W4 Personal Allowance Worksheet
Use this worksheet to set up the number of allowances you will claim on your W4.
A Check box if no one else claims you as a dependent:
B Check box if you are single and have only one job; or if you are 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 Check box for your spouse. But you may choose not to check if you are married and have either a working spouse or more than one job.:
D Enter number of dependents (other than your spouse or yourself) you will claim on your tax return:
E Check box if you will file as head of household on your tax return:
F Check box if you have at least $2,000 of child or dependent care expenses for which you plan to claim credit:
G Number eligible for Child Tax Credit:
You are Single and Income Under $70,000:
You are Single and Income between $70,000 and $84,000:
You are Married and Income under $100,000:
You are Married and Income between $100,000 and $119,000:
H Total Allowances (based on your answers to A through G:
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Federal and New Jersey Payroll Withholding

 
.....General Information.....
For Payroll in Tax Year:
Pay Periods per Year:
(Optional: Use Pay Period )
 
.....Federal W4? Information.....
Federal W4 Withholding Status:
Federal W4 Allowances:
W4 Allowance Worksheet  
Federal W4 Additional Withholding Amount:
 
.....New Jersey NJ-W4? Information.....
State Withholding Status:
New Jersey Claimed Allowances:
State Additional Withholding Amount:
 
.....Paycheck Income.....
Employee Type:     Salaried
    Hourly
Gross Salary per Pay Period:
Income to be taxed as supplemental income?:
 
.....Paycheck Deductions.....
Before Tax Retirement Benefits?:
Before Tax Cafeteria Plan Benefits?:
After Tax Deduction?:
Is employee subject to NJ State Disability Insurance?
Yes
No
NJ Family Leave Insurance?
Yes
No
Is employee subject to NJ State Unemployment Insurance?
Yes
No
Check for Social Security Withholding?
Check for Medicare Withholding?		Gross Salary YTD?
(Do not include this paycheck)
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