| Virginia Personal Exemption Worksheet | ||
| 1 | Check to claim yourself | |
| 2 | Check if you are married and your spouse is not claimed on his or her own certificate | |
| 3 | Enter the number of dependents you will claim | |
| 5a | Check if you will be 65 or older on January 1 | |
| 5b | Check if you claimed an exemption on line 2 and your spouse will be 65 or older on January 1 | |
| 6a | Check if you are legally blind | |
| 6a | Check if you claimed an exemption on line 2 and your spouse is legally blind | |
| 8 | Total number of allowances: | |
| 8 | Total number of blind/elderly allowances: Use This | |
| Cancel | ||