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The box that applies: Withhold at Single Rate Married (surviving spouse or unmarried Head of Household) Rate Married, but withhold at Single Rate 1. Total number of exemptions you are claiming not to exceed line f in worksheet below 1. 2. Additional withholding per pay period under agreement with employer 2. 3. I claim exemption from withholding because I do not expect to owe Maryland tax. See instructions below and check.

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