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Employee’s Withholding Allowance Certificate
Complete this form so that your employer can withhold the correct California state income tax from your paycheck.
Enter Personal Information
First, Middle, Last Name Social Security Number
Address Filing Status
Single or Married (with two or more incomes)
City State ZIP Code Married (one income)
Head of Household
1. Use Worksheet A for Regular Withholding allowances. Use other worksheets on the following pages as applicable.
1a. Number of Regular Withholding Allowances (Worksheet A) 0
1b. Number of allowances from the Estimated Deductions (Worksheet B, if applicable.) 0
1c. Total Number of Allowances you are claiming 0
2. Additional amount, if any, you want withheld each pay period (if employer agrees), (Worksheet C)
OR
Exemption from Withholding
3. I claim exemption from withholding for 2024, and I certify I meet both of the conditions for exemption. (Check box here)
OR
4. I certify under penalty of perjury that I am not subject to California withholding. I meet the conditions set
forth under the Service Member Civil Relief Act, as amended by the Military Spouses Residency Relief Act
and the Veterans Benefits and Transition Act of 2018. (Check box here)
Under the penalties of perjury, I certify that the number of withholding allowances claimed on this certificate does not exceed the
number to which I am entitled or, if claiming exemption from withholding, that I am entitled to claim the exempt status.
Employee’s Signature Date
Employer’s Section: Employer’s Name and Address California Employer Payroll Tax Account Number
Purpose: The Employee’s Withholding Allowance Certificate 1. You did not owe any federal/state income tax last year, and
(DE 4) is for California Personal Income Tax (PIT) withholding 2. You do not expect to owe any federal/state income tax this
purposes only. The DE 4 is used to compute the amount of taxes year. The exemption is good for one year.
to be withheld from your wages, by your employer, to accurately
reflect your state tax withholding obligation. If you continue to qualify for the exempt filing status, a new DE 4
designating exempt must be submitted by February 15 each year
Beginning January 1, 2020, Employee’s Withholding Allowance to continue your exemption. If you are not having federal/state
Certificate (Form W-4) from the Internal Revenue Service (IRS) income tax withheld this year but expect to have a tax liability
will be used for federal income tax withholding only. You must file next year, you are required to give your employer a new DE 4 by
the state form DE 4 to determine the appropriate California PIT December 1.
withholding.
Member Service Civil Relief Act: Under this act, as provided
If you do not provide your employer with a DE 4, the employer by the Military Spouses Residency Relief Act and the Veterans
must use Single with Zero withholding allowance. Benefits and Transition Act of 2018, you may be exempt from
California income tax withholding on your wages if
Check Your Withholding: After your DE 4 takes effect, compare
the state income tax withheld with your estimated total annual (i) Your spouse is a member of the armed forces present in
tax. For state withholding, use the worksheets on this form. California in compliance with military orders;
(ii) You are present in California solely to be with your spouse;
Exemption From Withholding: If you wish to claim exempt,
and
complete the federal Form W-4 and the state DE 4. You may
claim exempt from withholding California income tax if you meet (iii) You maintain your domicile in another state.
both of the following conditions for exemption: If you claim exemption under this act, check the box on Line 4.
You may be required to provide proof of exemption upon request.
DE 4 Rev. 53 (12-23) (INTERNET) Page 1 of 4 CU
