EMSI Employee Payroll Tax Deduction Forms (FED & CA)

Step 1 of 3 - EE Tax Update - W4 Federal Withholding

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Today's Date

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Initial Checkbox 1

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W-4 - Employee's Withholding Certificate

EE#:

Social Security #:(Required)

Date of Birth:(Required)

Name:(Required)

First Name Middle Iniitial Last Name

Email Address:

Address:(Required)

Street Address Apt/Unit# City State ZIP Code

Telephone:(Required)

Employee Start Date:

Step 1: Enter Personal Information

Filing Status (check one of the following boxes):(Required)

Single or Married filing separately

Married filing jointly or Qualifying window(er)

Head of household (check only if you're unmarried and pay more than half the costs of keeping up a home for yourself and a qualifying individual)

Complete Steps 2--4 ONLY if they apply to you; otherwise, skip to Step 5. See page 2 for more information on each step, who can claim exemption from withholding, when to use the estimator at www.irs.gov/W4App, and privacy.

Step 2: Multiple Jobs or Spouse Works

Complete this step if you (1) hold more than one job at a time, or (2) are married filing jointly and your spouse also works. The correct amount of withholding depends on income earned from all of these jobs.

Do only one of the following (check one of the following boxes):

Use the estimator at www.irs.gov/W4App for most accurate withholding for this step (and Steps 3-4); or

Use the Multiple Jobs Worksheet on page 3 and enter the result in Step 4(c) below for roughly accurate withholding; or

If there are only two jobs total, you may check this box. Do the same on Form W-4 for the other job. This option is accurate for jobs with similar pay; otherwise, more tax than necessary may be withheld.

TIP: To be accurate, submit a Form W-4 for all other jobs. If you (or your spouse) have self-employment income, including as an independent contractor, use the estimator.

Complete Steps 3-4(b) on Form W-4 for only ONE of these jobs. Leave those steps blank for the other jobs. (Your withholding will be most accurate if you complete Steps 3-4(b} on the Form W-4 for the highest paying job.)

Step 3: Claim Dependents

If your total income will be $200,000 or less ($400,000 or less if married filing jointly):

Multiply the number of qualifying chidren under age 17 by $2,000

PLEASE DO NOT ENTER A DOLLAR AMOUNT. Insert a number of deductions, calculation for the amount will happen below automatically

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MultipleBy2k

Multiply the number of other dependents by $500

Insert a number, calculation will happen in PDF

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MultipleBy500

Step 3 Total Amount for W-4

Add the amounts above and enter the total here

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TotalW4

Step 4: Other Adjustments (optional)

4(a) Other income (not from jobs)

If you want tax withheld for other income you expect this year that won't have withholding, enter the amount of other income here. This may include interest, dividends, and retirment income.

4(b) Deductions

If you expect to claim deducation other than the standard deducation and want to reduce your withholding, use the Deductions Worksheet on page 3 and enter the result here.

4(c) Extra withholding.

Enter any additional tax you want withheld each pay period.

Signature of Employee:(Required)

Under penalties of perjury, I declare that this certificate, to the best of my knowledge and belief, is true, correct, and complete.

(This form is not valid unless you sign it)

EMPLOYEE’S WITHHOLDING ALLOWANCE CERTIFICATE

Complete this form so that your employer can withhold the correct California state income tax from your paycheck.

Filing Status (check one of the following boxes):

SINGLE or MARRIED (with two or more incomes)

MARRIED (one income)

HEAD OF HOUSEHOLD

1. Use Worksheet A for Regular Withholding allowances. Use other worksheets on the following pages as applicable.

1a. Number of Regular Withholding Allowances (Worksheet A):

1b. Number of Allowances From the Estimated Deductions (Worksheet B, if applicable.):

1c. Total Number of Allowances You are Claiming:(Required)

Exemption from Withholding

3. I claim exemption from withholding for 2021, and I certify I meet both of the conditions for exemption.

- OR -

4. I certify under penalty of perjury that I am not subject to California withholding. I meet the conditions set forth under the Service Member Civil Relief Act, as amended by the Military Spouses Residency Relief Act and the Veterans Benefits and Transition Act of 2018.

Employee’s Signature(Required)

Under the penalties of perjury, I certify that the number of withholding allowances claimed on this certificate does not exceed the number to which I am entitled or, if claiming exemption from withholding, that I am entitled to claim the exempt status.

Employer's Section

California Employer Payroll Tax Account Number

This field is for validation purposes and should be left unchanged.

EMSI Employee Payroll Tax Deduction Forms (FED & CA)

Tax Forms (W4 & DE4) - ESPARZA MANAGEMENT

W-4 - Employee's Withholding Certificate

Step 1: Enter Personal Information

Step 2: Multiple Jobs or Spouse Works

Step 3: Claim Dependents

Step 4: Other Adjustments (optional)

INSTRUCTIONS — 1 — ALLOWANCES*

Worksheet A - Regular Withholding Allowances

EMPLOYEE’S WITHHOLDING ALLOWANCE CERTIFICATE

1. Use Worksheet A for Regular Withholding allowances. Use other worksheets on the following pages as applicable.

Exemption from Withholding