Form W-4p - Withholding Certificate - 2017
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1
22017
Form W-4P for Teachers’ Retirement System of Kentucky
Department of the Treasury Internal Revenue Service
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 who are
What do I need to do? Complete lines A through G of the Personal
Allowances Worksheet. Use the additional worksheets on page 2 to further
recipients of pensions, annuities (including commercial annuities), and certain
other deferred compensation. Use Form W-4P to tell payers the correct amount
adjust your withholding allowances for itemized deductions, adjustments to
of federal income tax to withhold from your payment(s). You also may use Form
income, any additional standard deduction, certain credits, or multiple
pensions/more-than-one-income situations. If you don’t want any federal income
W-4P to choose (a) not to have any federal income tax withheld from the
payment (except for eligible rollover distributions or for payments to U.S. citizens
tax withheld (see Purpose, earlier), you can skip the worksheets and go directly
to be delivered outside the United States or its possessions) or (b) to have an
to the Form W-4P below.
additional amount of tax withheld. Your options depend on whether the payment
Sign this form. Form W-4P is not valid unless you sign it.
is periodic, nonperiodic, or an eligible rollover distribution, as explained on pages
Future developments. For the latest information about Form W-4P, such as
3 and 4. Your previously filed Form W-4P will remain in effect if you don’t file a
legislation enacted after we release it, go to
Form W-4P for 2017.
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
Enter “1” if:
B
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 two to four eligible children or less “2” if you have five or more eligible children.
F
F ________
• 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 ▶
G Add lines A through F & enter total here. (Note: This may be different from the number of exemptions you claim on your tax return.) ▶
G ________
• If you plan to itemize or claim adjustments to income and want to reduce your withholding,
For accuracy,
see the Deductions and Adjustments Worksheet on page 2.
complete all
• If you’re 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
worksheets
withholding and your combined income from all sources exceeds $50,000 ($20,000 if married), see the Multiple Pensions/More Than-One-Income
that apply.
Worksheet on page 2 to avoid having too little tax withheld.
• If neither of the above situations applies, stop here and enter the number from line G on line 2 of Form W-4P below.
T
’ R
S
K
EACHERS
ETIREMENT
YSTEM OF
ENTUCKY
Withholding Certificate for
2017
W-4P
Pension or Annuity Payments
Form
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
Enter number
payment. (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
*MS-PM-10B*
pension or annuity payment. (Note. For periodic payments, you
cannot
enter an amount here without entering the number
zero) of allowances on line 2.) ▶
$_________
(including
Your signature ▶
Date ▶
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