Summary: This is an example of Form W-4 (2011), page 2 with items
included as described in the text.

- These items are completed in the Deductions and Adjustments Worksheet.
1. Enter an estimate of your 2011 itemized deductions. These include qualifying home mortgage interest, charitable contributions, state and local taxes, medical expenses in excess of 7.5% of your income, and miscellaneous deductions. (For 2010, you may have to reduce your itemized deductions if you income is over $166,800 ($83,400 if married filing separately). See Worksheet 2 in Pub. 919 for details.)

field contains 12,800 -
2. Enter $11,600 if married filing jointly or qualifying widow or widower, $8,500 if head of household, $5,800 if single or married filing separately

field contains 11,600 -
3. Subtract line 2 from line 1. If zero or less, enter 0

field contains 1,200 -
4. Enter an estimate of your 2011 adjustments to income and any additional standard deduction. (Pub 919)

field contains 4,000 -
5. Add lines 3 and 4 and enter the total. (Include any amount for credits from the Converting Credits to Withholding Allowances for 2011 Form W-4 Worksheet in Pub. 919.)

field contains 5,200 -
6. Enter an estimate of your 2011 nonwage income (such as dividends or interest)

field contains 600 -
7. Subtract line 6 from line 5. If zero or less, enter 0

field contains 4,600 -
8. Divide the amount on line 7 by 3,700 and enter the result here. Drop any fraction

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9. Enter the number from the Personal Allowances Worksheet, line H, page 1

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10. Add lines 8 and 9 and enter the total here. If you plan to use the Two Earner/Multiple Jobs Worksheet, also enter this total on line 1 below. Otherwise, stop here and enter this total on Form W-4, line 5, page 1

field contains 10

- These items are completed in the Two Earners/Multiple Jobs Worksheet.
1. Enter the number from line H, page 1 (or from line 10 above if you used the Deductions and Adjustments Worksheet)

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2. Find the number in Table 1 below that applies to the LOWEST paying job and enter it here. However, if you are married filing jointly and wages from the highest paying job are $65,000 or less, do not enter more than 3

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3. If line 1 is more than or equal to line 2, subtract line 2 from line 1. Enter the result here (if zero, enter 0) and on Form W-4, line 5, page 1. Do not use the rest of this worksheet

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