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New York W4

EMPLOYEE’S WITHHOLDING ALLOWANCE CERTIFICATE

Download W4 Instructions

New York W4

Step 1 of 4

25%

Name*
First Middle Last
Email*
Address*
Street Address Address Line 2 City State ZIP Code

Download W4 Instructions
Marital Status
- Single or Head of household
- Married
- Married, but withhold at higher single rate
Note: If married but legally separated, select the Single or Head of household box.
Are you a resident of New York City?
- Yes
- No
Are you a resident of Yonkers?
- Yes
- No

Download W4 Instructions
1. Total number of allowances you are claiming for New York State and Yonkers, if applicable (from line 20)
2. Total number of allowances for New York City (from line 35)
Use lines 3, 4, and 5 below to have additional withholding per pay period under special agreement with your employer.
3. New York State amount
4. New York City amount
5. Yonkers amount

Under penalties of perjury, I certify that I have examined this certificate and to the best of my knowledge and belief, it is true, correct, and complete.*
- I certify the above statement
Social Security Number*
Employee Signature – Type Your Name*
Today's Date*
My IP Address is: 44.192.115.114
This form was submitted on: 09/21/2023