Employee’s Withholding Certificate

(OMB No. 1545-0074

com W=4

Complete Form W-4 so that your employer can withhold the correct federal income tax from your pay.

Give Form W-6 to your employer.

2026

Intemal Revenue Service

Department ofthe Treasury

Your withholding is subject to review by the IRS.

(a) First name and middie inital

Lastname

1) Social security number

Step 1

Enter

Raaress

Does your name match the

Personal

‘name on your social security

Information

1rd? If nt, to ensure you get

City oF town, state, and ZIP code

credit for your earings,

‘contact SSA at 800-772-1213

(0F go to wwn.ssa.gov.

©)

single or Married filing separately

Ci Married fiting jointly or Qualifying surviving spouse

(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.)

‘Caution: To claim certain credits or deductions on your tax return, you (and/or your spouse if married fling jointly) are required to have a social security

‘number valid for employment. See page 2 for more information,

TIP: Consider using the estimator at www.irs.gov/W4App to determine the most accurate withholding for the rest of the year if you

are completing this form after the beginning of the year; expect to work only part of the year; or have changes during the year in your

marital status, number of jobs for you (and/or your spouse if married filing jointly), dependents, other income (not from jobs),

deductions, or credits. Have your most recent pay stub\s) from this year available when using the estimator. At the beginning of next

year, use the estimator again to recheck your withholding.

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

el

‘exemption from withholding, and when to use the estimator at www.irs.gov/W4App.

Step 2:

Complete this step if you (1) hold more than one job at a time, or (2) are married filing jointly and your spouse

Multiple Jobs

also works. The correct amount of withholding depends on income eared from all of these jobs.

or Spouse

Do only one of the following,

Works

{a) Use the estimator at www.irs.gov/W4App for the most accurate withholding for this step (and Steps 3-4). If

you or your spouse have self-employment income, use this option; or

(b) Use the Multiple Jobs Worksheet on page 3 and enter the result in Step 4(c) below; 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 generally more accurate than Step 2(b) if pay at the lower paying job is more than half of the pay at

the higher paying job. Otherwise, Step 2(b) is more accurate

Complete Steps 3-4(b) on Form W-4 for only ONE of these jobs. Leave those steps blank for the other jobs. (Your withholding will

be most accurate if you complete Steps 3-4(b) on the Form W-4 for the highest paying job.)

Step 3:

If your total income will be $200,000 or less ($400,000 or less if

Claim

married

1g jointly):

Dependent

{a) Multiply the number of qualifying children under age 17 by

and Other

$2,200 .

3(a) |$

(6) Muttiply the number of other dependents by $500

3(b) |S

Credits

‘Add the amounts from Steps 3(a) and 3(b), plus the amount for other credits. Enter the

total here

3 /$

Step 4:

(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.

Other

Adjustments

This may include interest, dividends, and retirement income

ata) |s

(b) Deductions. Use the Deductions Worksheet on page 4 to determine the amount of

deductions you may claim, which will reduce your withholding. (If you skip this line,

your withholding will be based on the standard deduction.) Enter the result here

4(b) |S.

(c) Extra withholding. Enter any additional tax you want withheld each pay period

Alc) |$

Exempt from

claim exemption from withholding for 2026, and | certify that | meet both of the conditions for exemption for

withholding

2026. See Exemption from withholding on page 2. | understand | will need to submit a new Form W-4 for 2027

Qa

Step 5:

Under penalties of perjury, | declare that this certificate, to the best of my knowledge and belief, is true, correct, and complete.

Sign

Here

Employee’s signature (This form is not valid unless you sign it)

Date

Employers

Employer's name and address

First date of

Employer identification

‘employment

‘number (EIN)

Only

For Privacy Act and Paperwork Reduction Act Notice, see page 4.

‘Cat. No. 102200

Form W-4 (2026) Created 12/8/25