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MI-W4
(Rev. 12-20)

EMPLOYEE’S MICHIGAN WITHHOLDING EXEMPTION CERTIFICATE

STATE OF MICHIGAN - DEPARTMENT OF TREASURY
This certificate is for Michigan income tax withholding purposes only. Read instructions on page 2 before completing this form.

Issued under P.A. 281 of 1967. 41. Full Social Security Number 42. Date of Birth

43. Name (First, Middle Initial, Last) 4. Driver’s License Number or State ID

Home Address (No., Street, P.O. Box or Rural Route) 45. Are you a new employee? (mm/dd/yyyy)
Yes If Yes, enter date of hire.........
City or Town State ZIP Code
No

6. Enter the number of personal and dependent exemptions (see instructions)............................................................ 46.

7. Additional amount you want deducted from each pay (if employer agrees)....................................................................7. $ .00

8. I claim exemption from withholding because (see instructions):

a. A Michigan income tax liability is not expected this year.

b. Wages are exempt from withholding. Explain: ____________________________________________________________________________________________________

c. Permanent home (domicile) is located in the following Renaissance Zone: ______________________________________________________________________

EMPLOYEE: If you fail or refuse to file this form, your employer must withhold Michigan income tax from your wages without allowance for any
exemptions. Keep a copy of this form for your records. See additional instructions on page 2.

Under penalty of perjury, I certify that the number of withholding exemptions claimed on this certificate does not exceed the number I am allowed to
claim. If claiming exemption from withholding, I certify that I do not anticipate a Michigan income tax liability this year.

9. Employee’s Signature 4Date

EMPLOYER: Complete the below section.

10. Employer’s Name 411. Federal Employer Identification Number

Address (No., Street, P.O. Box or Rural Route) City or Town State ZIP Code

Name of Contact Person Contact Phone Number

INSTRUCTIONS TO EMPLOYER: Keep a copy of this certificate with your records. All new hires must be reported to the State of Michigan. See
www.mi-newhire.com for information.

In addition, a copy of this form must be sent to the Michigan Department of Treasury if the employee claims 10 or more exemptions or claims they are
exempt from withholding. Send a copy to:
Michigan Department of Treasury
Tax Technical Section
P.O. Box 30477
Lansing, MI 48909
 INSTRUCTIONS TO EMPLOYEE’S
MICHIGAN WITHHOLDING EXEMPTION CERTIFICATE (Form MI-W4)
You must submit a Michigan withholding exemption Line 7: You may designate additional withholding if you
certificate (form MI-W4) to your employer on or before expect to owe more than the amount withheld.
the date that employment begins. If you fail or refuse
Line 8a: You may claim exemption from Michigan income
to submit this certificate, your employer must withhold
tax withholding if all of the following conditions are met:
tax from your compensation without allowance for any
exemptions. Your employer is required to notify the i) Your employment is intermittent, temporary, or less
Michigan Department of Treasury if you have claimed 10 than full time;
or more personal or dependency exemptions or claimed
ii) Your personal and dependency exemptions exceed
that you are exempt from withholding.
your annual taxable compensation;
You MUST provide a new MI-W4 to your employer

iii) 
You claimed exemption from federal withholding;
within 10 days if your residency status changes or if
and
your exemptions decrease because: a) your spouse, for
whom you have been claiming an exemption, is divorced iv) You did not incur a Michigan income tax liability for
or legally separated from you or claims his/her own the previous year.
exemption(s) on a separate certificate, or b) a dependent
Line 8b: Reasons wages might be exempt from
no longer qualifies under the Internal Revenue Code.
withholding include:
Line 5: If you check “Yes,” enter your date of hire.
• You are a nonresident spouse of military personnel
Line 6: Personal and dependency exemptions. The stationed in Michigan.
number of exemptions claimed here may not exceed
• You are a resident of one of the following reciprocal
the number of exemptions you are entitled to claim on a
states while working in Michigan: Illinois, Indiana,
Michigan Individual Income Tax Return (Form MI-1040).
Kentucky, Minnesota, Ohio, or Wisconsin.
Dependents include qualifying children and qualifying
relatives under the Internal Revenue Code, even if your • You are a member of a Native American tribe that
AGI exceeds the limits to claim federal tax credits for has a tax agreement with the State of Michigan
them. and whose principal place of residence is within the
designated agreement area.
Do not claim the same exemptions more than once or tax
will be under-withheld. Specifically, do not claim: • 
You are an enrolled member of a federally-
recognized tribe that does not have a tax
• Your personal exemption if someone else will claim
agreement with the State of Michigan, you reside
you as their dependent.
within that tribe’s Indian Country (as defined in 18
• 
Your personal exemption with more than one USC 1151), and compensation from this job will be
employer at a time. earned within that Indian Country.
• 
Your spouse’s personal exemption if they claim it Line 8c: For questions about Renaissance Zones,
with their employer. contact your local assessor’s office.
• Your dependency exemptions if someone else (for
example, your spouse) is claiming them with their
employer.