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MW-4 CITY OF MUSKEGON �Non-Resident �City Resident
EMPLOYEE’S WITHHOLDING CERTIFICATE
1. Print Full Name Social Security No. Office, Plant, Dept. Employee Identification No.
2. Address, Number and Street City, Township or Village where you reside State Zip Code
3.Predominant Place of Employment Non-Resident City Under
Print name of each city where you work for 25% 40% 60% 80% 100%
this employer and circle closest % City Under
of total earnings in each 25% 40% 60% 80% 100%
YOUR WITHHOLDING Check 4. Exemption for Regular $600 Additional $600 exemption Enter number of
EXEMPTIONS: boxes yourself � exemption � if 65 or over at end of year exemptions checked
(See instructions which 5. Exemption for Regular $600 Additional $600 exemption Enter number of
on reverse side) apply your wife (husband)� exemption � if 65 or over at end of year exemptions checked
6. (a) Exemptions for your childrenNumber 6. (b) Exemptions for your Number Enter total of line 6
other dependents (a plus b)
EMPLOYEE: File this form with your employ-
er. Otherwise he must withhold CITY OF 7. Add the number of exemptions which you have claimed on lines 4, 5 and 6 above and write the total
MUSKEGON income tax from your earnings
without exemption. 8. Additional amount you want deducted from each pay (if employer agrees) $ .00
EMPLOYER: Keep this certificate with your
records. If the information submitted by theI certify that the information submitted on this certificate is true, correct and complete to the best of my knowledge and belief.
employee is not believed to be true, correct
and complete the form, and the CITY must 9. Date Signature
be so advised.
LINE 3 INSTRUCTIONS - If you work for this employer in more than two cities or CHANGES IN EXEMPTIONS - You should file a new certificate at any time
communities, print names of the two Michigan cities or communities where you perform if the number of your exemptions INCREASES.
the greatest percent of your work. Circle the closest percent of total earnings for work You must file a new certificate within 10 days if the number of
done or services rendered in each city or community listed. The estimated percent of exemptions previously claimed by you DECREASES for any of the following
total earnings from this employer for work done or services performed within taxing reasons:
cities (line 3 on other side) is for withholding purposes only. In determining final tax lia- (a) Your wife (or husband) for whom you have been claiming exemption is
bility this estimate is subject to substantiation and audit. divorced or legally separated, or claims her (or his) own exemption on a
DEPENDENTS - To qualify as your dependent (line 6 on other side) a person (a) must separate certificate.
receive more than one-half of his or her support from you for the year, and (b) must have (b)The support of a dependent for whom you claimed exemption is taken
less than $600 gross income during the year (except your child who is a student or who over by someone else, so that you no longer expect to furnish more
is under 19 years of age), and (c) must not be claimed as an exemption by such person’s than half the support for the year.
husband or wife, and (d) must be a citizen or resident of the United States or a resident (c) You find that a dependent for whom you claimed exemption will receive
of Canada, Mexico, the Republic of Panama or the Canal Zone (this does not apply to an $600 or more of income of his own during the year (except your child
alien child legally adopted by and living with a United States citizen abroad), and (e) must who is a student who is under 19 years of age).
(1) have your home as his principal residence and be a member of your household for OTHER DECREASES in exemption, such as the death of a wife or a
the entire year, or (2) be related to you as follows: dependent, do not affect your withholding until the next year, but require the
Your son or daughter (including legally adopted children), grandchild, stepson, filing of a new certificate by December 1 of the year in which they occur.
stepdaughter, son-in-law or daughter-in-law; CHANGE OF RESIDENCE - You must file a new certificate within 10 days
Your father, mother, grandparent, stepfather, stepmother, father-in-law, or mother-in law; after you change your residence from or to a taxing city.
Your brother, sister, stepbrother, stepsister, half brother, half sister, brother-in-law, or CHANGES IN EMPLOYMENT - You must file a new certificate by
sister-in-law; December 1 of each year if your Line 3 estimate of the percent of work done
Your uncle, aunt, nephew, or niece (but only if related by blood). or services to be rendered in cities levying an income tax will change for the
ensuing year.
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