![]() Enlarge image | Vermont Department of Taxes Employee’s Withholding Allowance Certificate - Form W-4VT All Vermont employees should complete this form. To be filed with your employer. Last Name First Name Initial Social Security Number Filing Status - Check ONE Married/Civil Union Married/Civil Union Married, but withhold Single Filing Jointly Filing Separately at higher single rate Vermont Allowances Worksheet 1. Enter “1” for yourself if no one can claim you as a dependent. . . . . . . . . . . . . . . . . . 1. ___________ 2. Enter “1” if you are filing jointly and your spouse does not work ............... 2. ___________ 3. Enter the number of dependents you plan to claim on your tax return. If you file jointly, then only one of you should claim the dependents on your W-4VT ....... 3. ___________ 4. Enter “1” if you plan to file as “head of household”. . . . . . . . . . . . . . . . . . . . . . . . . . 4. ___________ 5. Total number of Vermont allowances. (Add Lines 1 through 4 and enter total here.) ............ 5. ___________ 6. Enter an additional amount, if any, you want withheld from each check. ...................... 6. ___________ Exempt: If you had a right to a refund of all your Vermont income tax withheld last year because you had no tax liability and you also expect to have no liability this year, write “Exempt” here. ....... ____________ General Information Form W-4VT is designed so that you can have as much “take-home pay” as possible without an income tax liability due to Vermont when you file your tax return. Each withholding allowance you claim on Line 5 above will reduce the amount of income you are taxed on and therefore the amount of Vermont income tax withheld each paycheck. Here are some things to remember as you complete this form: • Generally, dependents are children under 19 (or up to 24 if they are a full-time student) and any relatives who live with you and you support financially. • If you and your spouse both claim your dependents on your respective W-4VTs, not enough income tax will be withheld, and you might end up with taxes due when you file. Only one spouse should claim the dependents. • If you entered an additional amount to be withheld on the federal W-4, consider entering 30% of that amount on Line 6. • If you have more than one employer, consider claiming zero allowances with the employer(s) where you earn less income. Signature I certify that I am entitled to the number of withholding allowances claimed on this certificate. Employee’s Signature Date Form W-4VT Page 1 of 1 This form may be photocopied as needed. Rev. 12/18 |