IT 4 Rev. 5/07

Notice to Employee

1. For state purposes, an individual may claim only natural de-pendency exemptions. This includes the taxpayer, spouse and each dependent. Dependents are the same as defined in the Internal Revenue Code and as claimed in the taxpayer’s federal income tax return for the taxable year for which the taxpayer would have been permitted to claim had the tax-payer filed such a return.

2. You may file a new certificate at any time if the number of your exemptions increases.

You must file a new certificate within 10 days if the number of exemptions previously claimed by you decreases because: (a) Your spouse for whom you have been claiming exemp-tion is divorced or legally separated, or claims her (or his)
own exemption on a separate certificate.

(b) The support of a dependent for whom you claimed ex-emption is taken over by someone else.
(c) You find that a dependent for whom you claimed exemp-tion must be dropped for federal purposes.

The death of a spouse or a dependent does not affect your withholding until the next year but requires the filing of a new certificate. If possible, file a new certificate by Dec. 1st of the year in which the death occurs.

For further information, consult the Ohio Department of Taxa-tion, Personal and School District Income Tax Division, or your employer.

3. If you expect to owe more Ohio income tax than will be withheld, you may claim a smaller number of exemptions; or under an agreement with your employer, you may have an additional amount withheld each pay period.

4. A married couple with both spouses working and filing a joint return will, in many cases, be required to file an indi-vidual estimated income tax form IT 1040ES even though Ohio income tax is being withheld from their wages. This result may occur because the tax on their combined in-come will be greater than the sum of the taxes withheld from the husband’s wages and the wife’s wages. This requirement to file an individual estimated income tax form IT 1040ES may also apply to an individual who has two jobs, both of which are subject to withholding. In lieu of filing the individual estimated income tax form IT 1040ES, the individual may provide for additional withholding with his employer by using line 5.

✁ please detach here

hio

Department of Taxation

IT 4 Employee’s Withholding Exemption Certificate	Rev. 5/07

Print full name	Social Security number	

Home address and ZIP code

Public school district of residence	 School district no. 	

(See The Finder at tax.ohio.gov.)

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 the penalties of perjury, I certify that the number of exemptions claimed on this certificate does not exceed the number to which I am entitled.

Signature	Date