Form D-4A "Certificate of Nonresidence in the District of Columbia" - Washington, D.C.

What Is Form D-4A?

This is a legal form that was released by the Washington DC Office of Tax and Revenue - a government authority operating within Washington, D.C.. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on December 1, 2016;
  • The latest edition provided by the Washington DC Office of Tax and Revenue;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a printable version of Form D-4A by clicking the link below or browse more documents and templates provided by the Washington Dc Office of Tax and Revenue.

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Download Form D-4A "Certificate of Nonresidence in the District of Columbia" - Washington, D.C.

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Form D-4A Certifi cate of Nonresidence in the District of Columbia
Government of the
District of Columbia
Enter Year
First name
M.I. Last name
Temporary DC address (number and street)
Social security number
Permanent address (number and street)
Apartment number
City
State
Zip code + 4
Country or U.S. commonwealth
Signature
Under penalties of law, I certify that my permanent residence is not in DC and that I will not be residing in DC for 183 days or more in the tax year.
Signature
Date
Revised 12/2016
Form D-4A Certifi cate of Nonresidence in the District of Columbia
Government of the
District of Columbia
Enter Year
First name
M.I. Last name
Temporary DC address (number and street)
Social security number
Permanent address (number and street)
Apartment number
City
State
Zip code + 4
Country or U.S. commonwealth
Signature
Under penalties of law, I certify that my permanent residence is not in DC and that I will not be residing in DC for 183 days or more in the tax year.
Signature
Date
Revised 12/2016
Instructions
Who must fi le a Form D-4A?
What if your resident status changes?
If you are not a resident of DC you must f le a Form D-4A
If you become a DC resident any time after you have f led
with your employer to establish that you are not subject to DC
a Form D-4A with your employer, you must f le a Form D-4
income tax withholding. You qualify as a nonresident if:
promptly so that the proper amount of DC income tax can be
withheld from your wages.
• Your permanent residence is outside DC during all of
the tax year and you do not reside in DC for 183 days or
How do you fi le the Form D-4?
more in the tax year.
After completing this form, give it to your employer to keep
on f le.
• You are a service member’s spouse.
Employees who are residents of DC should f le a Form D-4,
DC Withholding Allowance Certif cate.
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