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Employee's Virginia Income Tax Withholding Exemption Certificate (Form VA-4) with sample data and marked fields.

Form VA-4 Employee's Virginia Income Tax Withholding Exemption Certificate with fields for Social Security Number, Name, Address, and checkboxes for exemption claims.

Form VA-4 Employee's Virginia Income Tax Withholding Exemption Certificate with fields for Social Security Number, Name, Address, and checkboxes for exemption claims.

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