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                                         Form OR-W-4 Instructions
                                        Oregon Withholding Statement                                                2024
                                           and Exemption Certificate

Purpose of this form                                              General information
Use Form OR-W-4 to tell your employer or other payer how          What is Oregon income tax withholding? 
much Oregon income tax to withhold from your wages or 
                                                                  Oregon income tax must be paid during the year as you earn 
other periodic income.                                            or receive your income. Employers and certain other pay-
Instructions for employer or other payer. Enter the business      ers are required by law to set aside (withhold) part of your 
name, federal employer identification number (FEIN), and          paycheck or other payment for taxes that they send to the 
address in the “Employer use only” section of Form OR-W-          Department of Revenue on your behalf every time they pay 
4. Keep the completed form with your records. For more            you. “Withholding” refers to the portion of income that your 
information and additional instructions, see Publication          employer or other payer holds back from each paycheck or 
150-211-602, W-4 Information for Employers, and the additional    other payment. 
resources listed on page 4.
                                                                  How is the amount of Oregon income tax 
Complete Form OR-W-4 if:                                          withholding determined?
• You’re starting a new job with an employer who must             The amount that the employer or other payer must withhold 
  withhold Oregon tax from your pay.                              depends on several things, such as:
• You’re receiving a pension or annuity and the payer must 
  withhold Oregon tax from each payment.                          • Your income.
• You’ve had a recent personal or financial change that           • Your marital status.
  affects your taxes, such as a change in your income, filing     • The number of children or other dependents you have.
  status, or number of dependents.                                Allowances. Depending on your situation, some of your 
• You weren’t satisfied with the amount of Oregon tax you         income might not be subject to withholding. Each allowance  
  owed or had refunded to you when you filed a recent             reduces the amount of income that is withheld from each 
  return.                                                         payment. The worksheets in these instructions will help you 
• You filed a federal Form W-4 with your employer after           determine how many allowances you may claim.
  2017 that didn’t specify withholding allowances for 
                                                                  Additional withholding. You may want to have more money 
  Oregon.
                                                                  withheld from each payment. If you have other income that 
The worksheets in these instructions are designed to help         isn’t subject to withholding, requesting additional withhold-
you estimate the amount of Oregon tax your employer               ing on Form OR-W-4 may help you avoid owing tax on that 
should withhold from your pay. For a more  accurate esti-         other income when you file your tax return.
mate, use the Oregon Withholding Calculator at  www.
                                                                  You report your marital status, allowances, and any addi-
oregon.gov/dor before you complete Form OR-W-4.
                                                                  tional amount you want withheld by completing Form 
Pension and annuity withholding. Use Form OR-W-4 to des-          OR-W-4 and submitting it to your employer or other payer. 
ignate the Oregon withholding from your pension, annuity,         They will use this information, along with Publication 150-
or other periodic payments.                                       206-436, Oregon Withholding Tax Formulas, to withhold a 
                                                                  specific amount each pay period. 
Questions to consider:
• Do you (including your spouse) have more than one  job?         What if too much or not enough is withheld?
• Do you expect your wages or your total income for 2024 to       If you have too much tax withheld, you may have a refund 
  be more than $100,000 (or $200,000 if you’re married and        when you file your tax return. This is money that you 
  will file a joint return with your spouse, or you’re a recent   couldn’t use during the year when you might have needed it. 
  widow(er)?
• Are you making mid-year changes to your withholding?            If you have too little tax withheld, you may owe tax when 
• Do you receive pension or annuity payments?                     you file your tax return, plus penalty and interest. This is 
• Do you live outside Oregon, or did you move to Oregon this      money that you might have used during the year but will 
  year?                                                           need to pay when you file your return after the year ends. 
• Are you a non-U.S. citizen without permanent resident status?   See Publication OR-17 for penalty and interest information.

     If you answered          yes to any of these questions, read Why can’t the federal form be used for all 
STOP the “Specific information” section in these instruc-
                                                                  withholding?
     tions before completing the worksheets or Form 
OR-W-4. Consider using the online       Oregon Withholding        Oregon employees used to be able to use federal Form W-4 
Calculator at  www.oregon.gov/dor instead of the work-            for both their federal and Oregon withholding. In 2020, the 
sheets for more accurate results.                                 Internal Revenue Service made some major changes to the 
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way that federal withholding is done. They changed Form        your withholding, you may owe tax, penalties, and interest 
W-4 in such a way that it can no longer be used for Oregon     when you file your return. See Publication OR-17 for penalty 
withholding purposes. Similar changes were made to Form        and interest information.
W-4P, for withholding from pensions and annuities, starting 
                                                               Pension or annuity payments. If you’ve opted out of federal 
in 2022. You must use Oregon’s Form OR-W-4 instead.
                                                               withholding from a pension, annuity, or other periodic pay-
How often does Form OR-W-4 have to be submitted?               ment, you’re automatically opted out of Oregon withholding 
                                                               also. If you’re not having tax withheld from this income, you 
Complete and submit a new Form OR-W-4 when you start 
                                                               may be required to make estimated tax payments. See Publi-
a new job and whenever your tax situation changes. This 
                                                               cation OR-ESTIMATE to determine the amount of estimated 
includes changes in your income, marital status, and number 
                                                               tax payments you need to make.
of dependents. 
                                                               If you elect to have Oregon tax withheld from your pension 
Note: If you are claiming an exemption from Oregon with-
                                                               or annuity payment, where the tax must be withheld at a 
holding, you must submit a new Form OR-W-4 by February 
                                                               certain percentage, you can’t claim allowances on Form 
15 every year if you continue to qualify for exemption. See 
                                                               OR-W-4, but you may request additional withholding.
the instructions for line 4.
                                                               Exemption from withholding. You may be in a situation 
What will happen if no Form OR-W-4 is submitted?               where none of your income is subject to Oregon tax. In that 
Your employer or other payer will refer to your most recent    case, your income may be exempt from withholding. The 
withholding form to determine your withholding. If no Form     exemption period depends on the type of income you have.  
OR-W-4 has been submitted, they will withhold for Oregon       For wages, the exemption ends on February 15th of the fol-
based upon the following order:                                lowing year. For commercial annuities, employer deferred 
                                                               compensation plans, and individual retirement plans where 
• An Oregon-only version of the federal Form W-4 for a year 
                                                               an election to have no withholding may be made, the exemp-
prior to 2020, or federal Form W-4P for a year prior to 2022.
                                                               tion ends when you notify the payer in writing that you 
• Federal Form W-4 for a year prior to 2020, or Form W-4P 
                                                               revoke the election. See the instructions for line 4.
for a year prior to 2022.
• Eight percent of your wages or other income subject to       Part-year and nonresidents. Have you recently moved to 
withholding.                                                   Oregon, or do you live outside the state? If so, you’ll report 
                                                               your Oregon income and deductions in the Oregon col-
What will happen if the information on the form                umn of your part-year or nonresident tax return. Use only 
is false?                                                      the amounts that will be in the Oregon column when you 
You may be assessed a penalty of $500 if there is no reason-   complete Worksheet B or C, or use the online withholding 
able basis for the instructions you’re giving your employer    calculator for more accurate results.
or other payer using Form OR-W-4.                              Non-U.S. citizen without permanent resident status. If all or 
                                                               a portion of your wages are exempt from federal withhold-
Specific information                                           ing, these wages are also completely or partially exempt from 
Two earners or multiple jobs. See the instructions for Work-   Oregon withholding. Submit federal exemption Form 8233 
sheet C or use the online withholding calculator if you have   to your employer to exempt all or part of your wages from 
more than one job at a time or will file a joint return with a Oregon withholding. 
working spouse.                                                If any portion of your wages is not exempt, submit Form 
Wages or adjusted gross income (AGI)* that exceed the          OR-W-4 to your employer. You may not qualify to claim 
                                                               certain deductions from your Oregon income, so you will 
threshold. Your income level affects your withholding. Do 
                                                               need to take extra steps to ensure that your withholding is 
you expect to have wages or AGI on your 2024 return that 
                                                               adequate. Follow the instructions below when completing 
are more than $100,000 (or $200,000 if using the married fil-
                                                               Form OR-W-4: 
ing jointly or the qualifying surviving spouse filing status)? 
If so, you may want to request additional withholding.         • Line 1. Check the “single” box regardless of your marital 
Consider using the online calculator to determine the correct    status. 
amount to put on your Form OR-W-4.                             • Line 2.  Usually, you should claim -0- withholding allow-
                                                                 ances. However, if you complete the worksheets, follow 
*Helpful tip: AGI. Your AGI is your total income minus 
                                                                 the instructions below. 
federal adjustments to income. This amount on your 2023 
                                                                  — Complete Worksheet B using amounts that will be 
federal Form 1040 may help you estimate your 2024 AGI.
                                                                 included in the Oregon column of your return. 
Mid-year changes. If you claimed too many allowances for          —  Once you have completed all applicable worksheets, 
the first part of the year, your withholding may not cover       subtract 1 allowance from the number on line A4, B15, 
all of your tax when you file your return. Use the online        or C5.
calculator to determine the additional amount you need         • Line 4. Don’t claim exempt due to “no tax liability” or for 
withheld to make up for the shortage. If you don’t change        the portion of your wages exempted on federal Form 8233.  

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Form OR-W-4 line instructions                                     Note: For wages, exemptions end February 15th of the fol-
                                                                  lowing year. A new Form OR-W-4 must be completed and 
For the form and all worksheet instructions, terms such           submitted to your employer each year.
as “pay,” “paycheck,” and “wages” also refer to pensions, 
annuities, and other periodic payments, and the word                               Exemption chart
“employer” also refers to other payers.                                             Exemption                               Code
Type or clearly print your name, Social Security number           Air carrier employee                                      A
(SSN), and mailing address.                                       American Indian enrolled tribal member living and 
                                                                                                                            B
                                                                  working in Indian country in Oregon.
Note. You must enter an SSN. You can’t use an individual 
taxpayer identification number (ITIN).                            Amtrak Act worker                                         C
                                                                  Casual laborer                                            D
Redetermination check box. If the department issued a 
determination letter to your employer specifying the amount       Domestic service worker                                   E
your employer needs to withhold from your wages and you           Hydroelectric dam worker at the Bonneville, John Day, 
                                                                                                                            F
want to decrease your withholding, you must have a per-           McNary, or The Dalles dam.
sonal or financial change affecting your tax situation. If you    Military pay for nonresidents stationed in Oregon and 
do, mark the “Redetermination” check box. Provide a copy          their spouses, residents stationed outside Oregon, and 
                                                                                                                            G
to your employer and send a copy with all of the applicable       service members or spouses treated as nonresidents 
worksheets filled out to the department at:                       for tax purposes.
                                                                  Minister who is duly ordained, commissioned, or licensed 
  ADP OR-W-4 Project                                              and performing duties in their ministry or a member of a  H
  Oregon Department of Revenue                                    religious order performing duties required by their order.
  PO Box 14560                                                    Real estate salesperson under a written contract not 
                                                                                                                            J
  Salem, OR 97309                                                 to be treated as an employee.
Line 1. If you anticipate using the single, married filing        Waterway worker                                           K
separately, or head of household filing status when you file      No tax liability. See above for definition.               L
your 2024 return, mark “Single.”                                  Nonresident who expects a refund of all Oregon income 
If you anticipate using the married filing jointly or qualify-    tax withheld because their wages won’t be subject to      M
                                                                  Oregon tax.
ing surviving spouse filing status when you file your 2024 
return, mark “Married.” If you meet the married filing jointly    Sign and date Form OR-W-4. Submit Form OR-W-4 to your 
qualifications, but want tax withheld at the higher “single”      employer. Don’t complete the employer’s information. Keep 
rate, mark “Married, but withhold at the higher single rate.”     the worksheets with your tax records.
For the qualifications of each filing status, see federal Publica-
tion 501, Exemptions, Standard Deduction, and Filing Information. Worksheet instructions

Line 2. Complete all applicable worksheets. Enter the allow-      Worksheet A—Personal allowances
ances from Worksheet A, line A4, Worksheet B, line B15, or        Note: If your annual wages from this job are more than 
Worksheet C, line C5.                                             $100,000 and you’re marking “Single” or “Married, but with-
Line 3. If you choose to have an additional amount withheld       hold at the higher single rate” ($200,000 if you’re marking 
from your pay, enter the amount that you want withheld            “Married”), skip Worksheet A and claim zero allowances on 
from each paycheck. If you completed Worksheet C, line C8         Form OR-W-4.
may direct you to claim an additional amount per paycheck.        Line A3. Dependents. Enter the total number of all qualify-
Line 4. If you’re claiming exemption from withholding, you        ing children and qualifying relatives you are able to claim 
must meet one of these requirements:                              as dependents on your Oregon return. See the “Exemp-
                                                                  tion credit” section of Publication OR-17 for dependent 
• Your wages must be exempt from Oregon taxation, or              qualifications.
• You must meet the qualification for having no tax liability.
                                                                  Worksheet B—Deductions, adjustments, credits, 
To claim exemption due to     no tax liability, you must meet 
both of the following conditions:                                 and nonwage income
                                                                  Line B1. If you have large amounts of nonwage income, such 
• Last year you had the right to a refund of   all Oregon tax 
                                                                  as interest, dividends, or self-employment income, consider 
withheld because you had no tax liability, and
                                                                  making estimated tax payments. For required payments and 
• This year you expect a refund of  all Oregon income tax 
                                                                  other information, see Publication OR-ESTIMATE. You may 
withheld because you expect to have no tax liability.
                                                                  also request additional withholding from each paycheck. 
To claim exempt, enter the corresponding code from the            Otherwise, you may owe additional tax when you file your 
Exemption chart on line 4a. Enter only one exemption code,        return, together with interest on any underpayment of 
even if more than one applies. Write “Exempt” on line 4b.         required estimated tax payments.

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Line B2. Additions are generally items the federal govern-    Line B13. Add lines B10 and B12. Round to the nearest whole 
ment doesn’t tax but Oregon does. See Publication OR-17       number that is closer to zero by eliminating the decimal value. 
for a list of additions and instructions.                     For example, round 4.3 or 4.8 to 4 and round -3.3 or -3.7 to -3.
Line B4. Enter your anticipated 2024 Oregon deductions. If    Example 1. Roger entered -3.1 on line B10. He entered 2.4 on 
you don’t know your anticipated 2024 deductions, enter the    line B12. He will enter -0- on line B13 (-3.1 + 2.4 = -0.7, which 
standard deduction for your anticipated filing status.        is rounded to 0).
The 2024 standard deduction for each filing status is:        Line B15. If the result when you add lines B13 and B14 is 
                                                              less than zero, you may owe tax when you file your return. 
• $2,745 for single or married filing separately. 
                                                              Request additional withholding or consider making esti-
• $4,420 for head of household.
                                                              mated tax payments to avoid owing tax plus potential 
• $5,495 for married filing jointly or qualifying surviving 
                                                              penalties and interest. See Publication OR-ESTIMATE for 
spouse.
                                                              information about estimated payments.
If you qualify for an additional standard deduction amount  
because you or your spouse are age 65 or older or blind, and  Worksheet C—Two earners / multiple jobs
you don’t plan to itemize your deductions, add the addi-      Use Worksheet C if you work more than one job at a time or 
tional amount to your anticipated deduction amount on line    you have a working spouse. 
B4. If you’re married (or a qualifying surviving spouse), the 
                                                              Line C5. For your highest paying job, enter the result of 
additional standard deduction is $1,000; for everyone else, 
                                                              Worksheet C, line C5 on Form OR-W-4, line 2. For all of your 
the additional amount is $1,200.   
                                                              lower paying jobs, claim zero allowances. 
Itemized deductions include items such as medical expenses 
                                                              Line C8. For your highest paying job, enter the result of 
that are more than 7 1/2 percent of your AGI, state and local 
                                                              Worksheet C, line C8 on Form OR-W-4, line 3. Round to the 
taxes you paid (limited to $10,000, but don’t include Oregon 
                                                              nearest whole dollar. For all of your lower paying jobs, claim 
income taxes), qualifying home mortgage interest, charitable 
                                                              zero as the additional amount to be withheld.
contributions,  and certain miscellaneous deductions. If you 
plan to itemize your deductions, enter your estimated Oregon  Example 2. Todd is completing this form in January and has 
itemized deductions. See Schedule OR-A Instructions for       entered $824 on line C7. For his highest paying job, he is paid 
more information.                                             every two weeks and has 25 paychecks left for the year. Todd 
                                                              will enter $33 on line C8 and Form OR-W-4, line 3 ($824 ÷ 25 
Line B7. Adjustments to income reduce your gross income, 
                                                              = $32.96, which is rounded up to the nearest whole dollar).
resulting in AGI on your federal return. See the instructions 
for federal Form 1040 and the “Adjustments” section of 
Publication OR-17 for more information.                         Additional resources
Subtractions are generally items the federal government       For additional information, refer to the following publications:
taxes but Oregon doesn’t. See Publication OR-17 for a list    • Publication 150-206-436, Oregon Withholding Tax Formulas.
of subtractions and instructions. Don’t include your federal  • Publication OR-17, Oregon Individual Income Tax Guide.
tax subtraction.                                              • Publication OR-ESTIMATE, Instructions for Estimated Income Tax.
Line B10. Divide line B9 by $3,200. Round to one decimal      • Publication 150-211-602, W-4 Information for Employers.
place. For example, round 4.84 to 4.8 and 4.85 to 4.9. This   • Federal Pub. 501, Exemptions, Standard Deduction, and Fil-
calculation converts the amount from line B9 into allowances.   ing Information.
                                                              • Federal Form 2833, Exemption From Withholding on Compensa-
Line B11. Credits reduce the amount of tax you must pay.        tion for Independent (and Certain Dependent) Personal Services 
Standard and carryfoward credits can reduce your tax to         of a Nonresident Alien Individual.
zero but can’t be refunded to you. Refundable credits can     • Federal Form 1040 Instructions.
reduce your tax to zero and also result in a refund of any 
remaining amount. See Publication OR-17 for a list of credits   Do you have questions or need help?
and instructions.
                                                                www.oregon.gov/dor
Enter an estimate of the credits you will claim on your 2024  503-378-4988 or 800-356-4222
Oregon return. Don’t include your exemption credits.          questions.dor@ dor.oregon.gov
Line B12. Divide line B11 by $249. Round using one decimal    Contact us for ADA accommodations or assistance in other 
place. For example, round 4.84 to 4.8 and 4.85 to 4.9. This   languages.
calculation converts the amount from B11 into allowances.

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                                    Worksheet A—Personal allowances

Note: If you marked “Single” or “Married, but withhold at higher single rate” and your annual wages for this job will be 
more than $100,000 ($200,000 if you marked “Married”), skip lines A1 through A3 and enter 0 on line A4. 

A1.   Enter “1” for yourself if no one else can claim you as a dependent. Otherwise, enter 0.................... A1.

 A2.  Enter “1” for your spouse if your spouse isn’t employed. Otherwise, enter 0 ................................... A2.

 A3.  Enter the number of dependents you will claim on your Oregon tax return ....................................... A3.

 A4.  Add lines A1 through A3. Enter the result here and follow the instructions below .............................. A4.
      Complete all worksheets that apply.
STOP  • Worksheet B—Use this worksheet if you plan to do any of the following on your 2024 Oregon return:
        o  Itemize your Oregon deductions or claim additional standard deduction amounts.
        o   Claim federal adjustments to income or Oregon additions, subtractions, or credits (other than personal exemption credits).
        o  Report nonwage income (such as dividends, interest, or self-employment income).
     •  Worksheet C—Use this worksheet if you (including your spouse) have more than one job and the combined earnings from 
        all jobs exceed $20,000.
If neither of the above worksheets apply, stop here and enter the number from line A4 on Form OR-W-4, line 2.

                                    – Keep this worksheet for your records –
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               Worksheet B—Deductions, adjustments, credits, and nonwage income

      Use this worksheet if you plan to do any of the following on your 2024 Oregon return:
 STOP •  Itemize your Oregon deductions or claim additional standard deduction amounts.
      •  Claim federal adjustments to income or Oregon additions, subtractions, or credits (other than personal exemption credits). 
      •  Report nonwage income (such as dividends, interest, or self-employment income).
Having your most recent Oregon tax return on hand may help you when completing this worksheet.  
Don’t use negative numbers unless otherwise instructed. For example, write a $1,000 Oregon subtraction as “$1,000”, not 
“($1,000)” or “-$1,000”. For more information, see the instructions for this worksheet starting on page 3.

B1.  Enter your estimated 2024 nonwage income (such as dividends or interest) .............B1.                                                            .00

B2.  Enter your estimated 2024 Oregon additions ...............................................................B2.                                        .00

B3.  Add lines B1 and B2 .............................................................................................................................B3.    .00

B4.  Enter your estimated 2024 Oregon deductions. (See instructions) ..............................B4.                                                    .00

B5.  Enter the standard deduction based on your anticipated 2024 filing status: ..............B5.                                                         .00
 • Single or Married Filing Separately: $2,745.
 • Head of Household: $4,420.
 • Married Filing Jointly or Qualifying Surviving Spouse: $5,495.

B6.  Line B4 minus line B5. If the result is zero or less, enter 0 ...................................................................B6.                    .00

B7.  Enter your estimated 2024 federal adjustments to income and Oregon subtractions 
 (exception—don’t include the federal tax subtraction) ........................................................................B7.                           .00

B8.  Add lines B6 and B7 .............................................................................................................................B8.    .00

B9.  Line B8 minus line B3. If less than zero, enter as a negative amount ..................................................B9.                              .00

B10. Line B9 divided by $3,200. Round to one decimal place. If less than zero, 
 enter as a negative amount.................................................................................................................B10.              .

B11. Enter your estimated 2024 Oregon standard, carryforward, or refundable 
 credits (exception—don’t include personal exemption credits) .................................B11.                                                       .00

B12. Divide line B11 by $249. Round to one decimal place .......................................................................B12.                          .

B13. Add lines B10 and B12. If less than zero, enter as a negative amount. Round to 
 the whole number closest to zero (See instructions) ..........................................................................B13. 

B14. Enter the number from Worksheet A, line A4 ....................................................................................B14. 

B15. Add lines B13 and B14. If zero or less, enter 0. (See instructions) .....................................................B15.
 If you’re using Worksheet C, enter the result from line B15 on Worksheet C, line C1. 
 Otherwise, stop here and enter the result from line B15 on Form OR-W-4, line 2. 

                                       – Keep this worksheet for your records –
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                                    Worksheet C—Two earners / multiple jobs

      If you (including your spouse) work three or more jobs at one time, consider using the Oregon Withholding Calculator at  www.
 STOP oregon.gov/dor for a more accurate calculation of your allowances. 

If you don’t use the online calculator, use this worksheet to figure the number of allowances to claim on the Form OR-W-4 for your highest 
paying job. For the best results, we recommend that you claim allowances only on the Form OR-W-4 you submit for your highest paying 
job, and that you claim zero allowances on Form OR-W-4, line 2 for all of your (or your spouse’s) other jobs. Doing so will help prevent 
under-withholding. For more information, see the instructions for this worksheet starting on page 4.

Complete this worksheet only if you (including your spouse) have more than oneandjob the combined earnings from  all                                      jobs exceed $20,000. 

C1.  Enter the number from Worksheet B, line B15. If you didn’t use Worksheet B, enter the 
  number from Worksheet A, line A4 ..................................................................................................... C1. 

C2.  Enter the indicated number based on your 2024 anticipated filing status ................... C2.
  •   Single, Head of Household, or Married Filing Separately: Enter “2”; 
      however, if two of your jobs individually exceed $40,000, enter “4”. 
  •   Married Filing Jointly or Qualifying Surviving Spouse: Enter “3”; however, 
    if two of your jobs individually exceed $50,000, enter “6”. 

C3.  If you (including your spouse) will work three or more jobs at the same time at 
  any point during the year, enter the indicated number for your 2024 anticipated 
  filing status. Otherwise, enter 0 .................................................................................... C3.
  •   Single, Head of Household, or Married Filing Separately: Enter “2”. 
  •   Married Filing Jointly or Qualifying Surviving Spouse: Enter “3”. 

C4.  Add lines C2 and C3 .............................................................................................................................C4.

C5.  Is line C1 less than line C4? 
  •   Yes. Enter 0 on line C5 and on Form OR-W-4, line 2. Continue with lines C6 through C8 
    to figure the additional withholding amount necessary to avoid owing tax with your return.
  •   No. Line C1 minus line C4. Enter the result on line C5 (if zero, enter 0) and on Form OR-W-4, 
    line 2. Don’t complete the rest of this worksheet.. ...........................................................................C5. 

C6.  Line C4 minus line C1 ...........................................................................................................................C6. 

C7.  Line C6 multiplied by $249 ...................................................................................................................C7.                .00

C8.  Line C7 divided by the number of paychecks remaining in 2024 for the highest paying job and 
  rounded to the nearest dollar. Enter the result here and on Form OR-W-4, line 3. This is the 
  additional amount to be withheld from each paycheck ....................................................................... C8.                                     .00

Reminder: If you’re requesting additional withholding for part of the year, remember to check your withholding again early next year. 

                                       – Keep this worksheet for your records –
150-101-402-1 (Rev. 10-04-23)                               7 of 7                                                          2024 Form OR-W-4 Instructions






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