Vermont Withholding Tax Payment

Withholding Tax Payment
Form W-4VT
Vermont Department of Taxes

Employee’s Withholding Allowance Certificate - Form W-4VT
All Vermont employees should complete this form.
To be filed with your employer.
Last Name	

First Name		

Initial	

Social Security Number

Filing Status - Check ONE

Single

Married/Civil Union
Filing Jointly

Married/Civil Union
Filing Separately

Married, but withhold
at higher single rate

Vermont Allowances Worksheet
	1.	 Enter “1” for yourself if no one can claim you as a dependent. . . . . . . . . . . . . . . . . . 1. ___________
	2.	Enter “1” if you are filing jointly and your spouse does not work. . . . . . . . . . . . . . . . 2. ___________
	3.	Enter the number of dependents you plan to claim on your tax return. If you file
jointly, then only one of you should claim the dependents on your W-4VT . . . . . . . . 3. ___________
	4.	Enter “1” if you plan to file as “head of household”. . . . . . . . . . . . . . . . . . . . . . . . . . 4. ___________
	5.	Total number of Vermont allowances. (Add Lines 1 through 4 and enter total here.) . . . . . . . . . . . .  5. ____________
	6.	Enter an additional amount, if any, you want withheld from each check.. . . . . . . . . . . . . . . . . . . . . .  6. ____________
Exempt: If you had a right to a refund of all your Vermont income tax withheld last year because you
had no tax liability and you also expect to have no liability this year, write “Exempt” here. . . . . . . . . _____________

General Information
Form W-4VT is designed so that you can have as much “take-home pay” as possible without an income tax liability due to
Vermont when you file your tax return. Each withholding allowance you claim on Line 5 above will reduce the amount of
income you are taxed on and therefore the amount of Vermont income tax withheld each paycheck.
Here are some things to remember as you complete this form:
•	

Generally, dependents are children under 19 (or up to 24 if they are a full-time student) and any relatives who
live with you and you support financially.

•	

If you and your spouse both claim your dependents on your respective W-4VTs, not enough income tax will be
withheld, and you might end up with taxes due when you file. Only one spouse should claim the dependents.

•	

If you entered an additional amount to be withheld on the federal W-4, consider entering 30% of that amount on
Line 6.

•	

If you have more than one employer, consider claiming zero allowances with the employer(s) where you earn
less income.

Signature
I certify that I am entitled to the number of withholding allowances claimed on this certificate.

Employee’s Signature	

Date

This form may be photocopied as needed.

Form W-4VT
Page 1 of 1
Rev. 12/18