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Virginia W4
EMPLOYEE’S VIRGINIA INCOME TAX WITHHOLDING EXEMPTION CERTIFICATE
Download W4 Instructions
Virginia W4
Step
1
of
3
33%
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Download W4 Instructions
COMPLETE THE APPLICABLE LINES BELOW
If subject to withholding, enter the number of exemptions claimed on:
(a) Subtotal of Personal Exemptions – line 4 of the Personal Exemption Worksheet
(b) Subtotal of Exemptions for Age and Blindness line 7 of the Personal Exemption Worksheet
(c) Total Exemptions – line 8 of the Personal Exemption Worksheet
2. Enter the amount of additional withholding requested (see instructions)
3. I certify that I am not subject to Virginia withholding. l meet the conditions set forth in the instructions.
Check Here
4. I certify that I am not subject to Virginia withholding. l meet the conditions set forth Under the Service member Civil Relief Act, as amended by the Military Spouses Residency Relief Act.
Check Here
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
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My IP Address is: 44.192.115.114 This form was submitted on: 09/21/2023
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