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Get DC D-4A 2016

Mber Permanent address (number and street) Apartment number City State Zip code + 4 Country or U.S. commonwealth Signature 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. Date Revised 12/2016 Instructions Who must file a Form D-4A? If you are not a resident of DC you must f le a Form D-4A with your employer to establish that you are not subject to DC income tax withholding..

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