STATE OF GEORGIA EMPLOYEE'S WITHHOLDING ALLOWANCE CERTIFICATE - Form G-4

Sep 19, 2026

Upload by Gelato

Georgia Form G-4, titled “State of Georgia Employee's Withholding Allowance Certificate,” collects employee identification and withholding preferences. The form guides completion of marital status allowances, dependent allowances, and additional withholding amounts, including a worksheet for calculating extra allowances using standard deduction or itemized deduction estimates. It also includes exemption certification options with specific eligibility conditions, employer acknowledgement fields, and instructions on submitting the form and withholding authorization.

LanguageEnglish

CategoryForms

FormatPDF

Pages2

Reading Time1 min

AccessFree to download

State of Georgia Employee's Withholding Allowance Certificate

Employee details (Lines 1a-2b)

Marital status allowances (Line 3)

Dependent allowances (Line 4)

Additional allowances and worksheet (Line 5)

Additional withholding amount (Line 6)

Total allowances and exemption section (Lines 7-8)

Employer information and when to mail (Line 9)

Instructions for Completing Form G-4

1811004012 STATE OF GEORGIA EMPLOYEE'S WITHHOLDING ALLOWANCE CERTIFICATE | 1a.YOUR FULL NAME | 1b.YOUR SOCIAL SECURITY NUMBER | | --- | --- | | 2a.HOME ADDRESS (Number,Streetor Rural Route) | 2b.CITY,STATE AND ZIP CODE | PLEASE READ INSTRUCTIONS ON REVERSE SIDE BEFORE COMPLETING LINES 3-8 3.MARITAL STATUS (If you do not wish to claim an allowance,enter "0"in the brackets beside your marital status.) A.Single:Enter 0 or1………………… ……[]4.DEPENDENT ALLOWANCES[] B.Married Filing Jointboth spouses working:Enter 0 or 1 …………………………… ……[] C.Married Filing Joint,one spouse working:5.ADDITIONAL ALLOWANCES[]Enter O or 1 or 2 ……………… …………[](worksheet below must be completed) D.Married Filing Separate: Enter O or 1 ………………………………… …[] E.Head of Household:6.ADDITIONAL WITHHOLDING $__________ Enter 0 or1 … …………[] | WORKSHEET FOR CALCULATING ADDITIONAL ALLOWANCES
(Must be completed in order to enter an amount on step 5)
1.COMPLETE THIS LINE ONLY IF USING STANDARD DEDUCTION:
Yourself:□ Age 65 or over □ Blind
Spouse:□ Age 65 or over □ Blind
Number of boxes checked___x×1300… …$__________
2.ADDITIONAL ALLOWANCES FOR DEDUCTIONS:
A.Federal Estimated Itemized Deductions(If Itemizing Deductions)… … ….________
B.Georgia Standard Deduction (enter one): Single/Head of Household $4,600
$_______
$3,000
Each Spouse
C.Subtract Line B from Line A(If zero or less,enter zero)…… …… …… …………___ —
D.Allowable Deductions to Federal Adjusted Gross Income……… ………… …… ……___ __
E.Add the Amounts on Lines 1,2C,and 2D… ………… …………… …… ………__________
F.Estimate of Taxable Income not Subject to Withholding …………………………… …………5_______
G.Subtract Line F from Line E(if zero or less,stop here,)… … … … …………__ —
H.Divide the Amount on Line G by $3,000.Enter total here and on Line 5 above … …… …_______
(This is the maximum number of additional allowances you can claim.If the remainder is over $1,500 round up) | | --- | 7.LETTER USED(Marital Status A,B,C,D,or E)_ TOTAL ALLOWANCES(Total of Lines 3-5) (Employer:The letter indicates the tax tables in Employer's Tax Guide) 8.EXEMPT:(Do not complete Lines 3-7 if claiming exempt)Read the Line 8 instructions on page 2 before completing this section. a)I claim exemption from witholding because l incurred no Georgia income tax liability last year and I do not expect tohave a Georgia income tax liability this year.Check here口 b)1 certify that l am not subject to Georgia witholding because I meet the conditions set forth under the ServicemembersCivil Relief Act as amended by the Military Spouses Residency Relief Act as provided on page 2.My state of residence is .My spouse's(servicemember)state of residence is_ _.The states of residencemust be the same to be exempt.Check here口 I certify under penalty of perjury that I am entitled to the number of withholding allowances or the exemption from withholding statusclaimed on this Form G-4.Also,I authorize my emplover to deduct per pay period the additional amount listed above Date Employee's Signature Employer:Complete Line 9 and mail entire form only if the employee claims over 14 allowances or exempt from withholding. If necessary,mail form to:Georgia Department of Revenue,Withholding Tax Unit,P.O.Box 49432,Atlanta,GA 30359. EMPLOYER'S FEIN: 9.EMPLOYER'S NAME AND ADDRESS: EMPLOYER'S WH\#: Do not accept forms claiming additional allowances unless the worksheet has been completed.Do not accept formsclaiming exempt if numbers are written on Lines 3-7. # INSTRUCTIONS FOR COMPLETING FORM G-4 Enter your full name,address and social security number in boxes la through 2b. Line 3:Writ

FAQs

What information must be entered in lines 1a through 2b on Form G-4?

Enter your full name, home address, and social security number in boxes 1a–2b. You must also include city, state, and zip code in the designated area.

How do I determine the number of allowances to enter for marital status on line 3?

Choose the letter matching your marital status (A Single, B Married Filing Joint with both spouses working, C with one spouse working, D Married Filing Separate, or E Head of Household) and enter the number of allowances in the brackets beside that status.

When can an employee claim exemption from Georgia withholding on line 8?

You may claim exemption if you filed a Georgia income tax return last year with qualifying zero tax liability based on Form 500EZ line 4 or Form 500 line 16, and you expect no Georgia tax liability this year. You must also complete the certification statements and meet the stated servicemembers/residency conditions when applicable.

Sep 19, 2026

Upload by Gelato