SAMPLEForm W-4 Employee's Withholding Certificate2026For informational / sample purposes only — not an official IRS document.Step 1: Personal InformationNameEmployee NameSSN—Address , , CA Filing StatussingleStep 2: Multiple Jobs or Spouse WorksNot checkedStep 3: Claim DependentsQualifying children credit$0.00Other dependents credit$0.00Total (line 3)$0.00Step 4: Other Adjustments4(a) Other income$0.004(b) Deductions$0.004(c) Extra withholding$0.00Employer Use OnlyEmployer name and address Employer Name , , CA First date of employment—Employer EIN—