W4 Personal Allowance Worksheet
Use this IRS worksheet to set up the number of allowances you will claim on your W4.
A Enter '1' for yourself if no one else can claim you as a dependent:
B Enter '1' if you are single and have only one job; or 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 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. (Enter a '0' may help you avoid having too little tax withheld):
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:
F Enter '1' if you have at least $2,000 of child or dependent care expenses for which you plan to claim credit:
G Child Tax Credit. If your total income will be less than $70,000 ($100,000 if married), enter '2' for each eligible child; 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 Total of lines A through G:
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Federal, Pennsylvania and Local 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:
 
.....Ohio W-4? Information.....
State Additional Withholding Amount:
School District
(and municipality):
Municipality
(and County) Taxing Body:
Resident of Municipality? Resident Non-resident
 
.....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?:
Does Employee pay Unemployment Insurance Tax?
Yes
No
Check Box for FICA Withholding?:
Check Box for Medicare Withholding?:
Gross Salary YTD?
(Do not include this paycheck)
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