EMPLOYEE’S WITHHOLDING ALLOWANCE CERTIFICATE

1 employee S WITHHOLDING ALLOWANCE CERTIFICATE1. Number of allowances for Regular WITHHOLDING Allowances, Worksheet ANumber of allowances from the Estimated Deductions, Worksheet BTotal Number of Allowances (A + B) when using the CaliforniaWithholding Schedules for 2005OR2. Additional amount of state income tax to be withheld each pay period (if employer agrees), Worksheet CUnder the penalties of perjury, I certify that the number of WITHHOLDING allowances claimed on this CERTIFICATE does notexceed the number to which I am entitled or, if claiming exemption from WITHHOLDING , that I am entitled to claim the Employer s Name and AddressCalifornia Employer Account Numbercut hereGive the top portion of this page to your employer and keep the remainder for your CALIFORNIA PERSONAL INCOME TAX MAY BE UNDERWITHHELD IF YOU DO NOT FILE THIS DE 4 FORMIF YOU RELY ON THE FEDERAL W-4 FOR YOUR CALIFORNIA WITHHOLDING ALLOWANCES, YOUR CALIFORNIA STATEPERSONAL INCOME TAX MAY BE UNDERWITHHELD AND YOU MAY OWE MONEY AT THE END OF THE.

2 This CERTIFICATE , DE 4, is for California personalincome tax WITHHOLDING purposes only. The DE 4 is used tocompute the amount of taxes to be withheld from your wages,by your employer, to accurately reflect your state should complete this form if either:(1) You claim a different marital status, number of regularallowances, or different additional dollar amount to be withheldfor California personal income tax WITHHOLDING than you claimfor federal income tax WITHHOLDING or,(2) You claim additional allowances for estimated FORM WILL NOT CHANGE YOUR FEDERAL WITH-HOLDING Federal Form W-4 is applicable for California withholdingpurposes if you wish to claim the same marital status, numberof regular allowances, and/or the same additional dollaramount to be withheld for state and federal , federal tax brackets and WITHHOLDING methods do notDE 4 Rev.

3 30 (1-05) (INTERNET)Page 1 of 4 CUCity, State, and ZIP CodeHome Address (Number and Street or Rural Route)Type or Print Your Full NameYour Social Security NumberFiling Status WITHHOLDING Allowances SINGLE or MARRIED (with two or more incomes) MARRIED (one income) HEAD OF HOUSEHOLD reflect state personal income tax WITHHOLDING tables. If yourely on the number of WITHHOLDING allowances you claimon your Federal W-4 WITHHOLDING ALLOWANCE certificatefor your state income tax WITHHOLDING , you may besignificantly underwithheld. This is particularly true if yourhousehold income is derived from more than one YOUR WITHHOLDING : After your W-4 and/or DE 4takes effect, compare the state income tax withheld with yourestimated total annual tax. For state WITHHOLDING , use theworksheets on this form and for federal WITHHOLDING use theInternal Revenue Service (IRS) Publication 919 or federalwithholding FROM WITHHOLDING : If you wish to claimexempt, complete the federal Form W-4.

4 You may only claimexempt from WITHHOLDING California income tax if you did notowe any federal income tax last year and you do not expectto owe any federal income tax this year. The exemptionautomatically expires on February 15 of the next year. If youcontinue to qualify for the exempt filing status, a new Form W-4 designating EXEMPT must be submitted before February you are not having federal income tax withheld this yearbut expect to have a tax liability next year, the law requiresyou to give your employer a new Form W-4 by December form can be used to manuallycompute your WITHHOLDING allowances, oryou can electronically compute them (MicrosoftExcel required).IF YOU NEED MORE DETAILED INFORMATION, SEE THE INSTRUCTIONS THAT CAME WITH YOUR LAST CALIFORNIAINCOME TAX RETURN OR CALL YOUR LOCAL FRANCHISE TAX BOARD YOU ARE CALLING FROM WITHIN THE UNITED STATES1-800-852-5711IF YOU ARE CALLING FROM OUTSIDE THE UNITED STATES (Not Toll Free)(916) 845-6500 FOR THE HEARING IMPAIRED1-800-822-6268 The California Employer s Guide (DE 44) provides the income tax WITHHOLDING tables.

5 This publication may be found onEDD s Web site at To assist you in calculating your tax liability, please visit theFranchise Tax Board s Web site at: do so, write to:Franchise Tax BoardSacramento CA 95867 Your letter should contain the basis of your request forreview. You will have the burden of showing the federaldetermination incorrect for state WITHHOLDING Franchise Tax Board (FTB) will limit its review to thatissue. FTB will notify both you and your employer of itsfindings. Your employer is then required to withhold stateincome tax as instructed by FTB. In the event FTB orIRS finds there is no reasonable basis for the number ofwithholding exemptions that you claimed on yourW-4/DE 4, you may be subject to a : You may be fined $500 if you file, with noreasonable basis, a DE 4 that results in less tax beingwithheld than is properly allowable.

6 In addition, criminalpenalties apply for willfully supplying false or fraudulentinformation or failing to supply information requiring anincrease in WITHHOLDING . This is provided for bySection 19176 of the California Revenue and Taxation : Your employer is required to senda copy of your DE 4 to the Employment DevelopmentDepartment (EDD) with the Quarterly Wage andWithholding Report (DE 6) if you claim more than10 WITHHOLDING allowances on the DE 4 and yourForm W-4 is not reportable to the THE IRS INSTRUCTS YOUR EMPLOYER TOWITHHOLD FEDERAL INCOME TAX BASED ON ACERTAIN WITHHOLDING STATUS, YOUREMPLOYER IS REQUIRED TO USE THE SAMEWITHHOLDING STATUS FOR STATE INCOMETAX WITHHOLDING IF YOUR WITHHOLDINGALLOWANCES FOR STATE PURPOSES MEETTHE REQUIREMENTS LISTED UNDER NOTIFICATION.

7 IF YOU FEEL THAT THEFEDERAL DETERMINATION IS NOT CORRECTFOR STATE WITHHOLDING PURPOSES, YOUMAY REQUEST A 4 Rev. 30 (1-05) (INTERNET)Page 2 of 4 CUINSTRUCTIONS 1 ALLOWANCESWhen determining your WITHHOLDING allowances, you must consideryour personal situation: Do you claim allowances for dependents or blindness? Are you going to itemize your deductions? Do you have more than one income coming into the household?TWO-EARNER/TWO-JOBS: When earnings are derived frommore than one source, underwithholding may occur. If you have awork-ing spouse or more than one job, it is best to check the box SINGLE or MARRIED (with two or more incomes). Figure thetotal number of allowances you are entitled to claim on all jobsusing only one DE 4 form.

8 Claim allowances with one not claim the same allowances with more than one WITHHOLDING will usually be most accurate when all allowancesare claimed on the DE 4 or W-4 filed for the highest paying job andzero allowances are claimed for the others.(A) ALLOWANCE for yourself enter 1.. (A)(B) ALLOWANCE for your spouse (if not separately claimed by your spouse) enter 1.. (B)(C) ALLOWANCE for blindness yourself enter 1.. (C)(D) ALLOWANCE for blindness your spouse (if not separately claimed by your spouse) enter 1.. (D)(E) ALLOWANCE (s) for dependent(s) do not include yourself or your spouse.. (E)E-1. Please enter the number of dependents for which you are claimingallowances:E-2. Please multiply the number entered in E-1 by 3 and enter on line E*(F) Total add lines (A) through (E) above.

9 (F)INSTRUCTIONS 2 ADDITIONAL WITHHOLDING ALLOWANCESIf you expect to itemize deductions on your California income tax return, you can claim additional WITHHOLDING allowances. Use Worksheet Bto determine whether your expected estimated deductions may entitle you to claim one or more additional WITHHOLDING allowances. Use lastyear s FTB 540 form as a model to calculate this year s WITHHOLDING not include deferred compensation, qualified pension payments or flexible benefits, etc., that are deducted from your gross pay but arenot taxed on this may reduce the amount of tax withheld from your wages by claiming one additional WITHHOLDING ALLOWANCE for each $1,000, or fraction of$1,000, by which you expect your estimated deductions for the year to exceed your allowable standard BESTIMATED DEDUCTIONSWORKSHEET AREGULAR WITHHOLDING ALLOWANCES 1.

10 Enter an estimate of your itemized deductions for California taxes for this tax year as listed in theschedules in the FTB 540 form.. 1. _____ 2. Enter $6,330 if married filing joint, head of household, or qualifying widow(er) with dependent(s) or$3,165 if single or married filing separately.. -2. _____ 3. Subtract line 2 from line 1, enter difference.. =3. _____ 4. Enter an estimate of your adjustments to income (alimony payments, IRA deposits).. +4. _____ 5. Add line 4 to line 3, enter sum.. =5. _____ 6. Enter an estimate of your nonwage income (dividends, interest income, alimony receipts).. -6. _____ 7. If line 5 is greater than line 6 (if less, see below);Subtract line 6 from line 5, enter difference.. =7. _____ 8. Divide the amount on line 7 by $1,000, round any fraction to the nearest whole number.