Form Mw 507p - Annuity And Sick Pay Request For Maryland Income Tax Withholding
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1Form MW 507P
Annuity and Sick Pay Request
Comptroller of Maryland
for Maryland Income Tax Withholding
Revenue Administration Division
Annapolis, Maryland 21411-0001
Type or print full name
Social Security Number
Home address (number & street)
City, state, and zip code
A. Annuity contract claim or identification number
B. Enter the amount withheld from each annuity or sick pay payment
$
I request voluntary income tax withholding from any annuity or sick pay payments as authorized by Section 10-907 (b) of the Tax-General Article
of the Annotated Code of Maryland
(Signature)
(Date)
COM/RAD-044 3/02
Form MW 507P
Annuity and Sick Pay Request
Comptroller of Maryland
for Maryland Income Tax Withholding
Revenue Administration Division
Annapolis, Maryland 21411-0001
Type or print full name
Social Security Number
Home address (number & street)
City, state, and zip code
A. Annuity contract claim or identification number
B. Enter the amount withheld from each annuity or sick pay payment
$
I request voluntary income tax withholding from any annuity or sick pay payments as authorized by Section 10-907 (b) of the Tax-General Article
of the Annotated Code of Maryland
(Signature)
(Date)
COM/RAD-044 3/02
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