Countries and Languages
| Countries | Languages |
|---|---|
| USA | English |
Extracted Fields
Asterisk (*) indicates a required field or field group. Values cannot be empty.
Form Information
| Field | Description |
|---|---|
| Year | The year when the form was revised. |
Step 1 - Enter Personal Information
| Field | Description |
|---|---|
| Box a - First Name and Middle Initial* | The first name and the middle initial of the employee. |
| Box a - Last Name* | The last name of the employee. |
| Box a - Address | The address of the employee. |
| Box a - City or Town State and ZIP Code | The address of the employee. |
| Box b - Social Security Number* | The social security number of the employee. |
Box c - Filing Status
| Field | Description |
|---|---|
| Single or Married Filing Separately | The anticipated filing status. |
| Married Filing Jointly or Qualifying Surviving Spouse | The anticipated filing status. |
| Head of Household | The anticipated filing status. |
Step 2 - Multiple Jobs or Spouse Works
| Field | Description |
|---|---|
| Box c - Only Two Jobs Total | Indicates that the employee has two jobs at the same time. |
Step 3 - Claim Dependents
| Field | Description |
|---|---|
| Multiply the Number of Qualifying Children Under Age 17 by $2000 | Determines the amount of child tax credit. |
| Multiply the Number of Other Dependents by $500 | Determines the credit for other dependents. |
| Total | The total credit amount. |
Step 4 (optional) - Other Adjustments
| Field | Description |
|---|---|
| Box a - Other Income (Not from Jobs) | The total of other estimated income for the year. |
| Box b - Deductions | The amount from the Deductions Worksheet. |
| Box c - Extra Withholding | Any additional amount withheld from the pay each pay period, including all amounts from the Multiple Jobs Worksheet. |
Step 5 - Sign Here
| Field | Description |
|---|---|
| Date | The date of signing. |
Employers Only
| Field | Description |
|---|---|
| Employer’s Name and Address | The name and address of the employer. |
| First Date of Employment | The first date of employment |
| Employer Identification Number (EIN) | The employer identification number. |
Key Fields
- Step 1 - Enter Personal Information/Box a - First Name and Middle Initial
- Step 1 - Enter Personal Information/Box a - Last Name
- Step 1 - Enter Personal Information/Box b - Social Security Number
Validation Rules
| Rule | Description |
|---|---|
| Correct Year | Checks the value in the Year field. It converts a 2-digit year (such as 24) into a 4-digit format (such as 2024). It assumes all 2-digit years are in the 2000s. |
