ࡱ> MPL bjbj 42LLT.j*4^^^v!>%"$I".......$024.!%1!%%4.^v U.+++%.^v.+%.++V,@N-^nlA%v6- -k.0.B- U3%@U3N-U3N-]""^+?#L#]"]"]"4.4.(]"]"]".%%%%U3]"]"]"]"]"]"]"]"]"L l: Form W-4 Employee s Withholding Allowance Certificate OMB No. 1545-0074 Department of the Treasury %Whether you are entitled to claim a certain number of allowances or exemption from withholding is Internal Revenue Service subject to review by the IRS. Your employer may be required to send a copy of this form to the IRS. 1 Your first name and middle initial Last name 2 Your social security number  Home address (number and street or rural route) 3  FORMCHECKBOX  Single  FORMCHECKBOX  Married  FORMCHECKBOX  Married, but withholding at higher Single Rate. Note: If married, but legally separated, or spouse is a nonresident alien, check the Single box.  City or town, state, and ZIP code 4 If your last name differs from that shown on your social security card, check here. You must call 1-800-772-1213 for a replacement card.( FORMCHECKBOX   5 Total number of allowances you are claiming (from line H above or from the applicable worksheet on page 2) ...... 5 6 Additional amount, if any, you want withheld from each paycheck. 6 $ 7 I claim exemption from withholding for 2017, and I certify that I meet both of the following conditions for exemption: Last year I had a right to a refund of all federal income tax withheld because I had no tax liability, and This year I expect a refund of all federal income tax withheld because I expect to have no tax liability. If you meet both conditions, writer Exempt here 7  Under penalties of perjury, I declare that I have examined this certificate and, to the best of my knowledge and belief, it is true, correct, and complete. Employees signature ( Date ( (Form is not valid unless you sign it.)  8 Employers name and address (Employer: Complete 8 and 10 only if sending to IRS) 9 Office 10 Employer identification number code The University of Akron (optional) 34-6002924 302 Buchtel Common Akron, OH 44325-6210  (For Privacy Act and Paperwork Reduction Act Notice, see page 2 Form W-4 (2017) Form NR-1 NON-RESIDENT ALIEN IDENTIFICATION Are you a U.S. citizen? Yes___ No___ Permanent Resident Alien: Yes___ VISA status (complete below ONLY if NOT a U.S. citizen): Student F-1___ J-1___ M-1___ Teacher/Scholar J-1___ H-1___ Other____________________ ____________________________________ Country of Legal Residence______________________ Signature FORM IT-4 (05/07) STATE OF OHIO DEPARTMENT OF TAXATION EMPLOYEES WITHHOLDING EXEMPTION CERTIFICATE Print Full Name__________________________________________ Social Security No._________________________ Home Address and Zip Code_____________________________________________________________________ Public School District of Residence_______________________________________ School District No. _________________ (See The Finder at tax.ohio.gov.) 1. Personal exemption for yourself, enter 1 if claimed...______________ If married, personal exemption for your spouse if not separately claimed (enter 1 if claimed)_____________ Exemption for dependents______________ Add the exemptions that you have claimed above and enter total ...______________ Additional withholding per pay period under agreement with employer.______________ Under the penalties of perjury, I certify that the number of exemptions claimed on this certificate does not exceed the number to which I am entitled. Signature__________________________________________________ Date _____________________________    H J    " p q ÷緖vjj^jX hUCJ *h$UhUCJaJ *h$UhU5CJ *h$Uh%5CJ *h$UhUhKhU5CJ aJ hKCJhU5CJ aJ hn5CJ aJ hK5CJ aJ hKhK5CJ aJ hK5CJ^JjhUCJUmHnHu ha5CJhU hU5CJ!jhU5CJUmHnHu  j C "B#U}$^a$$ & F h^a$$a$$ # p@ P 6$a$gdn$a$       # $ % & , . / = > ? 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