Form W-4 — Employee's Withholding Certificate

This online intake is used for Pumpkin Tax payroll setup. For official worksheets and wage tables, use IRS Form W-4 at www.irs.gov/FormW4.

Step 1: Enter Personal Information

First name Middle initial

Last name Social security number

Does your name match the name on your social security card? If not, contact SSA at 800-772-1213 or go to www.ssa.gov.

Address

City State

ZIP

Filing status

Single or Married filing separately Married filing jointly or Qualifying surviving spouse Head of household

Step 2: Multiple Jobs or Spouse Works

Only two jobs total (check this box on both Forms W-4 if there are only two jobs).

Step 3: Claim Dependent and Other Credits

Qualifying children under age 17 × $2,000 Other dependents × $500 Total credits

Step 4 (optional): Other Adjustments

4(a) Other income (not from jobs) 4(b) Deductions 4(c) Extra withholding Exempt (write Exempt if claiming exemption)

Step 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

Date

Mobile Mail ID

Employers Only

Employer's Name Address

First Date of Employment Employer Identification Number (EIN)

Thank you!