(a) Your spouse for whom you have been claiming an
exemption is divorced or legally separated from you, or claims
his or her own exemption on a separate certicate, or
(b) The support you provide to a dependent for whom you claimed
an exemption is expected to be less than half of the total support for the year.
OTHER DECREASES in exemptions or dependents, such as the death of a
spouse or a dependent, does not affect your withholding until next year, but
requires the ling of a new certicate by December 1 of the year in which
they occur.
You may claim additional amounts of withholding tax if desired. This will
apply most often when you have income other than wages.
You qualify for the low income tax rates if your total income from all
sources is:
(a) Single $10,941 to $14,400
(b) Married Filing Jointly $18,449 to $22,900
(1 or less dependents)
(c) Married Filing Jointly $22,203 to $28,700
(2 or more dependents)
(d) Head of Household/Qualifying Widow(er) $15,553 to $20,200
(1 or less dependents)
(e) Head of Household/Qualifying Widow(er) $18,540 to $22,900
(2 or more dependents)
STATE OF ARKANSAS
Employee’s Withholding Exemption Certicate
AR4EC
Arkansas :LWKKROGLQJ Tax Section
P. O. Box 8055
Little Rock,
Arkansas 72203-8055
Print Full Name ________________________________________________ Social Security Number ____________________________________
Print Home Address _____________________________________________ City _____________________________State _____ Zip _________
Employee:
File this form with
your employer.
Otherwise, your
employer must
withhold state
income tax from
your wages without
exemptions or
dependents.
Employer:
Keep this certicate
with your records.
How to Claim Your Withholding
See instructions below
1. CHECK ONE OF THE FOLLOWING FOR EXEMPTIONS CLAIMED
a. You claim yourself. (Enter one exemption) ......................................................................1a
b. You claim yourself and your spouse. (Enter two exemptions) .........................................1b
c. Head of Household, and you claim yourself. (Enter two exemptions) .............................1c
2. NUMBER OF CHILDREN or DEPENDENTS. (Enter one exemption per dependent) ................. 2
3. TOTAL EXEMPTIONS. (Add Lines 1a, b, c, and 2)
If no exemptions or dependents are claimed, enter zero .............................................................. 3
4. Additional amount, if any, you want deducted from each paycheck. (Enter dollar amount) ......... 4
5. I qualify for the low income tax rates. (See below for details) ....................................................... 5
Please check ling status: Single Married Filing Jointly Head of Household
I certify that the number of exemptions and dependents claimed on this certicate does not exceed the number to which I am entitled.
Signature: ______________________________________________________________________________________Date: _________________
For additional information consult your employer or write to:
Number of Exemptions
Claimed
Yes No
TYPES OF INCOME - This form can be used for withholding on all types
of income, including pensions and annuities.
NUMBER OF EXEMPTIONS – (Husband and/or Wife) Do not claim more
than the correct number of exemptions. However, if you expect to owe more
income tax for the year, you may increase your withholding by claiming a
smaller number of exemptions and/or dependents, or you may enter into an
agreement with your employer to have additional amounts withheld. This is
especially important if you have more than one employer, or if both husband
and wife are employed.
DEPENDENTS – To qualify as your dependent (line 2 of form), a person
must (a) receive more than 1/2 of their support from you for the year, (b)
not be claimed as a dependent by such person’s spouse, (c) be a citizen
or resident of the United States, and (d) have your home as their principal
residence and be a member of your household for the entire year or be
related to you as follows: son, daughter, grandchild, stepson, stepdaughter,
son-in-law or daughter-in-law; your father, mother, grandparent, stepfather,
stepmother, father-in-law or mother-in-law; your brother, sister, stepbrother,
stepsister, half brother, half sister, brother-in-law or sister-in-law; your uncle,
aunt, nephew or niece (but only if related by blood).
CHANGES IN EXEMPTIONS OR DEPENDENTS – You may le
a new certicate at any time if the number of exemptions or dependents
INCREASES. You must le a new certicate within 10 days if the number
of exemptions or dependents previously claimed by you DECREASES for
any of the following reasons:
Instructions
AR4EC (R 012/29/11)
