HomeMy WebLinkAbout0490 DEPARTMENT OF THE AtR FORCE
HEAOOUARTERS 351:~ COAIBAT SUPPORT GROUP (SAC) '
WHITEMAN AIR F~RCE BASE, MISSOURI 65301 ~
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QE~" D r~ 29 tQber 1971
~T-N oF` ~ ~1LE6 ANO RECpROEO
ST. ~UC(E COUMTY F~A.
5"9JE~r: Certification of Official Residence Records QOCER PO~TRAt
CtERK CIRCUIT COURT ~
p~~~Rn vFRlF~EO.....~~,
T°` Secretary of State of FloridR 21889~ N0V 15 3 sS 1 M~T ~
Tallahassee, Florida
I certify the official milicary records of Captain Richard F. Ennis
reflect the state of Florida as tiis state of domicile.
~ ~ ~ 4
MARY A. DELSMAN , Lt Col, US.~F
Chief, Base Personnel Office
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i~, ~"a' EMPLOYEE'S WITHNOlDIN6 EXEMP1i0N CERTIFlCATE ``~'T
` ?n+. ~c t~e..~.. f N9L,~ R~c ?+qRD F s.a~ s.~~+~, N..e.~ _ o ~ ~ ?a - 7~Ps
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~-9~!~YY._ Gry .Ps R T t~ C~ c~ t. s+w FL o l~ ! k L i~~ o.a ?3 `~t~
°~01~ How To cu~M YouR wm~~o~~r,c~ ~Priorrs
w. u~. tK.
~A ~r w~l~. 1. It SINGLE (or H n~med ~nd wi~A ~iLltqld~ne as siezte pe~• . ' no e~emptiora, rriU "0"
0~~ M 2 1( MARRIED, orn u~mpboa ach is attoM~Dls for Au~3 and rif~ it not c4im~Q on snothu ~tiate.
~id ~IrMN 1l.f. (a) It ~ d~~n OoM of Nw a~m ns, wj;ff "2": (p) ou tl~im on~ ol U~s» ~cem
, I~aM ta 1rM D~ / P~. ~"1,': (U ~9 yon
~ ~ tlsim neitMr ot thts~ ~csmptwes. wri "0" - • f/1/~~" ~7 . . .
3. Ex~n?ptionf (ot ap aad Dtindnest (sppliaDt~ Iy to You ~nd jr6tu r~f~ ut Mt e b:
~p~ (a) tf you or ~our wlt~ will Dt 65 yean d ~ er at d~s end of tM p~ar, and you clai~a tAis aemptan, wri "I";
K OotM ~riN b~ 65 a olde~, snd you d~~m Doth o m wnte "2" .
ri
(p) If you or rour wriN ire blir~ and you da~m this exempGon. . . •~m potb of
~ ~ tl~n~ auuptioas, writa "2" . .
N~ 4. If you d~ie oumptions lot on~ or nwre depenQents, wnb the numDer of sucA ~x~mptions. (Oo not daim atmption ...~Y-.
M/M~M ir M~
M~/ b 1~ 1ot a d~ptndtot uN~ss ~ou ~n awtit~ed ursdK Instructan 4 ort otRrr side.) .
t{aiM/ w ~ur S. ~ diiln add~tional ritANoddie~ sllorr~ntes tor itemi~ed deductions fdl out ~M ittich Schedu4 A(Form W-4), ~nd ent~f
~OindK tM numMt of ~sac~ daim~d (if d~imed fiN new Form W-4 esch ~r) . . . . . . . . . . . . . .
•MrY M» 6. Md tM u~pnptioa aad Nbw~nus (it amr) wA~ch pau Aaw dsim~d aDow ~nd wrft~ tM~t
Nri~. 7. Addition~) witAholdi ptriod unAtr a nunent w~lh ~mmpbper. (Sa Instruct~n 1). .
~ t~RTifY ~Iw d diYYWa u~.~tlw~ c4i.N M t~b er4twa M« .~t ac.N .A~cA 1 ~u .r--~r-~-~
10~t~I lt~. tsiA~q
~ . ;rl)~{~... ~i^'1`,~:~: i.", i~F h:_~1~. .a~~'.~'
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1. N::MBER OF E~1p~p,,.-po oot ckim m~e thm ti~e sibt~, 61e a ncw aaificsle b~ D~ie~mbet 1 a( t~e ~ar in „}~ich the
rotre~et number aE eiampea~m. No+rsva, if ~on eipect to ow•e morc death oceun.
lDCOme t~ i~a wiL bt ~rithbeld ~ ~m~lkr number d acrmptwns may For fureher infoimition ao~osuit pour laal District D~reROr o( Ia.
be dauned a~ou ma~ enter ~aeo aa ~nth ~out empJoyer to ternal Revrnne or ywr emplorer.
~n
have ~d.~tioeul amouab withheld. ote this if ~on hare more than
ooe emF~afer. or i[ bot6 6usbaad and wife are emplo~cd. s~d~e
~ DEPENDEHTS.-To quaLf~ as ~our depcudcot ( i:ne ~ on ocbet
perwn (a) must raci+~e mote ttun one half of hu or txr
2 REMI2ED DEDUCTlONS.-See Schcduie A(Form VP-4) for support from you for the peu. and (b) must hare las chan ~600 gros~
oo cla:m~qg a.ld,t~unal allowanca bsser~ on largc ucm~zed ,'n<urne d~~ ~ i•eu (exc t~our d,~ld who is a ~t~nt ot ~bo is
:~ada t9 ge and~c) musc not be dsimed as.aa ~mpt~on
b~ sucfi perxn's husband or wde, aad (dj must be a ot~sm or raidmt
3. CHAWGE.$ IN EXEM''1'IONS.--You ma~ 61e a rxw cert~bcate uf the l,'n~ted Sutes or a rcsi.ient of Caoa.~a. Maico, t3~e AepuMit d
at at~ ume i
f d ~ e a~ m b
a o E ~oar e:empaons INC1tFAStS. P~nama w the Canal Zooe (this does oot app ly to ~a i l~m ef?il d lejatl
~c3vF~rcd b! tnd lir+ng w~tb a Un,ted Suta cit;:ea ~brosd). ~od (t;
Yoe~ 111ust 6k a oew certificate w~ch,n t0 da~s if t6e n~:mber of m,.~t ( i) fnre ~our home as his pnMipal raidence aod be a rncmber
P~~~~1 ~~+~d bf 90~ DF.qtEASES 6cciuse: of ~our Iwusefiold for the entur ~eat. or (I) be retated eo ron as
1~1 Yq~r wdt {pr ?~~dl fot ~baia !iR yKy daim.n~ ~empboo is fOllOwf:
ae.orc:d or {~p!!~ ~an1~l. or el~+mr ~(o~ Lis) o~o eumpewe os • Yoor ~oo or d~a aea (ialud~ alt
t t~
~ryusls otsoiiatt. idopetd cAildteo). atpdcsild. i1eP
~on, +npdau~Eur. foc ia-1~~. or av~~ter ~o-li~:
(b T1t wppurt d t dep~eodea~t for ~6om ~oo daimcd aoern ioa is taken Ya~r (,cher awNtr, inndpuen~. xeP(at6u,
D~ rap~ot6er. fsther•iu-1~~. or
o+a ioewoe sLs, is ~t ~oo 0o iorrer arat o fnran6 mwe e6aa hal! t~e moenrr ~e-L. ~r~raLer. ~prpusecr, EaU Seot6er, aatf sirecr, lrabrr•
~iD~ lor.e6t s~v. Your arocber, ~uter,
(c1 Y~a fud th~t ~ io law, q intt~ in 1~~;
i6CO ar ~oie of ocame~d
l~~~ot ~ ioe ~ claiaxd ~emp:ioo • el.' rr~ri+e Yeur Ynck, •uet. aepbe~, a airce (bat oe1~ il yda+td bt bbod
a Mydeat or ~bo b~odet 19 t9t ~cat (ncept ~wr chill ~no ~s
°f'~`). S. PEHAITIES.-DCnalties are imposcti~ for w;llfull~ supplyiqs filx
1?~e doatb d t~ife or a depe~~deat, doe~ oot agat tour wich}wlding inForma~oo or .illful fnlure to supplf ~oform~4oo vh~cb ~rouid e+e-
uatil atst rtat. but ~equ~ta tht blig~ of a oe+? «st~6cate_ If poa- Juce the w~~thhold,ns e:cmpuons.
a~ w~wor ~wmw urst ~Y-1~--7fW1-1 t) R~~ f ~M
8at;l~ ~Cf vs.~ ~