Finish Applicaiton



    (Rev. December 2020)

    Department of the Treasury internal Revenue Service

    Employee's Withholding Certificate

    Complete Form W-4 so that your employer can withhold the correct federal income tax from your pay

    Give Form W-4 to your employer.

    Your withholding is subject to review by the IRS.

    OMB No. 1545-0074


    Step 1 :

    Does your name match the name on your social security card? If not,
    to ensure you get credit for your earnings, contact SSA at 800 772 1213 or go to

    Complete Steps 2-4 ONLY if they apply to you; otherwise, skip to step 5. See page 2 for more information on each step, who can claim exemption from withholding, when to use the estimator at, and privacy.

    Step 2 :
    Multiple Jobs
    or Spouse

    Complete this step if you (1) hold more than one job at a time, or (2) are married filing jointly and your spouse also works. The correct amount withholding depends on income earned from all of these jobs.

    Do only one of the following.

    (a) Use the estimator at for most accurate withholding for this step (and steps 3 - 4) ; or

    (b) Use the Multiple Jobs Worksheet on page 3 and enter the result in step 4(c) below for roughly accurate withholding ; or


    TIP : To be accurate, submit a 2021 Form W-4 for all other jobs. If you (or your spouse) have self-employment income, including as an independent contractor, use the estimator.

    Complete Steps 3-4(b) on Form W-4 for ONE of these jobs. Leave those steps blank for the other jobs. (Your withholding will be most accurate if you complete Steps 3-4(b) on the Form W-4 for the highest paying job.)

    Step 3 :

    If your total income will be $200,000 or less ($400,000 or less if married filling jointly):

    Multiply the number of qualifying children under age 17 by $2,000

    Multiply the number of other dependents by $5,00

    Add the amounts above and enter the total here............


    Step 4 :
    (Optional) :

    (a) Other income (not from jobs). If you want tax withheld for other income you
    expect this year that won't have withholding, enter the amount of other income here.
    This may include interest, dividends, and retirement income...

    (b) Deductions. If you expect to claim deductions other than the standard deduction and
    want to reduce your withholding,
    use the Deductions Worksheet on page 3 and enter the result here....

    (c) Extra withholding. Enter any additional tax you want withheld each pay period.

    4 (a)

    4 (b)

    4 (c)

    Step 5 :

    Under penalties of perjury, I declare that this certificate, to the best of my knowledge and belief, is true, correct, and complete.


    Employer's name and address

    First date of employment

    Employer identification number(EIN)

    For Privacy Act and Paperwork Reduction Act Notice, see page 3. Cat. No. 10220Q Form W-4 (2021)


    Employer's name and address

    First date of employment

    Employer identification number(EIN)




    (If you do not wish to claim an allowance, enter "0" in the brackets beside your marital status.)


    (Must be completed in order to enter an amount on step 5)






    Each Spouse








    (this is the maximum number of additional allowances you can claim. If the remainder is over $1,500 round up)

    (Employer: The letter indicates the tax tables in Employer's Tax Guide)

    8. EXEMPT: (Do not complete Lines 3 - 7 if claiming exempt) Read the Line 8 Instructions on page 2 before completing this section.

    a) I claim exemption from withholding because I incurred no Georgia income tax liability last year and I do not expect to have a Georgia income
    tax liability this year.

    b) I certify i am not subject to Georgia withholding because i meet the conditions set forth under the Service members Civil Relief Act as provided on page 2. My state of residence is . My spouse's (service member) state of residence is The states of residence must be
    the same to be exempt.

    I certify under penalty of purjury that I am entitled to the number of withholding allowances or the exemption from withholding status claimed on this Form G-4. Also, I authorize my employer
    to deduct per day period the additional amount listed above.

    Employer: Complete Line 9 and mail entire form only If the employee claims over 14 allowances or exempt from withholding.
    If necessary, mail from to: Georgia Department of Revenue, Withholding Tax Unit,
    1800 Century Blvd NE, Suite 8200, Atlanta, GA 30345

    Do not accept forms claiming additional allowances unless the worksheet has been completed. Do not accept
    forms claiming exempt if numbers are written on Lines 3 - 7.

    Employment Eligibility Verification
    Department of Homeland Security

    U.S. Citizenship and Immigration Services

    Form I-9

    OMB No. 1615-0047
    Expires 10/31/2022

    START HERE: Read instructions carefully before completing this form. The instructions must be available, either in paper or electronically, during completion of this form. Employers are
    liable for errors in the completion of this form.

    ANTI-DISCRIMINATION NOTICE: It is illegal to discriminate against work-authorized individuals. Employers CANNOT specify which document(s) an employee may present to establish employment authorization and identity. The refusal to hire or continue to employ an individual because the documentation presented has a future
    expiration date may also constitute illegal discrimination.

    Section 1. Employee Information and Attestation (Employess must complete and sign Section 1 of Form I-9 no later than first
    day of employemt,
    but not before accepting a job offer.)

    I am aware that federal law provides for imprisonment and/or fines for false statements or use of
    false documents in connection with the completion of this form.

    I attest, under penalty of perjury, that i am (check one of the following boxes):

    QR Code - Section 1
    Do Not Write In This Space

    Aliens authorized to work must provide only one of the following document numbers to complete Form I-9:
    An alien Registration Number/USCIS Number OR Form I-9 Admission Number OR Foreign Passport Number.

    Preparer and/or Translator Certification (check one):

    (Fields below must be completed and signed when preparers and/or translators assist an employee in completing Section 1.)

    I attest, under penalty of perjury, that I have assisted in the completion of Section 1 of this form and that to the best of my knowledge the information is true and correct.

    Employer Completes Next Page

    Employment Eligibility Verification
    Department of Homeland Security

    U.S. Citizenship and Immigration Services

    Form I-9

    OMB No. 1615-0047
    Expires 10/31/2022

    Section 2. Employer or Authorized Representative Review and Verification

    (Employers or their authorized representative must complete and sign Section 2 within 3 business days of the employee's
    first day of employment. You must physically examine one document from List A OR a combination of one document from List B and one document from List C as listed on the "Lists of Acceptable Documents.)

    Certification: I attest, under penalty of perjury, that (1) I have examined the document(s) presented
    by the above-named employee, (2) The above-listed document(s) appear to be genuine and to relate to the employee named, and (3) to the best of my knowledge the employee is authorized to work in the United States.

    Section 3. Reverification and Rehires (To be completed and signed by employer or authorized representative.)

    I attest, under penalty of perjury, that to the best of my knowledge. this employee is authorized to work in the United States, and if the employee presented document(s). The document(s) I have examined appear to be genuine and to relate to the individual.

    Direct Deposit Authorization



    This document must be signed by the employee requesting automatic deposit of paychecks and will be retained by Gusto.


    This authorizes ZenPayroll, Inc., dba Gusto ("Gusto") to send credit entries (and appropriate debit, reversal and adjustment entries), electronically or by any other commercially accepted method, to my account and to other accounts I identify in the future on the Gusto platform (the "Account"). This authorizes the financial institution holding the Account to post all the ACH transactions authorized herein shall comply with all applicable United States Laws. This authorization will be in effect until you delete the direct deposit account information from the Gusto platform and
    Gusto has had a reasonable opportunity to act on this change.

    Screening Fees & Equipment Acknowledgement

    I,* have been issued the equipment checked above and am notified
    that the related cost of will be deducted from my pay check.