No. 10220Q | Form W-4 (2022) |
| | | THIS FORM IS A SIMULATION OF AN OFFICIAL U.S. TAX FORM. IT IS NOT THE OFFICIAL FORM ITSELF. DO NOT USE THIS FORM FOR TAX FILINGS OR FOR ANY PURPOSE OTHER THAN EDUCATIONAL. 2023 McGraw-Hill Education. | |
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