Iowa Form W-4p - Withholding Certificate For Pension Or Annuity Payments

Iowa W-4P Instructions

Eligibility Requirements

$32,000 or less. Note: The amount of any pension exclusion or

A partial exemption is provided to qualified Iowa residents

Social Security Phase-out exclusion must be added back to

receiving pensions, annuities, self-employed retirement benefits,

income for purposes of determining the low income exemption.

deferred compensation, and other retirement benefits. To qualify

Only one spouse must be 65 or older to qualify for the

you must be 55 years of age or older, disabled or a surviving

exemption.

spouse or other survivor of an individual who would have

Taxpayers under 65: You are exempt if (1) Your income is

qualified for the partial exemption in the tax year. To be

less than $5,000 and you are claimed as a dependent on another

considered disabled you must be receiving the retirement

person’s Iowa return; or (2) You are single and your income is

income on the basis of a documented disability or you must

$9,000 or less and you are not claimed as a dependent on

meet federal or state criteria for disability. Social Security

another person’s Iowa return; or (3) Your filing status is other

benefits are not covered by this exemption. Federal Civil

than single and your combined income is $13,500 or less.

Service annuitants who want Iowa tax withheld from federal

pensions should call the Office of Personnel Management toll-

Claiming No Exemption

free at 1-888-767-6738 or e-mail them at retire@opm.gov.

If this box is checked, Iowa income tax will be withheld on the

entire amount of taxable benefits received.

Withholding Choices

Withholding Rates

An Iowa resident may choose to have Iowa tax withheld on the

annual taxable amount, exempting $6,000. Married taxpayers

Payers have the option of withholding at the rate of 5% or using

may exclude up to $12,000 from the annual taxable amount. If

the published withholding formulas or withholding tables.

no choice is made, you will automatically be given a $6,000

Where To Send The Iowa W-4P

exemption. If you are receiving retirement income from more

Return the completed form to the person who handles your

than one source, you are still entitled to claim only a maximum

pension/retirement check, or, if planning to retire, your current

$6,000/$12,000 exemption.

payroll officer. If you are a federal employee, return it to OPM.

Low Income Exemption From Tax

Your choice will remain in effect until you complete a new

Taxpayers 65 years of age or older: You are exempt if (1)

W-4P. Withholding agents will retain the completed W-4P as

You are single and your income is $24,000 or less, or (2) Your

required under Iowa rule 701-38.3(1).

filing status is other than single and your combined income is

Iowa Department of Revenue

2010 Iowa W-4P

Withholding Certificate for Pension or Annuity Payments

Name: _________________________________________________ SSN: _________________________

Address: ______________________________________________________________________________

City: _____________________________________ State: ____________________ Zip: ______________

Signature: __________________________________________________________ Date: _____________

Are you an Iowa resident? ............................................................................................

Yes

Iowa income tax can be withheld only for Iowa residents.

I choose not to have income tax withheld from my pension/annuity .......................................................

NOTE: If you are an Iowa resident and the taxable portion of your annual distribution is greater

than $6,000 ($12,000 married Iowa filers), Iowa tax must be withheld if federal tax is being withheld

unless you qualify for the low income exemption described in the instructions above.

I choose to have Iowa income tax withheld from my pension/annuity at a rate of 5% (or based on the

published withholding formulas if the payer so chooses). Select one of the following:

• claiming no exemption (see instructions)..........................................................................................

• exempting $6,000 in benefits each year ...........................................................................................

• exempting $12,000 in benefits each year (married – status 2, 3, or 4 – Iowa filers only) ................

.00

Additional amount, if any, to be withheld from each benefit payment (whole dollars): $ ______________

See instructions for eligibility requirements.

44-020 (04/14/10)

Iowa Form W-4p - Withholding Certificate For Pension Or Annuity Payments - 2010

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