My Tax Filing Information#

State/Country
Jurisdiction
Description

FEDERAL

Filing Status
# of Exemptions
Tax Amount
Tax Percent

MULTIPLE JOBS

Multiple Jobs/Two Jobs

CLAIM DEPENDENTS

Qualifying Children (age under 17) - Multiply by $2000 - $
Other Dependents - Multiply by $500 - $
Total Dependent amount $

OTHER ADJUSTMENTS

Other Income $
Deductions $
Extra Withholding

STATE

Filing Status
# of Exemptions
Add'l Tax Per Period
Additional Exemptions
Add'l Tax for Res
Add'l Tax for Work
Tax Amount
Tax Percent

Misc Parameters

Tax Parm
Misc. Identifier
Description
Type
Dflt Value
Value

Notes#

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