- Paper: Letter (8.5in x 11in)
- Copies to print: 2
- Give a blank form to a new employee or to employees who have changes in their tax situation.
- The employee fills up this form and returns it to the employer.
- Employer to keep a copy for their record.
- Forward a signed copy of this form if an employer believes an employee improperly claimed too many exemptions or dependency credits.
- The employer must include an explanation as to why he/she believes that the employee improperly completed this form and any other supporting documentation and mail to:
LOUISIANA DEPARTMENT OF REVENUE
CRIMINAL INVESTIGATIONS DIVISION
PO BOX 2389
BATON ROUGE LA 70821-2389
- Employers must keep a copy for their records.
- If the number of your claimed allowances decreases, you must file a new form within 10 days after the change. Except if the change is the result of the death of a spouse or a dependent.
- You may file a new form any time your withholding allowances increases.
For newly hired employees to report their withholding exemption to their employer. It is also for employees who have recently changed their tax status which will affect their withholding exemptions.