Form NH-4 (2024)

New Hiring Form

Complete this form so your employer can withhold the correct federal income tax.

Employer Copy Keep for your records

Note: Follow the step-by-step instructions. Your entries stay on file with your employer.

Step 1

Employee Information

First name and middle initial Last name Social security number

Home address (number and street) City, state, ZIP

Filing status (check one) Single or Married filing separately Married filing jointly or Qualifying surviving spouse Head of household

Step 2

Multiple Jobs or Spouse Works

Complete this step if you (1) hold more than one job or (2) are married filing jointly and your spouse works.

Use the IRS estimator and enter the result on Step 4(c). Check here if there are only two jobs total in the household. Use the worksheet on page 3 and enter the result on Step 4(c).

Step 3

Claim Dependents

Qualifying children under 17 x $2,000 Other dependents x $500 Add the amounts above

Step 4

Other Adjustments (Optional)

Other income (not from jobs) Deductions Extra withholding each pay period

Step 5

Sign Here

Under penalties of perjury, I declare that this form is true, correct, and complete.

Employee signature Date

For Employer Use Only

Employer name and address Employer identification number (EIN) First date of employment

Review your entries before submitting this form.