| D-4 DC Withholding Allowance Worksheet | ||
| a | Check to claim yourself | |
| b | Check if you are filing as head of household | |
| c | Check if you are 65 or older | |
| d | Check if you are blind | |
| e | Number of dependents | |
| f | Check if you have a spouse or registered domesstic partner filing jointly or filing separately on same return of if you a a qualifying widow(er) with dependent child | |
| g | Check if married or registered domestic partnet filing jointly or filing separately on thesame return and your spouse or registred domestic partner is 65 or over | |
| h | Check if married or registered domestic partnet filing jointly or filing separately on thesame return and your spouse or registred domestic partner is blind | |
| 4 | RI W-4 Line E - total number of personal allowances: | |
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