Form NJ-W4
State of New Jersey - Division of Taxation
(1-10, R-13)
Employee’s Withholding Allowance Certificate
1.
SS#
2. Filing Status:
(Check only one box)
1.
Single
Name
2.
Married/Civil Union Couple Joint
Address
3.
Married/Civil Union Partner Separate
4.
Head of Household
City
State
Zip
5.
Qualifying Widow(er)/Surviving Civil Union Partner
3. If you have chosen to use the chart from instruction A, enter the appropriate letter here . . . . . . . . . . . 3.
4. Total number of allowances you are claiming (see instructions) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4.
5. Additional amount you want deducted from each pay . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5.
$
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 . . . 6.
Under penalties of perjury, I certify that I am entitled to the number of withholding allowances claimed on this certificate or entitled to
7.
claim exempt status.
Employee’s Signature
Date
Employer’s Name and Address
Employer Identification Number
BASIC INSTRUCTIONS
Line 1 Enter your name, address and social security number in the spaces provided.
Line 2 Check the box that indicates your filing status. If you checked Box 1 (Single) or Box 3 (Married/Civil Union Partner Separate) you will be withheld at
Rate A.
Note: If you have checked Box 2 (Married/Civil Union Couple Joint), Box 4 (Head of Household) or Box 5 (Qualifying
Widow(er)/Surviving Civil Union Partner) and either your spouse/civil union partner works or you have more than one job
or more than one source of income and the combined total of all wages is greater than $50,000, see instruction A below.
If you do not complete Line 3, you will be withheld at Rate B.
Line 3 If you have chosen to use the wage chart below, enter the appropriate letter.
Line 4 Enter the number of allowances you are claiming. Entering a number on this line will decrease the amount of withholding and could result in an
underpayment on your return.
Line 5 Enter the amount of additional withholdings you want deducted from each pay.
Line 6 Enter “EXEMPT” to indicate that you are exempt from New Jersey Gross Income Tax Withholdings, if you meet one of the following conditions:
• Your filing status is SINGLE or MARRIED/CIVIL UNION PARTNER SEPARATE and your wages plus your taxable nonwage
income will be $10,000 or less for the current year.
• Your filing status is MARRIED/CIVIL UNION COUPLE JOINT, and your wages combined with your spouse’s/civil union
partner’s wages plus your taxable non wage income will be $20,000 or less for the current year.
• Your filing status is HEAD OF HOUSEHOLD or QUALIFYING WIDOW(ER)/SURVIVING CIVIL UNION PARTNER and your
wages plus your taxable nonwage income will be $20,000 or less for the current year.
Your exemption is good for ONE year only. You must complete and submit a form each year certifying you have no New Jersey Gross Income Tax liability and
claim exemption from withholding. If you have questions about eligibility, filing status, withholding rates, etc. when completing this form, call the Division of
Taxation’s Customer Service Center at 609-292-6400.
Instruction A - Wage Chart
This chart is designed to increase withholdings on your wages, if these wages will be taxed at a higher rate due to inclusion of other wages or income on
your NJ-1040 return. It is not intended to provide withholding for other income or wages. If you need additional withholdings for other income or wages
use Line 5 on the NJ-W4. This Wage Chart applies to taxpayers who are married/civil union couple filing jointly, heads of households or qualifying
widow(er)/surviving civil union partner. Single individuals or married/civil union partners filing separate returns do not need to use this chart. If you
have indicated filing status #2, 4 or 5 on the above NJ-W4 and your taxable income is greater than $50,000, you should strongly consider using the Wage
Chart. (See the Rate Tables on the reverse side to estimate your withholding amount).
WAGE CHART
HOW TO USE THE CHART
Total of All
0
10,001
20,001
30,001
40,001
50,001
60,001
70,001
80,001
OVER
Other Wages
10,000
20,000
30,000
40,000
50,000
60,000
70,000
80,000
90,000
90,000
1) Find the amount of your wages in the left-hand column.
0
B
B
B
B
B
B
B
B
B
B
10,000
2) Find the amount of the total for all other wages (including
10,001
B
B
B
B
C
C
C
C
C
C
20,000
your spouse’s/civil union partner’s wages) along the top
Y
row.
20,001
B
B
B
A
A
D
D
D
D
D
O
30,000
3) Follow along the row that contains your wages until you
U
30,001
B
B
A
A
A
A
A
E
E
E
40,000
come to the column that contains the other wages.
R
40,001
B
C
A
A
A
A
A
E
E
E
50,000
4) This meeting point indicates the Withholding Table that best
W
reflects your income situation.
50,001
B
C
D
A
A
A
E
E
E
E
60,000
A
60,001
5) If you have chosen this method, enter the “letter” of the
G
B
C
D
A
A
E
E
E
E
E
70,000
withholding rate table on Line 3 of the NJ-W4.
E
70,001
S
80,000
B
C
D
E
E
E
E
E
E
E
NOTE: If your income situation substantially increases (or
80,001
decreases) in the future, you should resubmit a
90,000
B
C
D
E
E
E
E
E
E
E
revised NJ-W4 to your employer.
over
THIS FORM MAY BE REPRODUCED
90,000
B
C
D
E
E
E
E
E
E
E