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Virginia Free Printable VA-4  08 23 11.indd for 2024 Virginia Employee's Withholding Exemption Certificate

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Employee's Withholding Exemption Certificate
VA-4 08 23 11.indd

FORM VA-4 COMMONWEALTH OF VIRGINIA DEPARTMENT OF TAXATION PERSONAL EXEMPTION WORKSHEET (See back for instructions) 1. If you wish to claim yourself, write “1”............................................................... ________________ 2. If you are married and your spouse is not claimed on his or her own certificate, write “1”................................................................ ________________ 3. Write the number of dependents you will be allowed to claim on your income tax return (do not include your spouse).................................... ________________ 4. Subtotal Personal Exemptions (add lines 1 through 3)...................................... ________________ 5. Exemptions for age (a) _If you will be 65 or older on January 1, write “1”................................... ________________ (b) _If you claimed an exemption on line 2 and your spouse _will be 65 or older on January 1, write “1”............................................. ________________ 6. Exemptions for blindness (a) _If you are legally blind, write “1”............................................................ ________________ (b) _If you claimed an exemption on line 2 and your _spouse is legally blind, write “1”............................................................ ________________ 7. Subtotal exemptions for age and blindness (add lines 5 through 6)...................................................._______________ 8. Total of Exemptions - add line 4 and line 7.........................................................................................._______________ Detach here and give the certificate to your employer. Keep the top portion for your records FORM VA-4 EMPLOYEE’S VIRGINIA INCOME TAX WITHHOLDING EXEMPTION CERTIFICATE Your Social Security Number Name Street Address City State Zip Code COMPLETE THE APPLICABLE LINES BELOW 1. If subject to withholding, enter the number of exemptions claimed on: (a) Subtotal of Personal Exemptions - line 4 of the Personal Exemption Worksheet............................................................................................ (b) Subtotal of Exemptions for Age and Blindness line 7 of the Personal Exemption Worksheet........................................................................ (c) Total Exemptions - line 8 of the Personal Exemption Worksheet......................................... 2. Enter the amount of additional withholding requested (see instructions)........................................... . 2601064 Rev. 08/11 3. I certify that I am not subject to Virginia withholding. l meet the conditions set forth in the instructions .................................................................................. (check here) 4. I certify that I am not subject to Virginia withholding. l meet the conditions set forth Under the Service member Civil Relief Act, as amended by the Military Spouses Residency Relief Act ........................................................................................... (check here) Signature Date EMPLOYER: Keep exemption certificates with your records. If you believe the employee has claimed too many exemptions, notify the Department of Taxation, P.O. Box 1115, Richmond, Virginia 23218-1115, telephone (804) 367-8037. Note: Employers may establish a system to electronically receive Forms VA-4 from employees, provided the system meets Internal Revenue Service requirements as specified in § 31.3402(f)(5)-1(c) of the Treasury Regulations (26 CFR). FORM VA-4 INSTRUCTIONS Use this form to notify your employer whether you are subject to Virginia income tax withholding and how many exemptions you are allowed to claim. You must file this form with your employer when your employment begins. If you do not file this form, your employer must withhold Virginia income tax as if you had no exemptions. PERSONAL EXEMPTION WORKSHEET You may not claim more personal exemptions on form VA-4 than you are allowed to claim on your income tax return unless you have received written permission to do so from the Department of Taxation. Line 1. You may claim an exemption for yourself. Line 2. You may claim an exemption for your spouse if he or she is not already claimed on his or her own certificate. Line 3. Enter the number of dependents you are allowed to claim on your income tax return. NOTE: A spouse is not a dependent. Line 5. If you will be age 65 or over by January 1, you may claim one exemption on Line 5(a). If you claim an exemption for your spouse on Line 2, and your spouse will also be age 65 or over by January 1, you may claim an additional exemption on Line 5(b). Line 6. If you are legally blind, you may claim an exemption on Line 6(a). If you claimed an exemption for your spouse on Line 2, and your spouse is legally blind, you may claim an exemption on Line 6(b). FORM VA-4 Be sure to enter your social security number, name and address in the spaces provided. Line 1. If you are subject to withholding, enter the number of exemptions from: (a) Subtotal of Personal Exemptions - line 4 of the Personal Exemption Worksheet (b) Subtotal of Exemptions for Age and Blindness - line 7 of the Personal Exemption Worksheet (c) Total Exemptions - line 8 of the Personal Exemption Worksheet Line 2. If you wish to have additional tax withheld, and your employer has agreed to do so, enter the amount of additional tax on this line. Line 3. If you are not subject to Virginia withholding, check the box on this line. You are not subject to withholding if you meet any one of the conditions listed below. Form VA-4 must be filed with your employer for each calendar year for which you claim exemption from Virginia withholding. (a) You had no liability for Virginia income tax last year and you do not expect to have any liability for this year. (b) You expect your Virginia adjusted gross income to be less than the amount shown below for your filing status: Taxable Years Taxable Years Taxable Years Taxable Years 2005, 2006 2008 and 2010 and 2012 and and 2007 2009 2011 Beyond Single $7,000 $11,250 $11,650 $11,950 Married $14,000 $22,500 $23,300 $23,900 Married, filing a separate return $7,000 $11,250 $11,650 $11,950 (c) You live in Kentucky or the District of Columbia and commute on a daily basis to your place of employment in Virginia. (d) You are a domiciliary or legal resident of Maryland, Pennsylvania or West Virginia whose only Virginia source income is from salaries and wages and such salaries and wages are subject to income taxation by your state of domicile. Line 4. Under the Servicemember Civil Relief Act, as amended by the Military Spouses Residency Relief Act, you may be exempt from Virginia income tax on your wages if (i) your spouse is a member of the armed forces present in Virginia in compliance with military orders; (ii) you are present in Virginia solely to be with your spouse; and (iii) you maintain your domicile in another state. If you claim exemption under the SCRA check the box on Line 4 and attach a copy of your spousal military identification card to Form VA-4.
Extracted from PDF file 2023-virginia-form-va-4.pdf, last modified August 2011

More about the Virginia Form VA-4 Individual Income Tax TY 2023

We last updated the Employee's Withholding Exemption Certificate in January 2024, so this is the latest version of Form VA-4, fully updated for tax year 2023. You can download or print current or past-year PDFs of Form VA-4 directly from TaxFormFinder. You can print other Virginia tax forms here.

Related Virginia Individual Income Tax Forms:

TaxFormFinder has an additional 135 Virginia income tax forms that you may need, plus all federal income tax forms. These related forms may also be needed with the Virginia Form VA-4.

Form Code Form Name
Form VA-4P Withholding Exemption Certificate for Recipients of Pension and Annuity Payment
Form VA-4B Employee's Withholding Income Tax Credit for Income Taxes Paid to Another State

Download all VA tax forms View all 136 Virginia Income Tax Forms


Form Sources:

Virginia usually releases forms for the current tax year between January and April. We last updated Virginia Form VA-4 from the Department of Taxation in January 2024.

Show Sources >

About the Individual Income Tax

The IRS and most states collect a personal income tax, which is paid throughout the year via tax withholding or estimated income tax payments.

Most taxpayers are required to file a yearly income tax return in April to both the Internal Revenue Service and their state's revenue department, which will result in either a tax refund of excess withheld income or a tax payment if the withholding does not cover the taxpayer's entire liability. Every taxpayer's situation is different - please consult a CPA or licensed tax preparer to ensure that you are filing the correct tax forms!

Historical Past-Year Versions of Virginia Form VA-4

We have a total of twelve past-year versions of Form VA-4 in the TaxFormFinder archives, including for the previous tax year. Download past year versions of this tax form as PDFs here:


2023 Form VA-4

VA-4 08 23 11.indd

2022 Form VA-4

VA-4 08 23 11.indd

2021 Form VA-4

VA-4 08 23 11.indd

2020 Form VA-4

VA-4 08 23 11.indd

2019 Form VA-4

VA-4 08 23 11.indd

2018 Form VA-4

VA-4 08 23 11.indd

2017 Form VA-4

VA-4 08 23 11.indd

2016 Form VA-4

VA-4 08 23 11.indd

Employee's Withholding Exemption Certificate 2015 Form VA-4

VA-4 08 23 11.indd

Employee's Withholding Exemption Certificate 2013 Form VA-4

VA-4 08 23 11.indd

2012 Form VA-4

VA-4 08 23 11.indd

2011 Form VA-4

VA-4 08 23 11.indd


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Source: http://www.taxformfinder.org/index.php/virginia/form-va-4