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D-4 DC Withholding Allowance Worksheet District of Columbia

Print Clear This is a FILL-IN format. Please do not handwrite any data on this form other than your signature. Government of the District of Columbia 2017 D-4 DC Withholding Allowance Certificate Social security number First name Last name Home address (number, street and suite/apartment number if applicable). City State Zip code +4. 1 Tax filing status (Fill in only one) Single Married/domestic partners filing jointly/qualifying widow(er) with dependent child Head of household Married filing separately Married/domestic partners filing separately on same return 2 Total number of Withholding allowances from Worksheet below. Enter total from Sec. A, Line i 0 Enter total from Sec. B, Line m Total number of Withholding allowances , Line n 0. 3 Additional amount, if any, you want withheld from each paycheck $. 4 Before claiming exemption from Withholding , read below.

District of Columbia Section A Number of withholding allowances a Enter 1 for yourself a c Enter 1 if you are 65 or over c d Enter 1 if you are blind d e Enter number of dependents e f Enter 1 for your spouse or registered domestic partner filing jointly or filing separately on same return or if you are a qualifying widow(er) with dependent ...

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