LONG BEACH UNIFIED SCHOOL DISTRICT,
1515 HUGHES WAY, LONG BEACH, CA 90810
EMPLOYEE’S WITHHOLDING ALLOWANCE CERTIFICATE
Federal and State
(This Certificate is for income tax withholding purposes only.)
Employer’s Federal ID #95-6001886
State ID #800-9069-9
Your withholding is subject to
review by the IRS.
(a) First name and middle initial
(b) Social security number
Does your name match the name on
your social security card? If not, to ensure
you get credit for your earnings, contact SSA
at 800-772-1213 or go to
City or town, state, and ZIP code
(c) Single or Married filing separately
Married filing jointly (or Qualifying widow(er))
Head of household (Check only if you’re unmarried and pay more than half the costs of keeping up a home for yourself and a qualifying individual.)
Complete Steps 2–4 ONLY if they apply to you; otherwise, skip to Step 5. See page 2 for more information on each step, who can claim exemption from
withholding, when to use the online estimator, and privacy.
Multiple Jobs or
Complete this step if you (1) hold more than one job at a time, or (2) are married filing jointly and your spouse also works.
The correct amount of withholding depends on income earned from all of these jobs.
Do only one of the following.
Use the estimator at www.irs.gov/W4App for most accurate withholding for this step (and Steps 3–4); or
Use the Multiple Jobs Worksheet on page 3 and enter the result in Step 4(c) below for roughly accurate withholding; or
If there are only two jobs total, you may check this box. Do the same on Form W-4 for the other job. This option
accurate for jobs with similar pay; otherwise, more tax than necessary may be withheld . . . . .
TIP: To be accurate, submit a 2020 Form W-4 for all other jobs. If you (or your spouse) have self-employment income,
including as an independent contractor, use the estimator.
Complete Steps 3–4(b) on Form W-4 for only ONE of these jobs. Leave those steps blank for the other jobs. (Your withholding will be most
accurate if you complete Steps 3–4(b) on the Form W-4 for the highest paying job.)
If your income will be $200,000 or less ($400,000 or less if married filing jointly):
Multiply the number of qualifying children under age 17 by $2,000
Multiply the number of other dependents by $500 . . . . .
Add the amounts above and enter the total here . . . . . . . . . . . . . . . . . . . . . . .
Other income (not from jobs). If you want tax withheld for other income you expect
this year that won’t
have withholding, enter the amount of other income here. This may
include interest, dividends, and retirement
income . . . . . . . . . . . . . . . .
b) Deductions. If you expect to claim deductions o
ther than the standard deduction and want to reduce
your withholding, use the Deductions Worksheet on page 3 and enter the result here . . . . . . . .
c) Extra withholding. Enter any additional
tax you want withheld each pay period.
To claim exemption from withholding, I certify that I meet both of the conditions stated under “Exemption from
withholding” on page 2 of the General Instructions. Write “Exempt” under 4(c).
Employee’s Withholding Allowance Certificate
State of California
Filing Status Withholding Allowances for the State of California only
SINGLE or MARRIED (with two or more incomes)
MARRIED (one income)
HEAD OF HOUSEHOLD
Total Number of allowances you're claiming (Use Work
sheet A for regular withholding allowances. Use other
worksheets on the following pages as applicable. Worksheet A+B).
Additional amount, if any, you want withheld each pay period (if employer agrees), (Worksheet B and C)
Exemption from Withholding
I claim exemption from withholding for 2020, and I certify I meet both of the conditions of exemption.
Under the penalties of perjury, I declare that this certificate, to the best of my knowledge and belief, is true, correct and
complete. I further certify that the number of withholding allowances claimed on this certificate does not exceed the number to
which I am entitled or, if claiming exemption from withholding, that I am entitled to claim the exempt status.
(This form is not valid unless you sign it.)
Form W-4 (2020)
Write "Exempt" here
I certify under penalty of perjury that I am not subject to California withholding. I meet the conditions set forth under
the Service Member Civil Relief Act, as amended by the Military Spouses Residency Relief Act and the Veterans
Benefits and Transition Act of 2018.