Form WH-4 - Employee’s Withholding Exemption and County Status Certificate

Sep 19, 2026

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Form WH-4 is an Indiana employee certificate used to claim withholding exemptions and report county status for state and/or county income tax. The form is kept by the employer and must not be sent to the Indiana Department of Revenue. It instructs employees to provide identifying details, select the appropriate exemption claims (including dependent, age 65, and blindness allowances), total the exemptions, and optionally enter additional withholding amounts per pay period. A signature and date certify the statements.

LanguageEnglish

CategoryForms

FormatPDF

Pages2

Reading Time1 min

AccessFree to download

How to Claim Your Withholding Exemptions

Lines 1–8 and exemption totals

Instructions for Completing Form WH-4

Eligibility, nonresident alien rules, and county status

Specific guidance for lines 1–8 and updating the form

| | Form WH-4
State Form 48845 (R2 / 8-08) | State of Indiana
Employee’s Withholding Exemption and County Status Certificate This form is for the employer’s records. Do not send this form to the Department of Revenue.
The completed form should be returned to your employer. | | --- | --- | --- | | Full Name Social Security Number or ITIN
Home Address City State Zip Code
________________________________
Indiana County of Residence as of January 1: (See instructions)
Indiana County of Principal Employment as of January 1: (See instructions) | | | | How to Claim Your Withholding Exemptions
1. You are entitled to one exemption. If you wish to claim the exemption, enter “1”.............................................................................. Nonresident aliens must skip lines 2 through 6. See instructions
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: You are 65 or older □ or blind □ Spouse is 65 or older □ or blind □
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. Enter the amount of additional state withholding (if any) you want withheld each pay period ........................................................... $
8. Enter the amount of additional county withholding (if any) you want withheld each pay period......................................................... $ I hereby declare that to the best of my knowledge the above statements are true.
Signature: Date: | | | Instructions for Completing Form WH-4 This form should be completed by all resident and nonresident employees having income subject to Indiana state and/or county income tax. Print or type your full name, Social Security number or ITIN and home address. Enter your Indiana county of residence and county of principal employment as of January 1 of the current year. If you did not live of work in Indiana on January 1 of the current year, enter “not applicable” on the line(s) . If you move to (or work in) another county after January 1, your county status will not change until the next calendar tax year. Nonresident alien limitation. A nonresident alien is allowed to claim only one exemption for withholding tax purposes. If you are a nonresident alien, enter “1” on line 1, then skip to line 7. You are considered to be a nonresident alien if you are not a citizen of the United States and do not meet the green card test and the substantial presence test (get Publication 519 from [www.irs.gov](www.irs.gov) for information about these tests) . All other employees should complete lines 1 through 7. Lines 1 & 2-You are allowed to claim one exemption for yourself and one for your spouse (if he/she does not claim the exemption for him/herself) . If a parent or legal guardian claims you on their federal tax return, you may still claim an exemption for yourself for Indiana purposes. You cannot claim more than the correct number of exemptions; however, you are permitted to claim a lesser number of exemptions if you wish additional withholding to be deducted. Line 3-Depe

FAQs

Who should complete Form WH-4 in Indiana?

All resident and nonresident employees with income subject to Indiana state and/or county income tax should complete the form.

How do nonresident aliens claim withholding exemptions on Form WH-4?

Nonresident aliens are allowed to claim only one exemption for withholding purposes: enter “1” on line 1, then skip to line 7.

What can line 4 (additional exemptions) include?

Line 4 allows additional exemptions if you and/or your spouse are over age 65 and/or are legally blind, with check boxes to indicate which applies.

When must an employee file a new Form WH-4?

Employees may file a new Form WH-4 at any time if exemptions increase, and must file a new form within 10 days if the previously claimed exemptions decrease due to reasons such as divorce/separation, a dependent’s support situation changing, or the exemption recipient exceeding the income threshold.

Sep 19, 2026

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