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EMPLOYEE’S WITHHOLDING ALLOWANCE CERTIFICATE
1. FIRST NAME AND MIDDLE INITIAL              LAST NAME                                                     2. TAXPAYER ID
   
HOME ADDRESS (NUMBER AND STREET OR RURAL ROUTE)                                                  3. MARITAL STATUS
CITY OR TOWN                                                                 STATE                                                                ZIP CODE
   
4
5

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

EMPLOYEE SIGNATURE (This form is not valid unless signed)
DATE
6. EMPLOYER’S NAME AND ADDRESS
7. FIRST DAY OF EMPLOYMENT                                                                  8. TAXPAYER ID (EMPLOYER IDENTIFICATION NUMBER)  

















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A Enter “1” for Yourself (2 if 60 years old or older) if no one else claims you as a dependent A
B Enter “1” for your Spouse (2 if 60 years old or older) if no one else claims your spouse as a dependent B
C Enter number of dependents other than your spouse that you will claim C
D Enter “1” if you qualify to take a child/dependent care credit for one child or dependent and “2” if you qualify to take the credit for two or more D
E Enter “1” if you are 65 or over OR blind. Enter “2” if you are both 65 or over AND blind E
F Enter “1” if your spouse is 65 or older OR blind. Enter “2” if your spouse is 65 or older AND blind. F
G Add Line A through Line F G

If you plan to itemize, or you receive non-wage income, or you can claim other deductions and wish to adjust your withholding, continue with Section H. Otherwise, STOP HERE and enter the number from Line G onto the Delaware Form W-4.

NOTE: Use this section only if you plan to itemize, claim other deductions, or have non-wage income. If computing this section on Married Filing Separate or Combined Separate status, include only the amount of itemized deductions that may be claimed on your separate return.

H – DEDUCTIONS AND INCOME ADJUSTMENTS

1 Enter an estimate of your itemized deductions for the current year,
i.e. home mortgage interest, real estate and other taxes (excluding state income tax paid) limited to $10,000,
charitable contributions, medical expenses in excess of 10% of adjusted gross income, and miscellaneous deductions
(most miscellaneous deductions are now deductible only in excess of 2% of your adjusted gross income).		 1
2 Delaware Standard Deduction ($3,250) 2
3 Subtract Line 2 from Line 1. If less than zero, enter 0. 3
4 Enter an estimate of your adjustments to income for the current year including alimony paid,
IRA contributions, the pension exclusion and the exclusion for certain persons over 60 years old or disabled 		4
5 Add Lines 3 and 4 5
6 Enter estimate of your non-wage income for the current year 6
7 Subtract Line 6 from Line 5 7
8 Divide the amount on Line 7 by $2,000 8
9 Enter the number from Line G above 9
10 Add Lines 8 and 9. Report this number of allowances to your employer on Delaware Form W-4. 10
I – SPECIAL INSTRUCTIONS
If the total on Line 10 is less than zero you may need additional withholding as a result of non-wage income to avoid owing tax on your income tax return. You can calculate the amount of additional withholding as follows:

Multiply number on Line 10 by $110

Divide the result by the number of pay periods during the year (e.g., if you are paid monthly, divide by 12); The result is the additional amount of withholding required per pay.

EXAMPLE: Total on Line 10 is “-2” and you are paid once a month.
You should notify your employer on a Delaware Form W-4 that your withholding allowance should be “0” and an additional $18.33 per pay should be withheld for the current year
(1) Line H = 2 x $110 = $220.00
(2) Number of pay periods = $220.00/12 = $18.33

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A Enter “1” for Yourself (2 if 60 years old or older) if no one else claims you as a dependent A
B Enter “1” for your Spouse (2 if 60 years old or older) if no one else claims your spouse as a dependent B
C Enter number of dependents other than your spouse that you will claim C
D Add Lines A through C D
INCOME AND ADJUSTMENTS

 Column B
TOTAL		 Column B
DELAWARE SOURCE
1 Wages 1 $
2 Non-wage Income (Net of Losses - See Instructions) 2 $
3 Total Income (Add Line 1 and Line 2) 3 $
4a Federal Adjustments to Income (See Instructions) 4a $
4b Delaware Adjustments to Income (See Instructions) 4b $
4c Total Adjustments to Income (Add Line 4a and Line 4b) 4c $
5 Adjusted Gross Income (Subtract Line 4c from Line 3) 5 $
6 PRORATION DECIMAL (Line 5: Column B ÷ Column A) 6
DEDUCTIONS
7 Deductions (Higher of Standard or Itemized - See Instructions) 7 $
8 Estimated Taxable Income (Subtract Line 7 from Line 5, Column A) 8 $
9 Gross Tax Liability (Computed using Line 8 - See Example Below) 9 $
10 Personal Credits (Multiply Line D by $110) 10 $
11 Net Liability before Proration (Subtract Line 10 from Line 9) 11 $
12 Proration Decimal (Enter from Line 6) 12
13 Estimated Tax Liability (Multiply Line 11 by Line 12) 13 $
14 Number of Pay Periods (From Employer or See Instructions) 14
15 Withholding per Pay Period (Divide Line 13 by Line 14) 15 $
Tax Table
Taxable Income Between Pay Plus On Amounts Over
$0 - 2,000 $0.00 0.00% $0
$2,001 - 5,001 $0.00 2.20% $2,000
$5,001 - 10,001 $66.00 3.90% $5,000
$10,001 - 20,001 $261.00 4.80% $10,000
$20,001 - 25,001 $741.00 5.20% $20,000
$25,001 - 60,001 $1,041.00 5.55% $25,000
$60,001 & over $2,943.50 6.60% $60,000
EXAMPLE OF GROSS TAX LIABILITY CALCULATION: If your Estimated Taxable Income (Line 8) is $12,000:

PAY: $261.00 + ((12,000 - 10,000) × 0.048)
= $261.00 + (2,000 × 0.048)
= $261.00 + 96.00
= $357.00
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