Fillable 2022 Colorado Employee Withholding Certicate (Colorado DORA)

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2022 Colorado Employee Withholding Certicate (Colorado DORA)

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This Certificate Is Optional for Employees
If you do not complete this certificate, then your employer
will calculate your Colorado withholding based on your
IRS Form W-4. That calculation is designed to withhold
the required Colorado income tax due on your wages
throughout the year, and it will generally result in a refund
when you file your Colorado income tax return.
Reasons to Complete This Certificate
Complete this certificate if you want to adjust your Colorado
withholding for one or more of the following reasons:
1. You earn most of your income from one job,
2. You expect to claim federal itemized deductions and/
or the Colorado child tax credit, or
3. You expect significant income from other sources.
For most taxpayers, completing this certificate will likely
increase your take-home pay, reduce your Colorado
withholding, and reduce your refund when you file your
Colorado income tax return. Consider the amounts you
enter carefully. If too little is withheld, then you will owe
tax when you file your Colorado return, and you may
owe a penalty.
When to Complete a New Certificate
You may adjust your withholding at any time. Consider
completing a new certificate for the following reasons:
1. You last completed a certificate three or more years ago;
2. Your wages or other income changes significantly;
3. Your number of jobs changes;
4. Your expected filing status (single, married filing
jointly, etc.) changes;
5. Your expected federal deductions change significantly;
6. You have a new qualifying child for the child tax credit; or
7. You or your child will no longer qualify for the Colorado
child tax credit, including if your child will turn 6 years
old this year.
If You Complete This Certificate
1. Give it to your employer; then they must calculate your
Colorado withholding based on the amounts you entered.
2. If you (and your spouse, if filing jointly) have multiple
jobs, complete a separate certificate for each one.
3. In order to prevent evasion of Colorado income tax,
the Department of Revenue may review and adjust
your withholding.
2022 Colorado Employee Withholding Certicate
DR 0004 (11/05/21)
COLORADO DEPARTMENT OF REVENUE
Tax.Colorado.gov
1. Personal Information
Last Name First Name Middle Initial
Mailing Address SSN or ITIN
City State ZIP Code
2. Annual Withholding Allowance
a. If you want to reduce your Colorado withholding based on the federal standard deduction and your number of jobs,
enter the appropriate amount from Table 1 below. If you have multiple jobs but earn most of your income from one
job, complete Worksheet 1 instead and enter the result here.
b. If you also want to reduce your Colorado withholding based on the additional federal deductions and/or Colorado
child tax credit you expect to claim, complete Worksheet 1 and enter the result here.
If you want a greater amount withheld, you may enter a smaller amount than either calculation.
$
3. Additional Withholding Per Pay Period
Enter any additional tax you want withheld from each paycheck. If you expect to receive other
income that will not have withholding, you may complete Worksheet 2 and include the result here.
$
4. Sign Here. This form is not valid unless you sign this declaration: I declare that the amounts on this certificate have not
been presented to willfully evade Colorado income tax or obstruct its collection.
Employee Signature Date (MM/DD/YY)
Table 1: Standard Allowance
Go down the first column to your expected filing status from IRS Form W-4 Step 1(c).
Then go across that row to the column with the number of jobs that you (and your spouse, if filing jointly) currently have.
Filing Status from IRS Form W-4 Step 1(c)
Standard Allowance for:
1 Job 2 Jobs 3 Jobs 4 or More Jobs
Single or Married Filing Separately
$10,500 $5,000 $3,500 $2,500
Head of Household
$16,500 $8,500 $5,500 $4,000
Married Filing Jointly or Qualifying Widow(er)
$23,000 $11,500 $7,500 $5,500
DR 0004 (11/05/21)
COLORADO DEPARTMENT OF REVENUE
Tax.Colorado.gov
Worksheet 1: Withholding Allowance
This worksheet is optional. You may complete the
Colorado Employee Withholding Certificate without
completing this worksheet. Complete this worksheet only
if you want to adjust your Colorado withholding for one or
both of the following reasons:
1. You expect to claim additional federal deductions and/
or the Colorado child tax credit; or
2. You (and your spouse, if filing jointly) have multiple jobs
but earn more income from one job.
To use the electronic DR 0004 Withholding Calculator, go
to Tax.Colorado.gov/Withholding-Forms.
You (and your spouse, if filing jointly) only need to complete
this worksheet once regardless of your number of jobs.
However, you will need to give a separate Colorado
Employee Withholding Certificate to each of your employers.
Do not give this worksheet to your employers.
For more information about itemized deductions, see IRS
Topic No. 501. For more information about qualifying for the
child tax credit, see IRS Publication 972. Please note that
the Colorado child tax credit is allowed for qualifying children
who do not have a work-eligible social security number.
1. Enter the amount of income you (and your spouse, if filing jointly) expect to receive this year
from all sources.
$
2. Enter your Standard Allowance, based on your expected filing status from IRS Form W-4 Step 1(c):
a. $10,500 if single or married filing separately;
b. $16,500 if head of household; or
c. $23,000 if married filing jointly or qualifying widow(er).
$
3. Enter the amount from IRS Form W-4 Step 4(b), if any, which is your estimated federal
deductions that exceed the standard deduction.
$
4. Enter your Child Tax Credit Allowance from Table 2 below.
$
If you do not want to reduce your withholding for the Colorado child tax credit, you may enter
zero on this line, even if you expect to claim the credit.
5. Add Lines 2, 3, and 4. This is your Total Withholding Allowance. $
6. Enter the number of jobs that you (and your spouse, if filing jointly) currently have.
7. Divide Line 5 by Line 6. This is your Annual Withholding Allowance for each job.
$
a. If you (and your spouse, if filing jointly) have multiple jobs but earn most of your income from one job, you may want
to divide the Total Withholding Allowance on Line 5 unevenly between your jobs. For example, if you earn 75% of
your income from one job, you could use 75% of Line 5 for that job and the remaining 25% of Line 5 for your other
job(s). If you choose to divide Line 5 unevenly, you will need to complete a separate Colorado Employee Withholding
Certificate for each job.
b. If you want a greater amount withheld, you may enter a smaller amount than your calculation.
Enter the amount you choose on Line 2 of your Colorado Employee Withholding Certificate.
Table 2: Child Tax Credit Allowance
Go down the first column to your expected filing status from IRS Form W-4 Step 1(c).
Then select the corresponding row in the second column with your expected income from Line 1 of Worksheet 1.
Finally, go across that row to the column with your number of qualifying children.
Filing Status from IRS
Form W-4 Step 1(c)
Income from Line 1
of Worksheet 1
Allowance for Qualifying Children Under Age 6 on December 31 of this year:
1 Child 2 Children 3 or More Children
Single, Married Filing
Separately, or Head of
Household
$0 - $25,000 $9,000 $13,000 $11,500
$25,001 - $50,000 $7,000 $13,000 $17,000
$50,001 - $75,000 $2,500 $5,000 $7,000
$75,001 or more $0 $0 $0
Married Filing Jointly or
Qualifying Widow(er)
$0 - $35,000 $10,000 $17,500 $20,000
$35,001 - $60,000 $7,000 $14,000 $19,000
$60,001 - $85,000 $2,500 $5,000 $7,000
$85,001 or more $0 $0 $0
DR 0004 (11/05/21)
COLORADO DEPARTMENT OF REVENUE
Tax.Colorado.gov
Worksheet 2: Additional Withholding
This worksheet is optional. You may complete the Colorado
Employee Withholding Certificate without completing this
worksheet. Complete this worksheet only if you would like
to calculate additional wage withholding to cover other
types of taxable income that you (and your spouse, if filing
jointly) expect to receive this year. This may include interest,
dividends, retirement income, rental income, or income from
self-employment or as an independent contractor.
To use the electronic DR 0004 Withholding Calculator, go to
Tax.Colorado.gov/Withholding-Forms.
Complete a separate copy of this worksheet for each job to
which you would like to add withholding. Do not give this
worksheet to your employer.
Alternatively, you may use form DR 0104EP to submit
estimated tax payments for any non-wage income that
you receive. If you do not ensure that you have enough
withholding and estimated tax payments, then you will owe
tax when you file your return, and you may owe a penalty.
For more information about withholding and estimated tax
payments, see parts 6 and 7 of the Colorado Individual
Income Tax Guide.
For more information about taxable and nontaxable income,
see IRS Publication 525. For information about the Colorado
pension and annuity subtraction, go to Tax.Colorado.gov/
Individual-Income-Tax-Guidance-Publications.
1. Enter the amount from IRS Form W-4 Step 4(a), which is your estimated non-business
income for this year.
$
2. Enter any other non-wage income that you (and your spouse, if filing jointly) expect to
receive this year, but is not included in the amount from IRS Form W-4 Step 4(a). This may
include income from self-employment or as an independent contractor.
$
3. Add Lines 1 and 2. This is your Total Additional Income. $
4. Multiply Line 3 by 4.55% (0.0455). This is your Total Additional Withholding. $
5. Divide Line 4 by the number of jobs to which you would like to add withholding. This is your
Additional Withholding Per Job. $
6. Divide Line 5 by the number of pay periods during the year for this job (see Table 3 below).
This is your Additional Withholding Per Pay Period.
$
Enter this amount on Line 3 of your Colorado Employee Withholding Certificate.
Table 3: Pay Periods During the Year
Semimonthly means twice a month, usually on the 15th and 30th.
Biweekly means every other week, usually on Fridays, regardless of the month.
Annually Semiannually Quarterly Monthly Semimonthly Biweekly Weekly Daily
1 2 4 12 24 26 52 260
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2022 Colorado Employee Withholding Certicate (Colorado DORA)

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Completed 4 January 2022

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