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              Government of the
              District of Columbia                                             2018     D-4 DC Withholding Allowance Certiﬁcate 

        Taxpayer identification number (TIN)  See instructions. 

        F rst name  i                                                                   M.I.   Last name 

        Home address (number street,  and suite/apartment number if applicable)        

        City                                                                                                            State   Zip code +4

        1    Tax fi ling status  (Fill in only one)                  Single             Married/domestic partners fi ling jointly/qualifying widow(er) with dependent child   
                      Head of household                              Married fi ling separately                          Married/domestic partners fi ling separately on same return
  2          Total number of withholding allowances from worksheet below.
         Enter total from Sec. A, Line i                             Enter total from Sec. B, Line m                          Total number of withholding allowances , Line n
  3          Additional amount, if any, you want withheld from each paycheck                                             $
  4          Before claiming exemption from withholding, read below.  If qualifi ed, write “EXEMPT” in this box.      
  5          My domicile is a state other than the District of Columbia                              Yes         No  If yes, give name of state of domicile __________________ 
             I am exempt because: last year I did not owe any DC income tax and had a right to a full refund of all DC income tax withheld from me; and this year I do 
             not expect to owe any DC income tax and expect a full refund of all DC income tax withheld from me; and I qualify for exempt status on federal Form W-4. 
             If claiming exemption from withholding, are you a full-time student?                                        Yes    No
        Signature     Under penalties of law, I declare that the information provided on this certiﬁ cate is, to the best of my knowledge, correct.
        Employee’s signature                                                   Date 

        Employer     Keep this certiﬁcate with your records. If 10 or more exemptions are claimed or if you suspect this certiﬁcate contains false information 
        please send a copy to: Ofﬁce of Tax and Revenue, 1101 4th St., SW, Washington, DC 20024  Attn: Compliance Administration
                                          Detach and give the top portion to your employer. Keep the bottom portion for your records.

              Government of the           D-4 DC Withholding Allowance Worksheet
              District of Columbia

Section A  Number of withholding allowances
a Enter 1 for yourself                                                                                                                                                       a 
b  Enter 1 if you are filing as a head of household                                                                                                                          b 
c  Enter 1 if you are 65 or over                                                                                                                                             c
d  Enter 1 if you are blind                                                                                                                                                  d
e  Enter number of dependents                                                                                                                                                e 
f   Enter 1 for your spouse or registered domestic partner ﬁling jointly or filing separately on same return or if you are a qualifying widow(er)                            f 
         with dependent child 
g  Enter 1 if married or registered domestic partner ﬁling jointly or filing separately on same return and your spouse or registered domestic                                g 
         partner is 65 or over
h        Enter 1 if married or registered domestic partner ﬁling jointly or filing separately on same return and your spouse or registered domestic                          h
    partner is blind
i   Number of allowances  Add Lines a through h, enter here and on Line 2 above, next to "Enter total from Sec. A, Line i".                                                  i
                                If you want to claim additional withholding allowances, complete Section B below.
Section B  Additional withholding allowances
j  Enter estimate of your itemized deductions                                                                                                               j
k Enter $6,500 if single, married/registered domestic partners ﬁling separately or a dependent. Enter $9,550 if
       head of household.  Enter $13,000 if married/registered domestic partner ﬁling jointly, married 
       ﬁling separately  on the same return, or qualifying widow(er) with dependent child.                                                                  k
l Subtract Line k from Line j                                                                                                                               l  
m Divide Line l by $4,150. Round to the nearest whole number, enter here and on Line 2 above, next to "Enter total from Sec.B, Line m".                                       m 
n       Add Lines     m and i, enter here and on Line 2 above, next to "Total number of withholding allowances, Line  ".          n                                            n 

Revised 10/2017

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Detach and give the top portion to your employer. Keep the bottom portion for your records.

Taxpayer Identification Number(s) (TIN) How many withholding allowances should you claim?
You must have a TIN, whether it is a Federal Employer Identification Use the worksheet on the front of this form to ﬁgure the number of
Number (FEIN), Social Security Number (SSN), Individual Taxpayer withholding allowances you should claim. If you want less
Identification Number (ITIN) or Preparer Tax Identification Number
(PTIN). money withheld from your paycheck, you may claim additional
allowances by completing Section B of the worksheet, Lines j
Who must file a Form D-4? through . However, if you claim too many allowances, you mayn
Every new employee who resides in DC and is required to have DC owe additional taxes at the end of the year.
income taxes withheld, must ﬁ ll out Form. D-4 and file it with his/
her employer. Should I have an additional amount deducted from my pay-
check?
If you are not liable for DC income taxes because you are a In some instances, even if you claim zero withholding allowances,
nonresident or military spouse, you must file Form D-4A, Certiﬁ cate you may not have enough tax withheld. You may, upon agreement
of Non-residence in the District of Columbia, with your employer. with your employer, have more tax withheld by entering on Line 3,
When should you ﬁ le? a dollar amount of your choosing.
File Form D-4 whenever you start new employment. Once filedwith What to ﬁle
your employer, it will remain in effect until you file a new certiﬁ cate. After completing Form D-4, detach the top portion and ﬁ le it with
You may file a new withholding allowance certiﬁcate any time the your employer. Keep the bottom portion for your records.
number of withholding allowances you are entitled to increases.

You must ﬁle a new certiﬁcate within 10 days if the number of
withholding allowances you claimed decreases.

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