Government of the
District of Columbia
Enter Year

D-4 DC Withholding
Allowance Certificate

     
  
Home address (number and street)

1. Tax filing status Fill in only one:

2. Total number of withholding allowances from worksheet below.


Enter total from Sec. A, Line i
Enter total from Sec. B, Line n
Total number of withholding allowances from Line o

3. Additional amount, if any, you want withheld from each paycheck

$

4. Before claiming exemption from withholding, read below. If qualified, 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 certificate 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.

DC Seal

Government of the
District of Columbia

D-4 DC Withholding Allowance Worksheet

Section A   Number of withholding allowances

a
b
c
d
e
f
g
h
i

Section B   Additional withholding allowances

j
k
l
m
n
o
D-4 P1
DC Withholding Allowance Certificate         Revised 12/2013


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

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Who must file a Form D-4?

Every new employee who resides in DC and is required to have DC income taxes withheld, must fill out Form D-4 and file it with his/her employer.

If you are not liable for DC income taxes because you are a nonresident or military spouse, you must file Form D-4A, Certificate of Nonresidence in the District of Columbia, with your employer.

When should you file?

File Form D-4 whenever you start new employment. Once filed with your employer, it will remain in effect until you file a new certificate. You may file a new withholding allowance certificate any time the 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.


How many withholding allowances should you claim?

Use the worksheet on the front of this form to figure the number of withholding allowances you should claim. If you want less money withheld from your paycheck, you may claim additional allowances by completing Section B of the worksheet, Lines i through o. However, if you claim too many allowances, you may owe additional taxes at the end of the year.

Should I have an additional amount deducted from my paycheck?

In some instances, even if you claim zero withholding allowances, you may not have enough tax withheld. You may, upon agreement with your employer, have more tax withheld by entering on Line 3, a dollar amount of your choosing.

What to file

After completing Form D-4, detach the top portion and file it with your employer. Keep the bottom portion for your records.