Employee Information Update

Step 1 of 3 - W-4 Information

Step 1: Enter Personal Information

(a) Name

First Middle Initial Last

(b) Social Security Number

Address

Street Address Address Line 2 City State ZIP Code

(c)

Single or Married filing separately

Married filling jointly or Qualifying widow(er)

Head of household (Check only if you're unmarried and pay more than half the costs of keeping up a home for yourself and a qualifying individual.)

Complete Steps 2–4 ONLY if they apply to you; otherwise, skip to Step 5. See page 2 for more information on each step, who can claim exemption from withholding, when to use the estimator at www.irs.gov/W4App, and privacy.

Step 2: Multiple Jobs or Spouse Works

Complete this step if you (1) hold more than one job at a time, or (2) are married filing jointly and your spouse also works. The correct amount of withholding depends on income earned from all of these jobs.

Do only one of the following.

(a) Use the estimator at www.irs.gov/W4App for most accurate withholding for this step (and Steps 3–4); or

(b) Use the Multiple Jobs Worksheet on page 3 and enter the result in Step 4(c) below for roughly accurate withholding; or

(c) If there are only two jobs total, you may check this box. Do the same on Form W-4 for the other job. This option is accurate for jobs with similar pay; otherwise, more tax than necessary may be withheld.

Step 2(b): Multiple Jobs Worksheet

If you choose the option in Step 2(b) on Form W-4, complete this worksheet (which calculates the total extra tax for all jobs) on only ONE Form W-4. Withholding will be most accurate if you complete the worksheet and enter the result on the Form W-4 for the highest paying job. Note: If more than one job has annual wages of more than $120,000 or there are more than three jobs, see Pub. 505 for additional tables; or, you can use the online withholding estimator at www.irs.gov/W4App.

How many jobs?

1 Two Jobs

2 Three Jobs

1 Two jobs.

If you have two jobs or you’re married filing jointly and you and your spouse each have one job, find the amount from the appropriate table on page 4. Using the “Higher Paying Job” row and the “Lower Paying Job” column, find the value at the intersection of the two household salaries and enter that value on line 1. Then, skip to line 3

2 Three jobs.

If you have two jobs or you’re married filing jointly and you and your spouse each have one Three jobs. If you and/or your spouse have three jobs at the same time, complete lines 2a, 2b, and 2c below. Otherwise, skip to line 3.

Find the amount from the appropriate table on page 4 using the annual wages from the highest paying job in the “Higher Paying Job” row and the annual wages for your next highest paying job in the “Lower Paying Job” column. Find the value at the intersection of the two household salaries and enter that value on line 2a

Add the annual wages of the two highest paying jobs from line 2a together and use the total as the wages in the “Higher Paying Job” row and use the annual wages for your third job in the “Lower Paying Job” column to find the amount from the appropriate table on page 4 and enter this amount on line 2b

Add the amounts from lines 2a and 2b and enter the result on line 2c

Enter the number of pay periods per year for the highest paying job. For example, if that job pays weekly, enter 52; if it pays every other week, enter 26; if it pays monthly, enter 12, etc.

Divide the annual amount on line 1 or line 2c by the number of pay periods on line 3. Enter this amount here and in Step 4(c) of Form W-4 for the highest paying job (along with any other additional amount you want withheld)

Step 3: Claim Dependents

If your total income will be $200,000 or less ($400,000 or less if married filing jointly):

Number of qualifying children under the age of 17:

Total for children under 17

Multiply the number of qualifying children under the age of 17 by $2,000

Number of other dependents:

Total for other dependents

Multiply the number of other dependents by $500

3 Total Amount

Step 4 (optional): Other Adjustments

If your total income will be $200,000 or less ($400,000 or less if married filing jointly):

(a) Other income (not from jobs).

If you want tax withheld for other income you expect this year that won’t have withholding, enter the amount of other income here. This may include interest, dividends, and retirement income.

(b) Deductions.

If you expect to claim deductions other than the standard deduction and want to reduce your withholding, use the Deductions Worksheet on page 3 and enter the result here.

Enter any additional tax you want withheld each pay period.

Step 4(b)—Deductions Worksheet

If your total income will be $200,000 or less ($400,000 or less if married filing jointly):

1 Enter an estimate of your 2022 itemized deductions (from Schedule A (Form 1040)). Such deductions may include qualifying home mortgage interest, charitable contributions, state and local taxes (up to $10,000), and medical expenses in excess of 7.5% of your income

2 Select:

$25,900 if you're married filing jointly or qualifying widow(er)

$19,400 if you're head of household

$12,950 if you're single or married filing separately

If line 1 is greater than line 2, subtract line 2 from line 1 and enter the result here. If line 2 is greater than line 1, enter “-0-”

Enter an estimate of your student loan interest, deductible IRA contributions, and certain other adjustments (from Part II of Schedule 1 (Form 1040)). See Pub. 505 for more information

Add lines 3 and 4. Enter the result here and in Step 4(b) of Form W-4

WEST VIRGINIA EMPLOYEE’S WITHHOLDING EXEMPTION CERTIFICATE

If SINGLE, and you claim an exemption, enter “1”, if you do not, enter “0"

Please enter a number from 0 to 1.

If MARRIED, one exemption each for husband and wife if not claimed on another certificate.

Please enter a number from 0 to 2.

(a) If you claim both of these exemptions, enter “2”; (b) If you claim one of these exemptions, enter “1”; (c) If you claim neither of these exemptions, enter “0”

If you claim exemptions for one or more dependents, enter the number of such exemptions.

Please enter a number greater than or equal to 0.

Add the number of exemptions which you have claimed above and enter the total

If you are Single, Head of Household, or Married and your spouse does not work, and you are receiving wages from only one job, and you wish to have your tax withheld at a lower rate, check here

I wish to have my tax withheld at a lower rate.

Additional withholding per pay period under agreement with employer, enter amount here

DIRECT DEPOSIT AUTHORIZATION

Name of Bank

Account Number

9-Digit Routing #

Amount Withdrawn

Please include a dollar amount, percentage, or say "Entire Paycheck".

Type of Account:

Checking

Savings