Note: You cannot claim exemption from estimated tax payments using Form 1040-ES.

Form W-4 (1997) withholding if (1) your income exceeds $650

and includes unearned income (e.g., interest
Otherwise, you may find that you owe
additional tax at the end of the year.
and dividends) and (2) another person can Two Earners/Two Jobs. If you have a working
Want More Money In Your Paycheck? claim you as a dependent on their tax return. spouse or more than one job, figure the total
If you expect to be able to take the earned Basic Instructions. If you are not exempt, number of allowances you are entitled to claim
income credit for 1997 and a child lives with complete the Personal Allowances Worksheet. on all jobs using worksheets from only one
you, you may be able to have part of the credit Additional worksheets are on page 2 so you W-4. This total should be divided among all
added to your take-home pay. For details, get can adjust your withholding allowances based jobs. Your withholding will usually be most
Form W-5 from your employer. on itemized deductions, adjustments to accurate when all allowances are claimed on
income, or two-earner/two-job situations. the W-4 filed for the highest paying job and
Purpose. Complete Form W-4 so that your Complete all worksheets that apply to your zero allowances are claimed for the others.
employer can withhold the correct amount of situation. The worksheets will help you figure
Federal income tax from your pay. Form W-4 Check Your Withholding. After your W-4
the number of withholding allowances you are takes effect, use Pub. 919, Is My Withholding
may be completed electronically, if your entitled to claim. However, you may claim
employer has an electronic system. Because Correct for 1997?, to see how the dollar
fewer allowances than this. amount you are having withheld compares to
your tax situation may change, you may want
to refigure your withholding each year. Head of Household. Generally, you may claim your estimated total annual tax. Get Pub. 919
head of household filing status on your tax especially if you used the Two-Earner/Two-Job
Exemption From Withholding. Read line 7 of return only if you are unmarried and pay more Worksheet and your earnings exceed $150,000
the certificate below to see if you can claim than 50% of the costs of keeping up a home (Single) or $200,000 (Married). To order Pub.
exempt status. If exempt, only complete lines for yourself and your dependent(s) or other 919, call 1-800-829-3676. Check your
1, 2, 3, 4, 7, and sign the form to validate it. qualifying individuals. telephone directory for the IRS assistance
No Federal income tax will be withheld from number for further help.
your pay. Your exemption expires February 17, Nonwage Income. If you have a large amount
1998. of nonwage income, such as interest or Sign This Form. Form W-4 is not considered
dividends, you should consider making valid unless you sign it.

Personal Allowances Worksheet

A Enter “1” for yourself if no one else can claim you as a dependent A

$ %
● 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 B
● Your wages from a second job or your spouse’s wages (or the total of both) are $1,000 or less.
C Enter “1” for your spouse. But, you may choose to enter -0- if you are married and have either a working spouse or
more than one job (this may help you avoid having too little tax withheld) C
D Enter number of dependents (other than your spouse or yourself) you will claim on your tax return D
E Enter “1” if you will file as head of household on your tax return (see conditions under Head of Household above) E
F Enter “1” if you have at least $1,500 of child or dependent care expenses for which you plan to claim a credit F

$
G Add lines A through F and enter total here. Note: This amount may be different from the number of exemptions you claim on your return © G
● 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 and your combined earnings from all jobs exceed $32,000 OR if
worksheets you are married and have a working spouse or more than one job, and the combined earnings from all jobs exceed
that apply. $55,000, see the Two-Earner/Two-Job Worksheet on page 2 if you want to avoid having too little tax withheld.
● If neither of the above situations applies, stop here and enter the number from line G on line 5 of Form W-4 below.

Cut here and give the certificate to your employer. Keep the top portion for your records.

Form W-4 Employee’s Withholding Allowance Certificate OMB No. 1545-0010

Department of the Treasury

Internal Revenue Service © For Privacy Act and Paperwork Reduction Act Notice, see reverse. 97
1 Type or print 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 on your social security card, check
here and call 1-800-772-1213 for a new card ©

5 Total number of allowances you are claiming (from line G above or from the worksheets on page 2 if they apply) 5
6 Additional amount, if any, you want withheld from each paycheck 6 $
7 I claim exemption from withholding for 1997, 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, enter “EXEMPT” here © 7
Under penalties of perjury, I certify that I am entitled to the number of withholding allowances claimed on this certificate or entitled to claim exempt status.

Employee’s signature © Date © , 19

8 Employer’s name and address (Employer: Complete 8 and 10 only if sending to the IRS) 9 Office code 10 Employer identification number
(optional)

Cat. No. 10220Q

Form W-4 (1997) Page 2
Deductions and Adjustments Worksheet
Note: Use this worksheet only if you plan to itemize deductions or claim adjustments to income on your 1997 tax return.
1 Enter an estimate of your 1997 itemized deductions. These include qualifying home mortgage interest,
charitable contributions, state and local taxes (but not sales taxes), medical expenses in excess of 7.5%
of your income, and miscellaneous deductions. (For 1997, you may have to reduce your itemized
deductions if your income is over $121,200 ($60,600 if married filing separately). Get Pub. 919 for details.) 1 $

$ %
$6,900 if married filing jointly or qualifying widow(er)
$6,050 if head of household 2 $
2 Enter:
$4,150 if single
$3,450 if married filing separately
3 Subtract line 2 from line 1. If line 2 is greater than line 1, enter -0- 3 $
4 Enter an estimate of your 1997 adjustments to income. These include alimony paid and deductible IRA contributions 4 $
5 Add lines 3 and 4 and enter the total 5 $
6 Enter an estimate of your 1997 nonwage income (such as dividends or interest) 6 $
7 Subtract line 6 from line 5. Enter the result, but not less than -0- 7 $
8 Divide the amount on line 7 by $2,500 and enter the result here. Drop any fraction 8
9 Enter the number from Personal Allowances Worksheet, line G, on page 1 9
10 Add lines 8 and 9 and enter the total here. If you plan to use the Two-Earner/Two-Job Worksheet, also enter
this total on line 1 below. Otherwise, stop here and enter this total on Form W-4, line 5, on page 1 10
Two-Earner/Two-Job Worksheet
Note: Use this worksheet only if the instructions for line G on page 1 direct you here.
1 Enter the number from line G on page 1 (or from line 10 above if you used the Deductions and Adjustments Worksheet) 1
2 Find the number in Table 1 below that applies to the LOWEST paying job and enter it here 2
3 If line 1 is GREATER 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, on page 1. DO NOT use the rest of this worksheet 3
Note: If line 1 is LESS THAN line 2, enter -0- on Form W-4, line 5, on page 1. Complete lines 4–9 to calculate
the additional withholding amount necessary to avoid a year end tax bill.
4 Enter the number from line 2 of this worksheet 4
5 Enter the number from line 1 of this worksheet 5
6 Subtract line 5 from line 4 6
7 Find the amount in Table 2 below that applies to the HIGHEST paying job and enter it here 7 $
8 Multiply line 7 by line 6 and enter the result here. This is the additional annual withholding amount needed 8 $
9 Divide line 8 by the number of pay periods remaining in 1997. (For example, divide by 26 if you are paid
every other week and you complete this form in December 1996.) Enter the result here and on Form W-4,
line 6, page 1. This is the additional amount to be withheld from each paycheck 9 $
Table 1: Two-Earner/Two-Job Worksheet
Married Filing Jointly All Others
If wages from LOWEST Enter on If wages from LOWEST Enter on If wages from LOWEST Enter on If wages from LOWEST Enter on
paying job are— line 2 above paying job are— line 2 above paying job are— line 2 above paying job are— line 2 above

0 - $4,000 0 35,001 - 40,000 8 0 - $5,000 0 75,001 - 90,000 8

4,001 - 7,000 1 40,001 - 50,000 9 5,001 - 11,000 1 90,001 - 110,000 9
7,001 - 12,000 2 50,001 - 60,000 10 11,001 - 15,000 2 110,001 and over 10
12,001 - 17,000 3 60,001 - 70,000 11 15,001 - 20,000 3
17,001 - 22,000 4 70,001 - 80,000 12 20,001 - 24,000 4
22,001 - 28,000 5 80,001 - 100,000 13 24,001 - 45,000 5
28,001 - 32,000 6 100,001 - 110,000 14 45,001 - 60,000 6
32,001 - 35,000 7 110,001 and over 15 60,001 - 75,000 7

Table 2: Two-Earner/Two-Job Worksheet

Married Filing Jointly All Others
If wages from HIGHEST Enter on If wages from HIGHEST Enter on
paying job are— line 7 above paying job are— line 7 above

0 - $50,000 $400 0 - $30,000 $400

50,001 - 100,000 740 30,001 - 60,000 740
100,001 - 130,000 820 60,001 - 120,000 820
130,001 - 240,000 950 120,001 - 250,000 950
240,001 and over 1,050 250,001 and over 1,050

Privacy Act and Paperwork Reduction Act Notice.—We ask You are not required to provide the information requested The time needed to complete this form will vary
for the information on this form to carry out the Internal on a form that is subject to the Paperwork Reduction Act depending on individual circumstances. The estimated
Revenue laws of the United States. The Internal Revenue unless the form displays a valid OMB control number. Books average time is: Recordkeeping 46 min., Learning about
Code requires this information under sections 3402(f)(2)(A) and or records relating to a form or its instructions must be the law or the form 10 min., Preparing the form 69 min. If
6109 and their regulations. Failure to provide a completed retained as long as their contents may become material in you have comments concerning the accuracy of these time
form will result in your being treated as a single person who the administration of any Internal Revenue Law. Generally, estimates or suggestions for making this form simpler, we
claims no withholding allowances. Routine uses of this tax returns and return information are confidential, as would be happy to hear from you. You can write to the Tax
information include giving it to the Department of Justice for required by Code section 6103. Forms Committee, Western Area Distribution Center, Rancho
civil and criminal litigation and to cities, states, and the Cordova, CA 95743-0001. DO NOT send the tax form to this
District of Columbia for use in administering their tax laws. address. Instead, give it to your employer.