demo-njw4 - Quick Simple OnboardingQuick Simple Onboarding

State of New Jersey – Division of Taxation

Employee’s Withholding Allowance Certificate

Form NJ-W4

1. SS# *

Name *

First

Middle

Last

Address *

Address Line 1

City

State

Zip Code

2. Filing Status: (Check only one box) *

3. If you have chosen to use the chart from instruction A, enter the appropriate letter here

LINK to Instruction A

4. Total number of allowances you are claiming (see instructions) *

Each dependent = 1

5. Additional amount you want deducted from each pay

Employer the claim

6. I claim exemption from withholding of NJ Gross Income Tax and I certify that I have met the conditions in the instructions of the NJ-W4. If you have met the conditions, enter “EXEMPT” here

7. Under penalties of perjury, I certify that I am entitled to the number of withholding allowances claimed on this certificate or entitled to claim exempt status.

Employee’s Signature *

Clear Signature

Date *

Employer’s Name and Address

Employer Identification Number