Louisiana Employee Withholding Exemption Certificate (L-4)

Employee Withholding Exemption Certificate (L-4)
R-1300
R-1300 (1/25)
This form must be filed with your employer.

Employee's Withholding
Certificate (L-4)

For Questions:
Phone: (855) 307-3893
Send an email by visiting www.revenue.louisiana.
gov/Contact/ContactUs.

Purpose: Complete Form L-4 so that your employer can withhold the correct amount of state income tax from your salary.
Instructions: Employees who are subject to state withholding must provide their expected tax return filing status in Block A.
•	 Employees must file a new certificate within 10 days if the number of their deductions decreases, except if the change is the result of the death of a spouse.
•	 Employees may file a new certificate any time the number of their deductions increases.
•	 Line 7 should be used to increase or decrease the tax withheld for each pay period. Decreases should be indicated as a negative amount.
Penalties will be imposed for willfully supplying false information or willfully failing to supply information that would reduce the withholding amount.
This form must be filed with your employer. If an employee fails to complete this withholding certificate, the employer must withhold Louisiana income tax
from the employee’s wages without any standard deduction.
Note to Employer: Keep this certificate with your records.
Block A
•	 Enter “0” to claim no standard deduction and check the appropriate box under number 3 below. You may enter “0” if you are
married, and have a working spouse or more than one job to avoid having too little tax withheld.

A.

•	 Enter “1” to claim a standard deduction if your filing status is single or married filing separate and check the appropriate box
under number 3 below if you did not claim this deduction in connection with other employment or if your spouse has not claimed
a deduction.
• Enter “2” to claim a standard deduction if your filing status is married filing jointly, head of household, or qualifying surviving
spouse and check the appropriate box under number 3 below.

Cut here and give the bottom portion of certificate to your employer. Keep the top portion for your records.
Form

L-4

Employee’s Withholding Certificate

Louisiana
Department of
Revenue
1.	First name and middle initial
2.	Social security number

Last name

3. Select one:
 No deduction  Single or married filing separately  Married filing jointly, qualifying surviving spouse, or head of household

4.	Home address (number and street or rural route)
5.	City

State

6.	Total number of deductions claimed in Block A

ZIP
6.

7.	 Adjustments. Enter any increase or decrease in the amount of tax to be withheld each pay period. Decreases should 7.
be indicated as a negative amount and cannot result in an amount less than zero to be withheld each pay period.
I declare under the penalties imposed for filing false reports that the number of deductions claimed on this certificate do not exceed the number to which
I am entitled.
Employee’s signature

Date
The following is to be completed by employer.

8. Employer’s name and address

9. Employer’s state withholding account number