Timbers W4 Please enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form.Personal Details1. Name *FirstLastEmail *2. SSN *Address *Address Line 1Address Line 2City— Select state —AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip Code3. Marital StatusSingle/Married Filing SeparatelyMarried Filing Jointly/WidowedUnmarried Head of Household4. If your last name differs from that shown on your social security card, check here. You must call 800-772-1213 for a replacement card. ▶4YesNo5. Total number of allowances you’re claiming (from the applicable worksheet on the following pages) . . . .6. Additional amount, if any, you want withheld from each paycheck . .6. I claim exemption from withholding for 2019, 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, write “Exempt” here ▶6If you meet both conditions, write “Exempt” here ▶ 78. 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. Employee’s signature (This form is not valid unless you sign it.) ▶Signature Clear Signature 9. First Day Date / TimeDateTime10 Employer identification number (EIN) Which Timbers?Timbers Bar & GrillTimbers PrimeA Enter “1” for yourself A. Enter “1” if you will file as married filing jointly BEnter “1” if you will file as head of household CChild tax credit. See Pub. 972, Child Tax Credit, for more information. • If your total income will be less than $71,201 ($103,351 if married filing jointly), enter “4” for each eligible child. • If your total income will be from $71,201 to $179,050 ($103,351 to $345,850 if married filing jointly), enter “2” for each eligible child. • If your total income will be from $179,051 to $200,000 ($345,851 to $400,000 if married filing jointly), enter “1” for each eligible child. • If your total income will be higher than $200,000 ($400,000 if married filing jointly), enter “-0-” ▶ECredit for other dependents. See Pub. 972, Child Tax Credit, for more information. • If your total income will be less than $71,201 ($103,351 if married filing jointly), enter “1” for each eligible dependent. • If your total income will be from $71,201 to $179,050 ($103,351 to $345,850 if married filing jointly), enter “1” for every two dependents (for example, “-0-” for one dependent, “1” if you have two or three dependents, and “2” if you have four dependents). • If your total income will be higher than $179,050 ($345,850 if married filing jointly), enter “-0-” . ▶ FSingle Line Tax Other credits. If you have other credits, see Worksheet 1-6 of Pub. 505 and enter the amount from that worksheet here. If you use Worksheet 1-6, enter “-0-” on lines E and F ▶ GAdd lines A through G and enter the total here ▶ HFor accuracy, complete all worksheets that apply. { • If you plan to itemize or claim adjustments to income and want to reduce your withholding, or if you have a large amount of nonwage income not subject to withholding and want to increase your withholding, see the Deductions, Adjustments, and Additional Income Worksheet below. • If you have more than one job at a time or are married filing jointly and you and your spouse both work, and the combined earnings from all jobs exceed $53,000 ($24,450 if married filing jointly), see the Two-Earners/Multiple Jobs Worksheet on page 4 to avoid having too little tax withheld. • If neither of the abo Note: Use this worksheet only if you plan to itemize deductions, claim certain adjustments to income, or have a large amount of nonwage income not subject to withholding1 Enter an estimate of your 2019 itemized deductions. These include qualifying home mortgage interest, charitable contributions, state and local taxes (up to $10,000), and medical expenses in excess of 10% of your income. See Pub. 505 for details ▶1 2 Enter: { $24,400 if you’re married filing jointly or qualifying widow(er) $18,350 if you’re head of household $12,200 if you’re single or married filing separately } ▶ 2 ($345,850 ▶7 differs Subtract line 2 from line 1. If zero or less, enter “-0-” ▶34 Enter an estimate of your 2019 adjustments to income, qualified business income deduction, and any additional standard deduction for age or blindness (see Pub. 505 for information about these items) . ▶ 4Add lines 3 and 4 and enter the total ▶ 5Enter an estimate of your 2019 nonwage income not subject to withholding (such as dividends or interest) . ▶ 6 Subtract line 6 from line 5. If zero, enter “-0-”. If less than zero, enter the amount in parentheses ▶7Divide the amount on line 7 by $4,200 and enter the result here. If a negative amount, enter in parentheses. Drop any fraction ▶89 Enter the number from the Personal Allowances Worksheet, line H, above ▶910 Add lines 8 and 9 and enter the total here. If zero or less, enter “-0-”. If you plan to use the Two-Earners/ Multiple Jobs Worksheet, also enter this total on line 1 of that worksheet on page 4. Otherwise, stop here and enter this total on Form W-4, line 5, page 1 . Submit fw4–2019 (1)Download