FORM W-4

Form W-4 (2019)

Purpose.Complete Form W-4 so that your
employer can withhold the correct federal income
tax from your pay. Consider completing a new Form
W-4 each year and when your personal or financial
situation changes.

Exemption from withholding.If you are exempt,
complete only lines 1, 2, 3, 4, and 7 and sign the
form to validate it. Your exemption for 2019 expires
February 15, 2019. See Pub. 505, Tax Withholding
and Estimated Tax.
Note:If another person can claim you as a dependent
on his or her tax return, you can’t claim exemption
from withholding if your total income exceeds $1,050
and includes more than $350 of unearned income (for
example, interest and dividends).

Exceptions.An employee may be able to claim
exemption from withholding even if the employee is
a dependent, if the employee:

Is age 65 or older,
Is blind, or
Will claim adjustments to income; tax credits; or
itemized deductions, on his or her tax return.

The exceptions don’t apply to supplemental wages
greater than $1,000,000.
Basic instructions.If you aren’t exempt, complete
the Personal Allowances Worksheet below. The
worksheets on page 2 further adjust your
withholding allowances based on itemized
deductions, certain credits, adjustments to income,
or two-earners/multiple jobs situations.

Complete all worksheets that apply. However, you
may claim fewer (or zero) allowances. For regular
wages, withholding must be based on allowances
you claimed and may not be a flat amount or
percentage of wages.
Head of household.Generally, you can claim head
of household filing status on your tax return only if
you are unmarried and pay more than 50% of the
costs of keeping up a home for yourself and your
dependent(s) or other qualifying individuals. See
Pub. 501, Exemptions, Standard Deduction, and
Filing Information, for information.
Tax credits .You can take projected tax credits into
account in figuring your allowable number of
withholding allowances. Credits for child or dependent
care expenses and the child tax credit may be claimed
using the Personal Allowances Worksheet below.
See Pub. 505 for information on converting your other
credits into withholding allowances.

Nonwage incomeIf you have a large amount of
nonwage income, such as interest or dividends,
consider making estimated tax payments using Form
1040-ES, Estimated Tax for Individuals. Otherwise,
you may owe additional tax. If you have pension or
annuity income, see Pub. 505 to find out if you should
adjust your withholding on Form W-4 or W-4P.
Two earners or multiple jobs.If you have a
working spouse or more than one job, figure the
total number of allowances you are entitled to claim
on all jobs using worksheets from only one Form
W-4. Your withholding usually will be most accurate
when all allowances are claimed on the Form W-4
for the highest paying job and zero allowances are
claimed on the others. See Pub. 505 for details.
Nonresident alien.If you are a nonresident alien, see
Notice 1392, Supplemental Form W-4 Instructions for
Nonresident Aliens, before completing this form.
Check your withholding.After your Form W-4 takes
effect, use Pub. 505 to see how the amount you are
having withheld compares to your projected total tax
for 2019. See Pub. 505, especially if your earnings
exceed $130,000 (Single) or $180,000 (Married).
Future developments.Information about any future
developments affecting Form W-4 (such as
legislation enacted after we release it) will be posted
at www.irs.gov/w4.

Personal Allowances Worksheet (Keep for your records.)

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

B Enter “1” if:
{

You’re single and have only one job; or
You’re married, have only one job, and your spouse doesn’t work; or
Your wages from a second job or your spouse’s wages (or the total of both) are $1,500 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. (Entering “-0-” 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 . . . . .

E Enter “1” if you will file as head of household on your tax return (see conditions under Head of household above) . .

F Enter “1” if you have at least $2,000 of child or dependent care expenses for which you plan to claim a credit. . . . . . . .. . .
(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.br>

If your total income will be less than $70,000 ($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 $70,000 and $84,000 ($100,000 and $119,000 if married), enter “1” for each eligible child.

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.)
For accuracy, complete all
worksheets that apply.
{

f you plan to itemize or claim adjustments to income and want to reduce your withholding, see the Deductions
and Adjustments Worksheet on page 2.
If you are single and have more than one job or are married and you and your spouse both work and the combined
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.
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.--------------------------------------------

FormW-4
Department of the Treasury
Internal Revenue Service

Employee’s Withholding Allowance Certificate
Whether you are entitled to claim a certain number of allowances or exemption from withholding is
subject to review by the IRS. Your employer may be required to send a copy of this form to the IRS.

OMB No. 1545-0074
2019

Your first name and middle initial

Last name

Your social security number

Home address (number and street or rural route)

Married Status :

Note: If married, but legally separated, or spouse is a nonresident alien, check the “Single” box.

City or town, state, and ZIP code

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. ▶

Yes No

Total number of allowances you are claiming (from line H above or from the applicable worksheet on page 2)

Additional amount, if any, you want withheld from each paycheck . . . . . . . . . . . . . .

I claim exemption from withholding for 2019, 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 . . . . . . . . . . . . . . .

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

(This form is not valid unless you sign it.) ▶

Date ▶

Employer’s name and address (Employer: Complete lines 8 and 10 only if sending to the IRS

Office code (optional)

Employer identification number (EIN)

Deductions and Adjustments 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 2019 itemized deductions. These include qualifying home mortgage interest, charitable contributions, state
and local taxes, medical expenses in excess of 10% of your income, and miscellaneous deductions. For 2019, you may have to reduce
your itemized deductions if your income is over $313,800 and you’re married filing jointly or you’re a qualifying widow(er); $287,650
if you’re head of household; $261,500 if you’re single, not head of household and not a qualifying widow(er); or $156,900 if you’re
married filing separately. See Pub. 505 for details . . . . . . . . . . . . . . . . . . . . .
2    Enter:{
$12,700 if married filing jointly or qualifying widow(er)
$9,350 if head of household
$6,350 if single or married filing separately
      }
3    Subtract line 2 from line 1. If zero or less, enter “-0-” . . ... .. . . . . . . . .
4    Enter an estimate of your 2019 adjustments to income and any additional standard deduction (see Pub. 505)
5    Add lines 3 and 4 and enter the total. (Include any amount for credits from the Converting Credits toWithholding Allowances for 2019 Form W-4 worksheet in Pub. 505.) . . . . . . . . . . . .
6    Enter an estimate of your 2019 nonwage income (such as dividends or interest) . . . . . . . .
7    Enter the number from the Personal Allowances Worksheet, line H, page 1 . . . . . . . . . .
8    Subtract line 6 from line 5. If zero or less, enter “-0-” . . . . . . . . . . . . . . . .
9    Divide the amount on line 7 by $4,050 and enter the result here. Drop any fraction . . . . . . .
10    Add lines 8 and 9 and enter the total here. If 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

Two-Earners/Multiple Jobs Worksheet (See Two earners or multiple jobs on page 1.)

Note: Use this worksheet only if the instructions under line H on page 1 direct you here.
1    Enter the number from line H, page 1 (or from line 10 above if you used the Deductions and Adjustments Worksheet)
2    Enter: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
than “3” . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
3    If 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: If 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.
4    Enter the number from line 2 of this worksheet . . . . . . . . . .
5    Enter the number from line 1 of this worksheet . . . . . . . . . .
6    Subtract line 5 from line 4 . . . . . . . . . . . . . . . . . . . . . . . . .
7    Find the amount in Table 2 below that applies to the HIGHEST paying job and enter it here . . . .
8    Multiply line 7 by line 6 and enter the result here. This is the additional annual withholding needed . .
9    Divide line 8 by the number of pay periods remaining in 2019. 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 2019. 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 1				Table 2
Married Filing Jointly		All Others		Married Filing Jointly		All Others
If wages from LOWEST paying job are—	Enter on line 2 above	If wages from LOWEST paying job are—	Enter on line 2 above	If wages from HIGHEST paying job are—	Enter on line 7 above	If wages from HIGHEST paying job are—	Enter on line 7 above
$0 - $7,000 7,001 - 14,000 14,001 - 22,000 22,001 - 27,000 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 - 150,000 150,001 and over	0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15	$0 - $8,000 8,001 - 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 - 140,000 140,001 and overr	0 1 2 3 4 5 6 7 8 9 10	$0 - $75,000 75,001 - 135,000 135,001 - 205,000 205,001 - 360,000 360,001 - 405,000 405,001 and over	$610 1,010 1,130 1,340 1,420 1,600	$0 - $38,000 38,001 - 85,000 85,001 - 185,000 185,001 - 400,000 400,001 and over	$610 1,010 1,130 1,340 1,600

Privacy Act and Paperwork Reduction Act Notice. We ask for the information on this form
to carry out the Internal Revenue laws of the United States. Internal Revenue Code sections
3402(f)(2) and 6109 and their regulations require you to provide this information; your employer
uses it to determine your federal income tax withholding. Failure to provide a properly
completed form will result in your being treated as a single person who claims no withholding
allowances; providing fraudulent information may subject you to penalties. Routine uses of
this information include giving it 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
administering their tax laws; and to the Department of Health and Human Services for use in
the National Directory of New Hires. We may also disclose this information to other countries
under a tax treaty, to federal and state agencies to enforce federal nontax criminal laws, or to
federal law enforcement and intelligence agencies to combat terrorism

You are not required to provide the information requested on a form that is
subject to the Paperwork Reduction Act unless the form displays a valid OMB
control number. Books or records relating to a form or its instructions must be
retained as long as their contents may become material in the administration of
any Internal Revenue law. Generally, tax returns and return information are
confidential, as required by Code section 6103.
The average time and expenses required to complete and file this form will vary
depending on individual circumstances. For estimated averages, see the
instructions for your income tax return.
If you have suggestions for making this form simpler, we would be happy to hear
from you. See the instructions for your income tax return.

860 E. Carson St #114 Carson, CA 90745

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