FormVirginia Employee's Withholding Exemption Certificate (Form VA-4) with instructionspage 2 of 2
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Part 86, page 35

DB Cooper-37879

Open in FBI Vault (Part 86, page 35 of the PDF)

FBI 164-81, Vault Part 86 p. 35 (DB Cooper-37879), Form — cooper.theunsolved.net/parts/Cooper-Part-86/pages/35

Transcript

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A. IF YOU FAIL to file this certifi[cate] with your employer, he must withhold Virginia income tax [from] your wages without exemption. If an employer believes that an employee is claim- ing an excessive number of exemptions, he will advise the Department of Taxation.

B. NUMBER OF EXEMPTIONS.—Do not claim more than the correct number of exemptions. However, if you expect to owe more income tax for the taxable year than will be withheld if you claim every exemption to which you are entitled, you may increase the withholding by claiming a smaller number of ex- emptions or you may enter into an agreement with your em- ployer to have additional amounts withheld.

C. EMPLOYEES WITH TWO OR MORE EMPLOYERS.—If you have more than one employer and wish to increase your with- holding to an amount nearer your correct income tax you should claim a smaller number or no exemptions on each Form Va.—4 filed with all employers other than your principal employer.

D. CHANGES IN EXEMPTIONS.—You may file a new certifi- cate at any time if the number of your exemptions INCREASES. You must file a new certificate within 10 days if the number of exemptions previously claimed by you DECREASES for any of the following reasons:

(1) Your wife (or husband) for whom you have been claiming exemp- tion is divorced or legally separated, or claims her (or his) own exemp- tion on a separate certificate.

(2) The support of a dependent for whom you claimed exemption is

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taken over by someone so that you no longer expect to furnish more than half the support [for the] [tax] year.

(3) You find that a dependent for whom you claimed exemption will receive $600 or more of income of his own during the taxable year.

OTHER DECREASES in exemption, such as the death of a wife or a dependent, do not affect your withholding until the next year, but require the filing of a new certificate by December 1 of the year in which they occur.

E. DEPENDENTS.—Do not claim any dependent in Line 4 (on other side) unless he or she meets all four of the follow- ing tests: (1) He or she is receiving over one-half of his or her support from you for the taxable year, and (2) he or she is "closely related" to you, and (3) he or she will not have as much as $600 gross income of his or her own during the taxable year (if a son, daughter, stepson, or stepdaughter is a full time student at an educational institution, this limitation does not apply), and (4) if married, her or his exemption is not claimed by her husband or his wife. "Closely related" means your children (including stepchildren and legally adopted children) and grandchildren; your parents and grandparents; your brothers and sisters; your immediate "in-laws" (mother-, father-, son-, daughter-, brother-, sister-in-law); your blood related uncles, aunts, nieces, and nephews.

F. PENALTIES.—Penalties are imposed for willfully supplying false information or willful failure to supply information which would reduce the withholding exemption.

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DB Cooper-37879