Fillable EMPLOYEE PERSONAL DATA SHEET (East Central College)

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EMPLOYEE PERSONAL DATA SHEET (East Central College)

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  • 14 check-boxes
  • 58 other fields

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EMPLOYEE PERSONAL DATA SHEET
Revised 9.7.17
HR USE ONLY: Colleague: Benefits
New Employee
Change of Information
Annual Update
Note: This form replaces all preceding forms. Please complete all sections prior to submitting to Human Resources.
PERSONAL INFORMATION
Last Name: First Name: MI:
Address:
City: State: Zip:
Phone # Alternate Phone #
Personal Email Address:
EMERGENCY INFORMATION: In case of an emergency, please contact the following individuals:
First Contact Name: Phone #
Relationship:
Second Contact Name: Phone #
Relationship:
THIS BELOW SECTION IS VOLUNTARY
EMPLOYEE SIGNATURE: DATE:
For EO Compliance & IPEDS Reporting Family Information:
RACE/ETHNICITY Spouse Name:
Hispanic / Latino Child(ren) Name(s):
American Indian or Alaskan Native
Asian
Black or African American
Native Hawaiian or Other Pacific Islander
White
Two or More Races
Race & Ethnicity Unknown
GENDER
Male
Female
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USCIS
Form I-9
OMB No. 1615-0047
Expires 08/31/2019
Employment Eligibility Verification
Department of Homeland Security
U.S. Citizenship and Immigration Services
Form I-9 07/17/17 N
Page 1 of 3
►START HERE: Read instructions carefully before completing this form. The instructions must be available, either in paper or electronically,
during completion of this form.
Employers are liable for errors in the completion of this form.
ANTI-DISCRIMINATION NOTICE: It is illegal to discriminate against work-authorized individuals. Employers CANNOT specify which
document(s) an employee may present to establish employment authorization and identity. The refusal to hire or continue to employ
an individual because the documentation presented has a future expiration date may also constitute illegal discrimination.
Section 1. Employee Information and Attestation (Employees must complete and sign Section 1 of Form I-9 no later
than the first day of employment, but not before accepting a job offer.)
Last Name (Family Name) First Name (Given Name)
Middle Initial
Other Last Names Used (if any)
Address (Street Number and Name)
Apt. Number City or Town
State
ZIP Code
Date of Birth (mm/dd/yyyy)
U.S. Social Security Number
-
-
Employee's E-mail Address
Employee's Telephone Number
I am aware that federal law provides for imprisonment and/or fines for false statements or use of false documents in
connection with the completion of this form.
I attest, under penalty of perjury, that I am (check one of the following boxes):
1. A citizen of the United States
2. A noncitizen national of the United States (See instructions)
3. A lawful permanent resident
4. An alien authorized to work until
(See instructions)
(expiration date, if applicable, mm/dd/yyyy):
(Alien Registration Number/USCIS Number):
Some aliens may write "N/A" in the expiration date field.
Aliens authorized to work must provide only one of the following document numbers to complete Form I-9:
An Alien Registration Number/USCIS Number OR Form I-94 Admission Number OR Foreign Passport Number.
1. Alien Registration Number/USCIS Number:
2. Form I-94 Admission Number:
3. Foreign Passport Number:
Country of Issuance:
OR
OR
QR Code - Section 1
Do Not Write In This Space
Signature of Employee
Today's Date (mm/dd/yyyy)
Preparer and/or Translator Certification (check one):
I did not use a preparer or translator. A preparer(s) and/or translator(s) assisted the employee in completing Section 1.
(Fields below must be completed and signed when preparers and/or translators assist an employee in completing Section 1.)
I attest, under penalty of perjury, that I have assisted in the completion of Section 1 of this form and that to the best of my
knowledge the information is true and correct.
Signature of Preparer or Translator
Today's Date (mm/dd/yyyy)
Last Name (Family Name) First Name (Given Name)
Address (Street Number and Name)
City or Town
State
ZIP Code
Employer Completes Next Page
Form I-9 07/17/17 N
Page 2 of 3
USCIS
Form I-9
OMB No. 1615-0047
Expires 08/31/2019
Employment Eligibility Verification
Department of Homeland Security
U.S. Citizenship and Immigration Services
Section 2. Employer or Authorized Representative Review and Verification
(Employers or their authorized representative must complete and sign Section 2 within 3 business days of the employee's first day of employment. You
must physically examine one document from List A OR a combination of one document from List B and one document from List C as listed on the "Lists
of Acceptable Documents.")
Last Name (Family Name) M.I.First Name (Given Name)
Employee Info from Section 1
Citizenship/Immigration Status
List A
Identity and Employment Authorization
Identity
Employment Authorization
OR List B AND List C
Additional Information
QR Code - Sections 2 & 3
Do Not Write In This Space
Document Title
Issuing Authority
Document Number
Expiration Date (if any)(mm/dd/yyyy)
Document Title
Issuing Authority
Document Number
Expiration Date (if any)(mm/dd/yyyy)
Document Title
Issuing Authority
Document Number
Expiration Date (if any)(mm/dd/yyyy)
Document Title
Issuing Authority
Document Number
Expiration Date (if any)(mm/dd/yyyy)
Document Title
Issuing Authority
Document Number
Expiration Date (if any)(mm/dd/yyyy)
Certification: I attest, under penalty of perjury, that (1) I have examined the document(s) presented by the above-named employee,
(2) the above-listed document(s) appear to be genuine and to relate to the employee named, and (3) to the best of my knowledge the
employee is authorized to work in the United States.
The employee's first day of employment (mm/dd/yyyy):
(See instructions for exemptions)
Signature of Employer or Authorized Representative
Today's Date (mm/dd/yyyy)
Title of Employer or Authorized Representative
Last Name of Employer or Authorized Representative First Name of Employer or Authorized Representative
Employer's Business or Organization Name
Employer's Business or Organization Address (Street Number and Name)
City or Town
State
ZIP Code
Section 3. Reverification and Rehires (To be completed and signed by employer or authorized representative.)
A. New Name (if applicable)
Last Name (Family Name)
First Name (Given Name) Middle Initial
B. Date of Rehire (if applicable)
Date (mm/dd/yyyy)
Document Title Document Number
Expiration Date (if any) (mm/dd/yyyy)
C. If the employee's previous grant of employment authorization has expired, provide the information for the document or receipt that establishes
continuing employment authorization in the space provided below.
I attest, under penalty of perjury, that to the best of my knowledge, this employee is authorized to work in the United States, and if
the employee presented document(s), the document(s) I have examined appear to be genuine and to relate to the individual.
Signature of Employer or Authorized Representative
Today's Date (mm/dd/yyyy)
Name of Employer or Authorized Representative
LISTS OF ACCEPTABLE DOCUMENTS
All documents must be UNEXPIRED
Employees may present one selection from List A
or a combination of one selection from List B and one selection from List C.
LIST A
2. Permanent Resident Card or Alien
Registration Receipt Card (Form I-551)
1. U.S. Passport or U.S. Passport Card
3. Foreign passport that contains a
temporary I-551 stamp or temporary
I-551 printed notation on a machine-
readable immigrant visa
4. Employment Authorization Document
that contains a photograph (Form
I-766)
5. For a nonimmigrant alien authorized
to work for a specific employer
because of his or her status:
Documents that Establish
Both Identity and
Employment Authorization
6. Passport from the Federated States of
Micronesia (FSM) or the Republic of
the Marshall Islands (RMI) with Form
I-94 or Form I-94A indicating
nonimmigrant admission under the
Compact of Free Association Between
the United States and the FSM or RMI
b. Form I-94 or Form I-94A that has
the following:
(1) The same name as the passport;
and
(2) An endorsement of the alien's
nonimmigrant status as long as
that period of endorsement has
not yet expired and the
proposed employment is not in
conflict with any restrictions or
limitations identified on the form.
a. Foreign passport; and
For persons under age 18 who are
unable to present a document
listed above:
1. Driver's license or ID card issued by a
State or outlying possession of the
United States provided it contains a
photograph or information such as
name, date of birth, gender, height, eye
color, and address
9. Driver's license issued by a Canadian
government authority
3. School ID card with a photograph
6. Military dependent's ID card
7. U.S. Coast Guard Merchant Mariner
Card
8. Native American tribal document
10. School record or report card
11. Clinic, doctor, or hospital record
12. Day-care or nursery school record
2. ID card issued by federal, state or local
government agencies or entities,
provided it contains a photograph or
information such as name, date of birth,
gender, height, eye color, and address
4. Voter's registration card
5. U.S. Military card or draft record
Documents that Establish
Identity
LIST B
OR AND
LIST C
7. Employment authorization
document issued by the
Department of Homeland Security
1. A Social Security Account Number
card, unless the card
includes one of
the following restrictions:
2. Certification of report of birth issued
by the Department of State (Forms
DS-1350, FS-545, FS-240)
3. Original or certified copy of birth
certificate issued by a State,
county, municipal authority, or
territory of the United States
bearing an official seal
4. Native American tribal document
6. Identification Card for Use of
Resident Citizen in the United
States (Form I-179)
Documents that Establish
Employment Authorization
5. U.S. Citizen ID Card (Form I-197)
(2) VALID FOR WORK ONLY WITH
INS AUTHORIZATION
(3) VALID FOR WORK ONLY WITH
DHS AUTHORIZATION
(1) NOT VALID FOR EMPLOYMENT
Page 3 of 3
Form I-9 07/17/17 N
Examples of many of these documents appear in Part 13 of the Handbook for Employers (M-274).
Refer to the instructions for more information about acceptable receipts.
Updated 12/12/2012
AUTHORIZATION AGREEMENT OF AUTOMATIC PAYROLL DEPOSIT
East Central College offers direct deposit into multiple institutions. A voided check for your
selected account(s) must be attached to this form:*
I hereby authorize East Central College to initiate direct deposit for account(s) listed below:
Employee Name (Please Type or Print): ________________________________________
Name of Financial Institution #1: _________________________________________
Institutional Routing Number: _________________________________________
Institutional Account Number : _________________________________________
Please check account type: CHECKING SAVINGS
Amount to be dispersed: $____________
Employee Name (Please Type or Print): ________________________________________
Name of Financial Institution #2: _________________________________________
Institutional Routing Number: _________________________________________
Institutional Account Number : _________________________________________
Please check account type: CHECKING SAVINGS
Amount to be dispersed: $____________
*Please note: The first paycheck after setting up and/or changing automatic deposit, will be an actual check to
be picked up at the Cashier’s window located on the first floor of Buescher Hall.
**I understand that I will not receive a printed copy of my pay advices. I will have access to all my pay advices
through my eCentral account.
This authorization will remain in force until a written notification is received from the employee to change
or cancel the signed agreement.
Employee’s Signature: _________________________________________ Date: ________________
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1. Filing Status: Check the appropriate filling status below.
r Single or Married Spouse Works or Married Filing Separate r Married (Spouse does not work)
r Head of Household
2. Additional withholding: If you expect to have a balance due (as a result of interest income, dividends, income from a
part-time job, etc.) on your tax return, you may request your employer to withhold an additional amount of tax from each
pay period. To calculate the amount needed, divide the amount of the expected tax by the number of pay periods in a
year. Enter the additional amount to be withheld each pay period on line 2..................................... 2
3.
Reduced withholding: If
you expect to receive a refund (as a result of itemized deductions, modifications or tax credits)
on your tax return, you may direct your employer to only withhold the amount indicated on line 3. Your employer
will not use the standard calculations for withholding.
If you designate an amount that is too low, it could result in you
being under withheld. To calculate the amount needed, divide the amount of your expected tax by the number of pay
periods in a year. Enter the amount to be withheld instead of the standard calculation. If no amount is indicated on
line 3, the standard calculations will be used............................................................. 3
4. Exempt Status: Select the appropriate reason you are claiming an exemption from withholding below and indicate
EXEMPT on line 4. ................................................................................ 4
r I am exempt because I had a right to a refund of all Missouri income tax withheld last year and expect to have no tax liability
this year. A new MO W-4 must be completed annually if you wish to continue the exemption.
r I am exempt because I meet the conditions set forth under the Servicemember Civil Relief Act, as amended by the
Military Spouses Residency Relief Act and have no Missouri tax liability.
r I am exempt because my income is earned as a member of any active duty component of the Armed Forces of the
United States and I am eligible for the military income deduction.
This certificate is for income tax withholding and child support enforcement purposes only. Type or print.
Notice To Employer:
Within 20 days of hiring a new employee, send a copy of Form MO W-4 to the Missouri Department of Revenue, P.O. Box 3340, Jefferson City, MO
65105-3340 or fax to (573) 526-8079.
Please visit http://dss.mo.gov/child-support/employers/new-hire-reporting.htm for additional information regarding new hire reporting.
Notice to Employee:
Return completed form to your Employer. Consider completing a new Form MO W-4 each year and when your personal or financial situation changes.
Visit our online withholding calculator https://mytax.mo.gov/rptp/portal/home/withholding-calculator.
Items to Remember:
• Employees must complete a new form if their filing status changes or to adjust the amount of withholding.
• If you are claiming an “Exempt” status due to the Military Spouses Residency Relief Act you must provide one of the following to your employer: Leave
and Earnings Statement of the non-resident military servicemember, Form W-2 issued to the nonresident military servicemember, a military
identification card, or specific military orders received by the servicemember. You must also provide verification of residency such as a copy of
your state income tax return filed in your state of residence, a property tax receipt from the state of residence, a current drivers license, vehicle
registration or voter ID card. For additional assistance in regard to Military, visit the department’s website https://dor.mo.gov/military/.
• Additional information can be found at https://dor.mo.gov/business/withhold/.
EmployeeEmployer
Employer’s Name Employer’s Address
City State ZIP Code
Date Services for Pay First Performed by Employee (MM/DD/YYYY) Federal Employer I.D. Number Missouri Tax Identification Number
| | | | | | | | | | | | | | |
__ __ / __ __ / __ __ __ __
Full Name Social Security Number
Home Address (Number and Street or Rural Route) City or Town State ZIP Code
Under penalties of perjury, I certify that the information provided on this form is true and accurate.
Signature
Employee’s Signature (Form is not valid unless you sign it) Date (MM/DD/YYYY)
__ __ / __ __ / __ __ __ __
Mail to: Taxation Division Phone: (573) 522-0967
P.O. Box 3340 Fax: (573) 526-8079
Jefferson City, MO 65105-3340
Form MO W-4 (Revised12-2019)
Form
MO W-4
Employee’s Withholding Certificate
Reset Form
Print Form
Form
W-4
Department of the
Treasury
Internal Revenue Service
Employee’s Withholding Certificate
▶
Complete Form W-4 so that your employer can withhold the correct federal income tax from your pay.
▶
Give Form W-4 to your employer.
▶
Your withholding is subject to review by the IRS.
OMB No. 1545-0074
2020
Step 1:
Enter
Personal
Information
(a) First name and middle initial
Last name
(b) Social security number
Address
▶
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
www.ssa.gov.
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.
Step 2:
Multiple Jobs
or Spouse
Works
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.
(a)
Use the estimator at www.irs.gov/W4App for most accurate withholding for this step (and Steps 3–4); or
(b)
Use the Multiple Jobs Worksheet on page 3 and enter the result in Step 4(c) below for roughly accurate withholding; or
(c)
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
is 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.)
Step 3: If your income will be $200,000 or less ($400,000 or less if married filing jointly):
Claim
Dependents
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 . . . . . . . . . . . . .
3
$
Step 4
(a) Other income (not from jobs). If you want tax withheld for other income you expect
(optional):
this year that won’t have withholding, enter the amount of other income here. This may
Other
include interest, dividends, and retirement income . . . . . . . . . . . .
Adjustments
(b)
Deductions. If you expect to claim deductions other 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
.
4(a)
$
4(b)
$
4(c)
$
For Privacy Act and Paperwork Reduction Act Notice, see page 3. Cat. No. 10220Q Form W-4 (2020)
Step 5:
Sign
Here
Under penalties of perjury, I declare that this certificate, to the best of my knowledge and belief, is true, correct, and complete.
Employee’s signature (This form is not valid unless you sign it.) Date
Employers
Only
Employer identification
number (EIN)
First date of
employment
Employer’s name and address
▲
▲
Page
2
Form W-
4 (2020)
General Instructions
Future Developments
For the latest information about developments related to
Form W-4, such as legislation enacted after it was published,
go to www.irs.gov/FormW4.
Purpose of Form
Complete Form W-4 so that your employer can withhold the
correct federal income tax from your pay. If too little is
withheld, you will generally owe tax when you file your tax
return and may owe a penalty. If too much is withheld, you will
generally be due a refund. Complete a new Form W-4 when
changes to your personal or financial situation would change
the entries on the form. For more information on withholding
and when you must furnish a new Form W-4, see Pub. 505.
Exemption from withholding. You may claim exemption from
withholding for 2020 if you meet both of the following
conditions: you had no federal income tax liability in 2019 and
you expect to have no federal income tax liability in 2020. You
had no federal income tax liability in 2019 if (1) your total tax on
line 16 on your 2019 Form 1040 or 1040-SR is zero (or less
than the sum of lines 18a, 18b, and 18c), or (2) you were not
required to file a return because your income was below the
filing threshold for your correct filing status. If you claim
exemption, you will have no income tax withheld from your
paycheck and may owe taxes and penalties when you file your
2020 tax return. To claim exemption from withholding, certify
that you meet both of the conditions above by writing “Exempt”
on Form W-4 in the space below Step 4(c). Then, complete
Steps 1a, 1b, and 5. Do not complete any other steps. You will
need to submit a new Form W-4 by February 16, 2021.
Your privacy. If you prefer to limit information provided in
Steps 2 through 4, use the online estimator, which will also
increase accuracy.
As an alternative to the estimator: if you have concerns
with Step 2(c), you may choose Step 2(b); if you have
concerns with Step 4(a), you may enter an additional amount
you want withheld per pay period in Step 4(c). If this is the
only job in your household, you may instead check the box
in Step 2(c), which will increase your withholding and
significantly reduce your paycheck (often by thousands of
dollars over the year).
When to use the estimator. Consider using the estimator at
www.irs.gov/W4App if you:
1.
Expect to work only part of the year;
2.
Have dividend or capital gain income, or are subject to
additional taxes, such as the additional Medicare tax;
3.
Have self-employment income (see below); or
4.
Prefer the most accurate withholding for multiple job
situations.
Self-employment. Generally, you will owe both income and
self-employment taxes on any self-employment income you
receive separate from the wages you receive as an
employee. If you want to pay these taxes through
withholding from your wages, use the estimator at
www.irs.gov/W4App to figure the amount to have withheld.
Nonresident alien. If you’re a nonresident alien, see Notice
1392, Supplemental Form W-4 Instructions for Nonresident
Aliens, before completing this form.
Specific Instructions
Step 1(c). Check your anticipated filing status. This will
determine the standard deduction and tax rates used to
compute your withholding.
Step 2. Use this step if you (1) have more than one job at the
same time, or (2) are married filing jointly and you and your
spouse both work.
Option (a) most accurately calculates the additional tax
you need to have withheld, while option (b) does so with a
little less accuracy.
If you (and your spouse) have a total of only two jobs, you
may instead check the box in option (c). The box must also be
checked on the Form W-4 for the other job. If the box is
checked, the standard deduction and tax brackets will be cut
in half for each job to calculate withholding. This option is
roughly accurate for jobs with similar pay; otherwise, more tax
than necessary may be withheld, and this extra amount will be
larger the greater the difference in pay is between the two jobs.
Multiple jobs. Complete Steps 3 through 4(b) on only
one Form W-4. Withholding will be most accurate if
you do this on the Form W-4 for the highest paying job.
Step 3. Step 3 of Form W-4 provides instructions for
determining the amount of the child tax credit and the credit
for other dependents that you may be able to claim when
you file your tax return. To qualify for the child tax credit, the
child must be under age 17 as of December 31, must be
your dependent who generally lives with you for more than
half the year, and must have the required social security
number. You may be able to claim a credit for other
dependents for whom a child tax credit can’t be claimed,
such as an older child or a qualifying relative. For additional
eligibility requirements for these credits, see Pub. 972, Child
Tax Credit and Credit for Other Dependents. You can also
include other tax credits in this step, such as education tax
credits and the foreign tax credit. To do so, add an estimate
of the amount for the year to your credits for dependents
and enter the total amount in Step 3. Including these credits
will increase your paycheck and reduce the amount of any
refund you may receive when you file your tax return.
Step 4 (optional).
Step 4(a). Enter in this step the total of your other
estimated income for the year, if any. You shouldn’t include
income from any jobs or self-employment. If you complete
Step 4(a), you likely won’t have to make estimated tax
payments for that income. If you prefer to pay estimated tax
rather than having tax on other income withheld from your
paycheck, see Form 1040-ES, Estimated Tax for Individuals.
Step 4(b). Enter in this step the amount from the Deductions
Worksheet, line 5, if you expect to claim deductions other than
the basic standard deduction on your 2020 tax return and
want to reduce your withholding to account for these
deductions. This includes both itemized deductions and other
deductions such as for student loan interest and IRAs.
Step 4(c). Enter in this step any additional tax you want
withheld from your pay each pay period, including any
amounts from the Multiple Jobs Worksheet, line 4. Entering an
amount here will reduce your paycheck and will either increase
your refund or reduce any amount of tax that you owe.
CAUTION
▲
!
Page
3
Form W-
4 (2020)
If you choose the option in Step 2(b) on Form W-4, complete this worksheet (which calculates the total extra tax for all jobs) on only ONE
Form W-4. Withholding will be most accurate if you complete the worksheet and enter the result on the Form W-4 for the highest paying job.
Note: If more than one job has annual wages of more than $120,000 or there are more than three jobs, see Pub. 505 for additional
tables; or, you can use the online withholding estimator at www.irs.gov/W4App.
1
Two jobs. If you have two jobs or you’re married filing jointly and you and your spouse each have one
job, find the amount from the appropriate table on page 4. Using the “Higher Paying Job” row and the
“Lower Paying Job” column, find the value at the intersection of the two household salaries and enter
that value on line 1. Then, skip to line 3 . . . . . . . . . . . . . . . . . . . . . 1 $
2
Three jobs. If you and/or your spouse have three jobs at the same time, complete lines 2a, 2b, and
2c below. Otherwise, skip to line 3.
a
Find the amount from the appropriate table on page 4 using the annual wages from the highest
paying job in the “Higher Paying Job” row and the annual wages for your next highest paying job
in the “Lower Paying Job” column. Find the value at the intersection of the two household salaries
and enter that value on line 2a . . . . . . . . . . . . . . . . . . . . . . . 2a $
b
Add the annual wages of the two highest paying jobs from line 2a together and use the total as the
wages in the “Higher Paying Job” row and use the annual wages for your third job in the “Lower
Paying Job” column to find the amount from the appropriate table on page 4 and enter this amount
on line 2b . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2b $
c
Add the amounts from lines 2a and 2b and enter the result on line 2c . . . . . . . . . . 2c $
3
Enter the number of pay periods per year for the highest paying job. For example, if that job pays
weekly, enter 52; if it pays every other week, enter 26; if it pays monthly, enter 12, etc. . . . . . 3
4
Divide the annual amount on line 1 or line 2c by the number of pay periods on line 3. Enter this
amount here and in Step 4(c) of Form W-4 for the highest paying job (along with any other additional
amount you want withheld) . . . . . . . . . . . . . . . . . . . . . . . . . 4 $
1
Enter an estimate of your 2020 itemized deductions (from Schedule A (Form 1040 or 1040-SR)). Such
deductions may include qualifying home mortgage interest, charitable contributions, state and local
taxes (up to $10,000), and medical expenses in excess of 10% of your income . . . . . . . . 1 $
2
Enter:
•
$24,800 if you’re married filing jointly or qualifying widow(er)
•
$18,650 if you’re head of household
•
$12,400 if you’re single or married filing separately
. . . . . . . . 2 $
3
If line 1 is greater than line 2, subtract line 2 from line 1. If line 2 is greater than line 1, enter “-0-” . .
3
$
4 Enter an estimate of your student loan interest, deductible IRA contributions, and certain other
adjustments (from Schedule 1 (Form 1040 or 1040-SR)). See Pub. 505 for more information . . .
4
$
5 Add lines 3 and 4. Enter the result here and in Step 4(b) of Form W-4 . . . . . . . . . . .
5
$
Privacy Act and Paperwork Reduction Act Notice. We ask for the information
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The average time and expenses required to complete and file this form will vary
depending on individual circumstances. For estimated averages, see the
instructions for your income tax return.
If you have suggestions for making this form simpler, we would be happy to hear
from you. See the instructions for your income tax return.
Step 4(b)—Deductions Worksheet (Keep for your records.)
Step 2(b)—Multiple Jobs Worksheet (Keep for your records.)
{
}
Page
4
Form W-
4 (2020)
Married Filing Jointly or Qualifying Widow(er)
Higher Paying Job
Lower Paying Job Annual Taxable Wage & Salary
Annual Taxable
Wage & Salary
$0 -
9,999
$10,000 -
19,999
$20,000 -
29,999
$30,000 -
39,999
$40,000 -
49,999
$50,000 -
59,999
$60,000 -
69,999
$70,000 -
79,999
$80,000 -
89,999
$90,000 -
99,999
$100,000 -
109,999
$110,000 -
120,000
$0 -
9,999
$0
$220
$850
$900
$1,020
$1,020
$1,020
$1,020
$1,020
$1,210
$1,870
$1,870
$10,000 - 19,999
220
1,220
1,900
2,100
2,220
2,220
2,220
2,220
2,410
3,410
4,070
4,070
$20,000 - 29,999
850
1,900
2,730
2,930
3,050
3,050
3,050
3,240
4,240
5,240
5,900
5,900
$30,000 - 39,999
900
2,100
2,930
3,130
3,250
3,250
3,440
4,440
5,440
6,440
7,100
7,100
$40,000 - 49,999
1,020
2,220
3,050
3,250
3,370
3,570
4,570
5,570
6,570
7,570
8,220
8,220
$50,000 - 59,999
1,020
2,220
3,050
3,250
3,570
4,570
5,570
6,570
7,570
8,570
9,220
9,220
$60,000 - 69,999
1,020
2,220
3,050
3,440
4,570
5,570
6,570
7,570
8,570
9,570
10,220
10,220
$70,000 - 79,999
1,020
2,220
3,240
4,440
5,570
6,570
7,570
8,570
9,570
10,570
11,220
11,240
$80,000 - 99,999
1,060
3,260
5,090
6,290
7,420
8,420
9,420
10,420
11,420
12,420
13,260
13,460
$100,000 - 149,999
1,870
4,070
5,900
7,100
8,220
9,320
10,520
11,720
12,920
14,120
14,980
15,180
$150,000 - 239,999
2,040
4,440
6,470
7,870
9,190
10,390
11,590
12,790
13,990
15,190
16,050
16,250
$240,000 - 259,999
2,040
4,440
6,470
7,870
9,190
10,390
11,590
12,790
13,990
15,520
17,170
18,170
$260,000 - 279,999
2,040
4,440
6,470
7,870
9,190
10,390
11,590
13,120
15,120
17,120
18,770
19,770
$280,000 - 299,999
2,040
4,440
6,470
7,870
9,190
10,720
12,720
14,720
16,720
18,720
20,370
21,370
$300,000 - 319,999
2,040
4,440
6,470
8,200
10,320
12,320
14,320
16,320
18,320
20,320
21,970
22,970
$320,000 - 364,999
2,720
5,920
8,750
10,950
13,070
15,070
17,070
19,070
21,290
23,590
25,540
26,840
$365,000 - 524,999
2,970
6,470
9,600
12,100
14,530
16,830
19,130
21,430
23,730
26,030
27,980
29,280
$525,000 and over
3,140
6,840
10,170
12,870
15,500
18,000
20,500
23,000
25,500
28,000
30,150
31,650
Single or Married Filing Separately
Higher Paying Job
Lower Paying Job Annual Taxable Wage & Salary
Annual Taxable
Wage & Salary
$0 -
9,999
$10,000 -
19,999
$20,000 -
29,999
$30,000 -
39,999
$40,000 -
49,999
$50,000 -
59,999
$60,000 -
69,999
$70,000 -
79,999
$80,000 -
89,999
$90,000 -
99,999
$100,000 -
109,999
$110,000 -
120,000
$0 -
9,999
$460
$940
$1,020
$1,020
$1,470
$1,870
$1,870
$1,870
$1,870
$2,040
$2,040
$2,040
$10,000 - 19,999
940
1,530
1,610
2,060
3,060
3,460
3,460
3,460
3,640
3,830
3,830
3,830
$20,000 - 29,999
1,020
1,610
2,130
3,130
4,130
4,540
4,540
4,720
4,920
5,110
5,110
5,110
$30,000 - 39,999
1,020
2,060
3,130
4,130
5,130
5,540
5,720
5,920
6,120
6,310
6,310
6,310
$40,000 - 59,999
1,870
3,460
4,540
5,540
6,690
7,290
7,490
7,690
7,890
8,080
8,080
8,080
$60,000 - 79,999
1,870
3,460
4,690
5,890
7,090
7,690
7,890
8,090
8,290
8,480
9,260
10,060
$80,000 - 99,999
2,020
3,810
5,090
6,290
7,490
8,090
8,290
8,490
9,470
10,460
11,260
12,060
$100,000 - 124,999
2,040
3,830
5,110
6,310
7,510
8,430
9,430
10,430
11,430
12,420
13,520
14,620
$125,000 - 149,999
2,040
3,830
5,110
7,030
9,030
10,430
11,430
12,580
13,880
15,170
16,270
17,370
$150,000 - 174,999
2,360
4,950
7,030
9,030
11,030
12,730
14,030
15,330
16,630
17,920
19,020
20,120
$175,000 - 199,999
2,720
5,310
7,540
9,840
12,140
13,840
15,140
16,440
17,740
19,030
20,130
21,230
$200,000 - 249,999
2,970
5,860
8,240
10,540
12,840
14,540
15,840
17,140
18,440
19,730
20,830
21,930
$250,000 - 399,999
2,970
5,860
8,240
10,540
12,840
14,540
15,840
17,140
18,440
19,730
20,830
21,930
$400,000 - 449,999
2,970
5,860
8,240
10,540
12,840
14,540
15,840
17,140
18,450
19,940
21,240
22,540
$450,000 and over
3,140
6,230
8,810
11,310
13,810
15,710
17,210
18,710
20,210
21,700
23,000
24,300
Head of Household
Higher Paying Job
Lower Paying Job Annual Taxable Wage & Salary
Annual Taxable
Wage & Salary
$0 -
9,999
$10,000 -
19,999
$20,000 -
29,999
$30,000 -
39,999
$40,000 -
49,999
$50,000 -
59,999
$60,000 -
69,999
$70,000 -
79,999
$80,000 -
89,999
$90,000 -
99,999
$100,000 -
109,999
$110,000 -
120,000
$0 -
9,999
$0
$830
$930
$1,020
$1,020
$1,020
$1,480
$1,870
$1,870
$1,930
$2,040
$2,040
$10,000 - 19,999
830
1,920
2,130
2,220
2,220
2,680
3,680
4,070
4,130
4,330
4,440
4,440
$20,000 - 29,999
930
2,130
2,350
2,430
2,900
3,900
4,900
5,340
5,540
5,740
5,850
5,850
$30,000 - 39,999
1,020
2,220
2,430
2,980
3,980
4,980
6,040
6,630
6,830
7,030
7,140
7,140
$40,000 - 59,999
1,020
2,530
3,750
4,830
5,860
7,060
8,260
8,850
9,050
9,250
9,360
9,360
$60,000 - 79,999
1,870
4,070
5,310
6,600
7,800
9,000
10,200
10,780
10,980
11,180
11,580
12,380
$80,000 - 99,999
1,900
4,300
5,710
7,000
8,200
9,400
10,600
11,180
11,670
12,670
13,580
14,380
$100,000 - 124,999
2,040
4,440
5,850
7,140
8,340
9,540
11,360
12,750
13,750
14,750
15,770
16,870
$125,000 - 149,999
2,040
4,440
5,850
7,360
9,360
11,360
13,360
14,750
16,010
17,310
18,520
19,620
$150,000 - 174,999
2,040
5,060
7,280
9,360
11,360
13,480
15,780
17,460
18,760
20,060
21,270
22,370
$175,000 - 199,999
2,720
5,920
8,130
10,480
12,780
15,080
17,380
19,070
20,370
21,670
22,880
23,980
$200,000 - 249,999
2,970
6,470
8,990
11,370
13,670
15,970
18,270
19,960
21,260
22,560
23,770
24,870
$250,000 - 349,999
2,970
6,470
8,990
11,370
13,670
15,970
18,270
19,960
21,260
22,560
23,770
24,870
$350,000 - 449,999
2,970
6,470
8,990
11,370
13,670
15,970
18,270
19,960
21,260
22,560
23,900
25,200
$450,000 and over
3,140
6,840
9,560
12,140
14,640
17,140
19,640
21,530
23,030
24,530
25,940
27,240
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EMPLOYEE PERSONAL DATA SHEET (East Central College)

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Completed 26 July 2020

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