UC W-4 Form

UNIVERSITY OF CALIFORNIA EMPLOYEE'S FEDERAL-STATE WITHHOLDING ALLOWANCE CERTIFICATE (Abbreviated)

Before completing this form, you must review the full W-4 form available here and as a PDF download. The full form has detailed explanations about the information you are entering. If you have any questions, review the full form thoroughly before contacting us.

Enter "N/A" for any question that does not apply to you.

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I. FEDERAL TAX FILING STATUS AND ALLOWANCES


II. STATE TAX FILING STATUS AND ALLOWANCES

OR If you are exempt from California income tax withholding because you are a nonresident of the State of California and are earning compensation while located outside the State, enter 997 in the box above. Complete and submit the Out-of-State Withholding form, UPAY 830.




III. EXEMPTION FROM TAX WITHHOLDING (NONRESIDENT ALIENS-DO NOT COMPLETE THIS SECTION)

I claim exemption from Federal and State withholding for 2017 and I certify that I meet BOTH of the following conditions for exemption:

  1. Last year I had a right to a refund of ALL Federal income tax withheld because I had NO tax liability; AND
  2. This year I expect a refund of ALL Federal income tax withheld because I expect to have NO tax liability. (If you claim exemption from withholding, it will automatically expire on February 15 of next year unless you file a new UC W-4/DE 4 on or before February 15 of next year.


  1. I certify under penalty of perjury that I am not subject to California withholding because I meet the conditions set forth under the Service Member Civil Relief Act, as amended by the Military spouses Residency Relief Act. (See page 2 of DE4)


IV. ADDITIONAL TAX WITHHOLDING
NONRESIDENT ALIENS-REFER TO INSTRUCTIONS ON FULL FORM



1. ADDITIONAL FEDERAL TAX WITHHOLDING


2. ADDITIONAL STATE TAX WITHHOLDING


CERTIFICATION

Under the penalties of perjury, I certify that the number of withholding allowances claimed on this certificate does not exceed the number to which I am entitled or, if claiming exemption from withholding, that I am entitled to claim the exempt status. I declare that I have examined this certificate and to the best of my knowledge and belief, it is true, correct, and complete.


Sign electronically by typing in your full name.