Fillable IRS Form 4670 – Employee Statement for Paid Family & Medical Leave Credit

Form 4670, Employee’s Statement Regarding Eligibility for the Paid Family and Medical Leave Credit, is required when you claim the new credit on your federal tax return. Instead of printing, printing, and hand‑signing a paper copy, you can fill out the fillable PDF directly in your browser using the Formize PDF Filler app.

What Is IRS Form 4670?

This form is used by employees to certify that they meet the eligibility criteria for the Paid Family and Medical Leave (PFML) credit. The credit reduces the employer’s payroll tax liability and is claimed on Form 941 or the annual Form 944.

How to Complete Form 4670 Online

Follow the simple steps below to fill out the form without leaving the page:

• Click the "Fill out this form" button below.
• Wait a few seconds while the Formize PDF Filler app loads.
• Enter your personal information, employer details, and answer the eligibility questions.
• Use the built‑in e‑signature field to sign electronically.
• When you’re done, download the completed PDF or print it for your records.

Common Mistakes & Tips

• Incorrect SSN or EIN: Double‑check the numbers before submitting.
• Leaving a required box blank: The PDF filler will highlight missing fields.
• Using an outdated form version: Always use the latest PDF from the IRS (link provided below).
• Signature errors: The e‑signature field must be completed; otherwise the form is considered incomplete.

Where to Submit the Completed Form

The employee’s signed Form 4670 is attached to the employer’s payroll‑tax filing (Form 941 or Form 944). Keep a copy for your records and provide the original to your employer.

Download the Official PDF

If you prefer a hard copy, you can download the official IRS PDF from the link below. The same file is used by the Formize filler, ensuring full compatibility.

Download IRS Form 4670 (PDF)