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Form VA-4 Employee's Withholding Exemption Certificate

VA-4_2012.pdf

Form Instructions

INSTRUCTIONS: EMPLOYEE'S VIRGINIA INCOME TAX WITHHOLDING EXEMPTION CERTIFICATE (Form VA-4)

When beginning employment with a Virginia employer, you must file a form VA-4 with them to notify them you are subject to wage withholding and to document exemptions you are allowed to claim. Otherwise, your employer will withhold tax as if you did not possess any exemptions. This document can be obtained from the website of the Virginia Department of Taxation.

Employee's Virginia Income Tax Withholding Exemption Certificate VA-4 Step 1: The top half of the form contains an exemption worksheet to be retained in your records. If claiming yourself, enter "1" on line 1.

Employee's Virginia Income Tax Withholding Exemption Certificate VA-4 Step 2: If married and your spouse is not claimed on their own certificate, write "1" on line 2.

Employee's Virginia Income Tax Withholding Exemption Certificate VA-4 Step 3: Enter the total number of non-spouse dependents you can claim on your income tax return on line 3.

Employee's Virginia Income Tax Withholding Exemption Certificate VA-4 Step 4: Add lines 1 through 3. Enter the resulting sum on line 4.

Employee's Virginia Income Tax Withholding Exemption Certificate VA-4 Step 5: If you will be 65 or older at the beginning of January, write "1" on line 5a.

Employee's Virginia Income Tax Withholding Exemption Certificate VA-4 Step 6: If you entered "1" on line 2 and your spouse will be 65 or older at the beginning of January, write "1" on line 5b.

Employee's Virginia Income Tax Withholding Exemption Certificate VA-4 Step 7: If you are legally blind, enter "1" on line 6a. If you entered "1" on line 2 and your spouse is legally blind, enter "1" on line 6b.

Employee's Virginia Income Tax Withholding Exemption Certificate VA-4 Step 8: Add lines 5a through 6b. Enter the resulting sum on line 7.

Employee's Virginia Income Tax Withholding Exemption Certificate VA-4 Step 9: Add lines 4 and 7. Enter the resulting sum on line 8. These are your total exemptions.

Employee's Virginia Income Tax Withholding Exemption Certificate VA-4 Step 10: Separate the worksheet from the certificate along the dotted line.

Employee's Virginia Income Tax Withholding Exemption Certificate VA-4 Step 11: Provide all information required on the certificate concerning your identification and exemptions which will be claimed.

Employee's Virginia Income Tax Withholding Exemption Certificate VA-4 Step 12: Sign and date the bottom of the certificate.

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