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Form W-4V for Paterson New Jersey: What You Should Know

Social security number. Enter the name(s) of each dependent listed in box 22c. If you are the primary caregiver, report the relationship and the number of dependent children under 19 days old. Enter the filing status of each dependent, e.g., married filing jointly, as appropriate for the filing status. (NOTE: If you are filing for an increase in exemption for dependents who are 19 years or older before the date of a child's birth, report the age of the dependent child on Line 4 of Form W-4V with all applicable boxes checked.) 3. Name of the payer. 4. Date of Birth: Enter date you became legally responsible for the child. 5. Name and address of the child's birth certificate or if the child does not know his or her own birthdate or identity, use an acceptable image. 6. Name and address of any person who will be legally responsible for the child under 1) who does not have an acceptable birth certificate, or whose birth certificate is unavailable. 7. Estimated monthly income (see paragraph (a) below) of your child for each covered month of the child's life. 8. Social Security number or Social Security number of the payer. (See paragraph (b) below for additional required documents) 9. A statement of your child's health status which states how the child is expected to look and/or act when he or she reaches 18 years old and, if not, why that decision was made. 10. Proof of non-expiration date of any insurance that he or she has maintained to cover the health care needs of any dependents. Please provide this to your employer for approval. (e.g., letter from a physician or the like.) 11. Age of the child or child age when you expect the child to reach 18 or, if there is no child age when you expect the child to reach 18, your estimated age. 12. The number of dependents to be covered for the child by his or her payer if there is no acceptable birth certificate or proof of non-expiration date of any insurance. If the child is 16, then: Enter 8 or fewer dependents for this child. If the child is 16 or 17, then: Enter 4 or more dependents for this child. If the child is 18 or older, then: Enter 2 or more dependents for this child. 13.

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