How To Complete A W-4 With Exemptions
The following items MUST be completed in order for your W-4 to be processed.
q Box 1: Name and address (Please Print)
q Box 2: Employee Social Security Number
q Box 3: Withholding Status
q Box 4: Mark only if applicable
q Box 5: If you are not claiming EXEMPT (box #7), you must enter the number of exemptions you wish to claim. You may enter (0) if you choose. (Please note that DPS is required to submit a copy of your W-4 form to the IRS if you claim more than 10 exemptions.)
q Box 6: This box is used only if you wish to have an additional amount deducted over and beyond your regular federal exemptions. Must be “whole” dollars.
q Box 7: Leave Blank (See instructions for filing EXEMPT)
q Signature and Date (You may use current or future dates only)
q Box 8-10: For employer use only. (Please leave blank)
