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Ohio W4

Employee’s Withholding Exemption Certificate

Download W4 Instructions

Ohio W4

Step 1 of 3

33%

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

Download W4 Instructions
Public school district of residence (See The Finder at tax.ohio.gov.)
School District No
1. Personal exemption for yourself, enter “1” if claimed
2. If married, personal exemption for your spouse if not separately claimed (enter “1” if claimed)
3. Exemptions for dependents
4. Add the exemptions that you have claimed above and enter total
5. Additional withholding per pay period under agreement with employer

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