How To Complete A W-4 With Exempt Status
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: Leave Blank
q Box 6: Leave Blank
q Box 7: Enter the word “EXEMPT”
q Signature and Date (You may use current or future dates only)
q Box 8-10: For employer use only. (Please leave blank)
