5.  Allowances for child and dependent care credit. ........................................................ 5. ______________  
6.  Total allowances. Add lines 1 through 5. .................................................................. 6. _____________ 3
_  
7.  Additional amount, if any, you want deducted each pay period. ................................. 7. ______________  
I, the undersigned, declare under penalties of perjury or false certificate, that I have examined this claim, and, 
to the best of my knowledge and belief, it is true, correct, and complete.