Figure 1-A, Form W-4—Illustrated (John and Joyce Green)

• These items are completed in the Personal Allowances Worksheet
• A. Enter 1 for yourself if no one else can claim you as a dependent field contains 1
• C. Enter 1 for your spouse. But, you may choose to enter 0 if you are married and have either a working spouse or more than one job. (Entering 0 may help you avoid having too little tax withheld) field contains 1
• D. Enter number of dependents (other than your spouse or yourself) you will claim on your tax return field contains 2
• F. Enter 1 if you have at least $1,900 of child or dependent care expense for which you plan to claim a credit field contains 1
• G. Child Tax Credit (including additional child tax credit). See Pub. 972, Child Tax Credit, for more information. If your total income will be less than $61,000 ($90,000 if married), enter 2 for each eligible child; then less 1 if you have three or more eligible children. If your total income will be between $61,000 and $84,000 ($90,000 and $119,000 if married), enter 1 for each eligible child plus 1 additional if you have six or more eligible children field contains 4
• H. Add lines A through G and enter total here. (Note. This may be different from the number of exemptions you claim on your tax return.) field contains 9

• These items are completed on the Employee's Withholding Allowance Certificate
• 1. Type or print your first name and middle initial field contains John M.
• • Last name field contains Green
  • Home address (number and street or rural route) field contains 28 Fairway
  • City or town, state, and ZIP code field contains Anytown, State 00000
• 2. Your social security number field contains 444-00-4444
• 3. Married checkbox checked
• 5. Total number of allowances you are claiming (from line H above or from the applicable worksheet on page 2) field contains 8
• Employee's signature (Form is not valid unless you sign it.) field contains John M. Green
• Date field contains January 5, 2012

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