Form W-4 Department of the TreasuryInternal Revenue Service Employee’s Withholding Certificate Complete Form W-4 so that your employer can withhold the correct federal income tax from your pay. Give Form W-4 to your employer.Your withholding is subject to review by the IRS. OMB No. 1545-0074 2025 1 Enter Personal Information First name and middle initial * Last name * Social security number * Address * City or town, state, and ZIP code * Does your name match the name on your social security card? If not, to ensure you get credit for your earnings, contact SSA at 800-772-1213 or go to www.ssa.gov. (a) Single or Married filing separately (b) Married filing jointly or Qualifying surviving spouse (c) Head of household 2 Multiple Jobs or Spouse Works Complete this step if you hold more than one job at a time, or are married filing jointly and your spouse also works. Check here if this applies to you 3 Claim Dependent and Other Credits (a) Multiply the number of qualifying children under age 17 by $2,000 (b) Multiply the number of other dependents by $500 (c) Add the amounts above and enter the total here 4 Other Adjustments (optional) (a) Other income (b) Deductions (c) Extra withholding 5 Sign Here Under penalties of perjury, I declare that this certificate, to the best of my knowledge and belief, is true, correct, and complete. Employee’s signature (type full legal name) * Date * Submit this W-4 securely to your payroll onboarding record. Submit W-4 Form