Form WH-4

State of Indiana

Employee's Withholding Exemption and County Status Certificate

Indiana County of Residence as of January 1:

Indiana County of Principal Employment as of January 1:


1. You are entitled to one exemption. If you wish to claim the exemption, enter “1”



2. If you are married and your spouse does not claim his/her exemption, you may claim it, enter “1”



3. You are allowed one (1) exemption for each dependent. Enter number claimed.



4. Additional exemptions are allowed if: (a) you and/or your spouse are over the age of 65 and/or; (b) if you and/or your spouse are legally blind. Check box(es) for additional exemptions:










Enter the total number of boxes checked


5. Add lines 1, 2, 3, and 4. Enter the total here


6. You are entitled to claim an additional exemption for each qualifying dependent (see instructions)



7. You are entitled to claim an additional exemption for each qualifying dependent claimed for the first time (see instructions)



8. You are entitled to claim an additional exemption for each adopted qualifying dependent (see instructions) .



9. Enter the amount of additional state withholding (if any) you want withheld each pay period.



10. Enter the amount of additional county withholding (if any) you want withheld each pay period.




How much do you earn each paycheck?


You must enter in a value greater than zero (0) above to continue!



How often are you paid?



Do you have pre-tax deductions come out of your paycheck?



How much total pre-tax deductions come out of your paycheck?




Your total Estimated Indiana Local Taxes per check would be:


Your total Estimated Indiana State Taxes per check would be:


Your total State and County Taxes per paycheck would be:



**The above number is an estimation and should only be used as a reference point. Questions regarding the amounts you are paid, deducted, or taxed should all be brought to your employer for further clarification. Workforce 2080 provides these estimations to assist employees and employers determine a rough estimation of what taxes, payments, or deductions *could* be. These estimations should not be construed as implict or explicit guarantees in any way. Many factors come into play, such as rounding of figures in Payroll Software, errors in the submission through this portal etc. Workforce 2080 assumes no risk with these estimations and provides these tools to help educate the general population. All users who use these products and estimators outside of their intended use assume risk when used outside of the scope of educational and general knowledge.

Follow us!

LinkedIn LinkedIn tiktok

Last Updated on 5/18/2024 @ 12:00 PM CDT