Form

W-4E

(of Federal Income Tax)

For use by employees who incurred no tax liability for 1976 and anticipate no tax 'lability for 1977

Exemption From Withholding

77

Department of the Treasury Internal Revenue Service

Social

number

Type or print full name

I	I

L

i

I

Home address (Number and street)

City, State, and ZIP code

Employee.—File this certificate with your employer. Otherwise, your employer must withhold Federal in-come tax from your wages.	
Employer.—Keep this certificate with your records. This certiifcate may be used instead of Form W-4 by those employees qualified to claim the exemption.	

Employee's certification.—Under penalties of perjury. I certify that I incurred no liability for Federal income tax for 1976 and that I anticipate that I will incur no liability for Federal income tax for 1977.

(Signature)

(D MZ

1-

L

Form

W-4E

(of Federal Income Tax)

For use by employees who Incurred no tax for 1976 and anticipate no tax liability for

 a1977y

Exemption From Withholding

77

Department of the Treasury Internal Revenue Service

Social securiyt number

Type or print full name

1

i

L

1

Home address (Number and street)

City, State, and ZIP code

Employee.—File this certificate with your employer. Otherwise, your employer must withhold Federal in-come tax from your wages.	

(Signature)

(Date)

-

-

-

Employee's certification.—Under penalties of perjury, I certify that I incurred no liability for Federal income tax for 1976 and that I anticipate that I will incur no liability for Federal income tax for1977.

F°""

W-4E

(of Federal Income Tax)

For use by employees who incurred no tax liability for 1976 and anticipate no tax liability for 1977

Exemption From Withholding

II 77

Department of the Treasury Internal Revenue Service

Social security number

Type or print full name

i

Home address (Number and street)

City, State, and ZIP code

Employee.—File this certificate with your employer. Otherwise, your employer must withhold, Federal In-come tax from your wages.	
Employer.—Keep this certificate with your records. This certificate may be used instead of Form W-• by those employees qualified to claim the exemption.	

(Signature)

(Data)

Employee's certification.—Under penalties of perjury, I certify that I incurred no liability for Federal income tax for 1976 and that i anticipate that I will incur no liability for Federal income tax for 1977.

—

I‑

those employees qualified to claim the exemption.

Employer.—Keep this certificate with your records.

This certificate may be used instead of Form W-4 by

Instructions

Who May Claim Exemption from With. holding of Income Tax.—You may be en-titled to claim exemption from withhold-ing of Federal income tax if you incurred no liability for income tax for 1976 and you anticipate that you will incur no ii• ability for income tax for 1977. For this purpose, you incur tax liability if your joint or separate return shows tax before the

you determine you are entitled to claim	income tax liability for 1977 or (2) on or
the exemption. You must file a certificate	before December 1, 1977, if you antici‑
each year if you wish to continue to claim	pate you will incur Federal income tax
the exemption.

liability for 1978.

If you want to discontinue or are re‑

Multiple Employers.—If you are em-ployed by more than one employer, you may claim the exemption from withhold-ing with each employer, provided that the

quired to revoke this exemption, you must file a new Employee's Withholding Allow-ance Certificate (Form W-.4) with your employer.

allowance of any credit for income tax
total of your anticipated income will not
withheld. If you claim this exemption, cause you to incur any liability for Fed‑

Expiration Date of Exemption.—This' certificate will expire on April 30, 1978.

your employer will not withhold Federal eral income tax for 1977 and you incurred income tax from your wages. However, no liability for Federal Income tax for this certificate does not affect liability for 1976.
the social security tax imposed by the
Federal Insurance Contributions Act.

Liability for Estimated Tax.—If your employer does not withhold Income tax from your wages and you incur income tax liability, you may be required to pay estimated tax and be subject to the penalty . if it is not paid,

When You Must Revoke this Exemp‑

tion.—You must revoke this exemption

When to Claim Exemption.—File this certificate: (1) within 10 days from the certificate with your employer as soon as day you anticipate you will incur Federal

Instructions

Who May Claim Exemption from With holding of Income Tax.—You may be en-titled to claim exemption from withhold-ing of Federal income tax if you incurred no liability for income tax for 1976 and you anticipate that you will incur no li-ability for income tax for 1977. For this purpose, you incur tax liability if your joint or separate return shows tax before the allowance of any credit for income tax

you determine you are entitled to claim the exemption. You must file a certificate each year if you wish to continue to claim the exemption.

income tax liability for 1977 or (2) on or before December 1, 1977, if you anticipate you will incur Federal income tax

liability for 1978.

Multiple Employers.—If you are em-ployed by more than one employer, you may claim the exemption from withhold-ing with each employer, provided that the

If you want to discontinue or are re• quired to revoke this exemption, you must file a new Employee's Withholding Allow-ance Certificate (Form W-4) with your employer.

total of your anticipated income will not

withheld. If you claim this exemption, cause you to incur any liability for Fed‑

Expiration Date of Exemption.—This certificate will expire on April 30, 1978.

your employer will not withhold Federal eral income tax for 1977 and you incurred income tax from your wages. However, no liability for Federal income tax for this certificate does not affect liability for 1975.
the social security tax imposed by the
Federal Insurance Contributions Act,

Liability for Estimated Tax.—If your employer does not withhold income tax from your wages and you incur income tax liability, you may be required to pay estimated tax and be subject to the penalty if it is not paid.

When You Must Revoke this Exemp‑

tion.—You must revoke this exemption

When to Claim Exemption.—File this certificate: (1) within 10 days from the certificate with your employer as soon as day you anticipate you will incur Federal

Instructions

Who May Claim Exemption from With-holding of Income Tax.—You may be en-titled to claim exemption from withhold-ing of Federal income tax if you incurred no liability for income tax for 1976 and you anticipate that you will incur no li• ability for income tax for 1977. For this purpose, you incur tax liability if your joint or separate return shows tax before the

you determine you are entitled to claim the exemption. You must file a certificate each year if you wish to continue to claim the exemption.

income tax liability for 1977 or (2) on or before December 1, 1977, if you anticipate you will incur Federal income tax

liability for 1978.

If you want to discontinue or are re‑

Multiple Employers.—If you are em-ployed by more than one employer, you may claim the exemption from withhold-ing with each employer, provided that the

quired to revoke this exemption, you must file a new Employee's Withholding Allow-ance Certificate (Form W•4) with your employer.

allowance of any credit for income tax
total of your anticipated income will not
withheld. If you claim this exemption, cause you to incur any liability for Fed.

Expiration Date of Exemption.—This certificate will expire on April 3001978.

your employer will not withhold Federal eral income tax for 1977 and you incurred income tax from your wages. However, no liability for Federal income tax for this certificate does not affect liability for 1976.
the social security tax imposed by the
Federal Insurance Contributions Act.

Liability for Estimated Tax.—if your employer does not withhold income tax from your wages and you incur income tax liability, you may be required to pay estimated tax and be subject to the penalty If it is not paid,

When You Must Revoke this Exemp-tion.—You must revoke this exemption

When to Claim Exemption.—File this certificate: (1) within 10 days from the certificate with your employer as soon as day you anticipate you will incur Federal

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