Form W-4p Kentucky Teachers' Retirement System Withholding Certificate For Pension Or Annuity Payments

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2016
Department of the Treasury Internal Revenue Service
Form W-4P for Kentucky Teachers’ Retirement System
Withholding Certificate for Pension or Annuity Payments / OMB No. 1545-0074
Purpose.. Form W-4P is for U.S. citizens, resident aliens, or their estates
What do I need to do? Complete lines A through G of the Personal
who are recipients of pensions, annuities (including commercial
Allowances Worksheet. Use the additional worksheets on page 2 to
annuities), and certain other deferred compensation. Use Form W-4P to
further adjust your withholding allowances for itemized deductions,
tell payers the correct amount of federal income tax to withhold from
adjustments to income, any additional standard deduction, certain
your payment(s). You also may use Form W-4P to choose (a) not to have
credits, or multiple pensions/more-than-one-income situations. If you do
any federal income tax withheld from the payment (except for eligible
not want any federal income tax withheld (see Purpose, earlier), you can
rollover distributions or payments to U.S. citizens delivered outside the
skip the worksheets and go directly to the Form W-4P below.
Sign this form. Form W-4P is not valid unless you sign it.
United States or its possessions) or (b) to have an additional amount of
tax withheld.
Future developments. The IRS has created a page on IRS.gov for
Your options depend on whether the payment is periodic, nonperiodic, or
information about Form W-4P and its instructions, at
an eligible rollover distribution, as explained on pages 3 and 4. Your
Information about any future developments affecting Form W-4P (such as
previously filed Form W-4P will remain in effect if you do not file a Form
legislation enacted after we release it) will be posted on that page.
W-4P for 2016.
Personal Allowances Worksheet (Keep for your records.)
Enter “1” for yourself if no one else can claim you as a dependent ▶
A
A ________
• You are single and have only one pension; or
• You are married, have only one pension, and your spouse has no income subject to withholding; or
B
Enter “1” if:
B ________
• Your income from a second pension or a job or your spouse’s pension or wages (or the total of all) is
$1,500 or less. ▶
Enter “1” for your spouse. But, you may choose to enter “-0-” if you are married and have either a spouse who has income subject to
withholding or more than one source of income subject to withholding. (Entering “-0-” may help you avoid having too little tax
C
C ________
withheld.) ▶
Enter number of dependents (other than your spouse or yourself) you will claim on your tax return ▶
D
D ________
Enter “1” if you will file as head of household on your tax return ▶
E
E ________
Child Tax Credit (including additional child tax credit). See Pub. 972, Child Tax Credit, for more information.
• If your total income will be less than $70,000 ($100,000 if married), enter “2” for each eligible child; then less “1” if you have
F
F ________
two to four eligible children or less “2” if you have five or more eligible children.
• If your total income will be between $70,000 and $84,000 ($100,000 and $119,000 if married), enter “1” for each eligible child ▶
Add lines A through F and enter total here. (Note: This may be different from the number of exemptions you claim
on your tax return.) ▶
G
G ________
• If you plan to itemize or claim adjustments to income and want to reduce your withholding, see the Deductions and Adjustments Worksheet on page 2.
For accuracy,
• If you are single and have more than one source of income subject to withholding or are married and you and your spouse both have income subject to
complete all
withholding and your combined income from all sources exceeds $50,000 ($20,000 if married), see the Multiple Pensions/More-Than-One-Income Worksheet
worksheets
on page 2 to avoid having too little tax withheld.
that apply.
• If neither of the above situations applies, stop here and enter the number from line G on line 2 of Form W-4P below.
OMB No. 1545-0074
K
T
’ R
S
ENTUCKY
EACHERS
ETIREMENT
YSTEM
Withholding Certificate for
2016
W-4P
Pension or Annuity Payments
Form
For Privacy Act and Paperwork Reduction Act Notice, see page 4.
Your first name & middle initial
Last Name
Your Social Security Number
Home address (number & street or rural route)
Claim or identification number
(if any) of your pension or
annuity contract
City or town, state, and ZIP code
Complete the following applicable lines.
Check here if you do not want any federal income tax withheld from your pension or annuity. (Do not complete line 2 or 3.) ▶
1.
2.
Total number of allowances and marital status you are claiming for withholding from each periodic pension or annuity payment.
Enter number
(You also may designate an additional dollar amount on line 3.) ▶
of allowances
(Enter number of allowances.) Marital status:
Single
Married
Married, but withhold at higher Single rate.
_________
3.
Additional amount, if any, you want withheld from each pension
or
annuity payment. (Note. For periodic payments, you cannot enter an
*MS-PM-10B*
amount here without entering the number (including
zero) of
allowances on line 2.) ▶
$_________
Your signature ▶
Date ▶
KTRS W-4P May 2016

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