Arizona Form A-4 - Employee'S Arizona Withholding Percentage Election - 1998
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1ARIZONA FORM
1998
Employee's Arizona Withholding Percentage Election
A-4
Type or print your full name
Your social security number
Home address (number and street or rural route)
City or town, state, and ZIP code
Arizona Withholding Percentage Election Options (choose only one).
1.
My annual compensation is $15,000 or more. I choose to have Arizona withholding at the rate of
17%
20%
22%
28%
32%
of the federal tax withholding. (check only one box)
2.
My annual compensation is less than $15,000. I choose to have Arizona withholding at the rate of
10%
17%
20%
22%
28%
32%
of the federal tax withholding. (check only one box)
3.
I hereby elect an Arizona withholding percentage of zero for 1998 payroll periods beginning on or after August 21, 1998, and I certify that I meet BOTH of the
following qualifying conditions for this election:
I had NO Arizona tax liability for the taxable year 1997, AND
I expect to have NO Arizona tax liability for the taxable year 1998.
I certify that I have made the percentage election marked above.
,
Signature
Date
19
ADOR 06-0041 (98)
ARIZONA FORM
Employee's Arizona Withholding Percentage Election
1998
A-4
Type or print your full name
Your social security number
Home address (number and street or rural route)
City or town, state, and ZIP code
Arizona Withholding Percentage Election Options (choose only one).
1.
My annual compensation is $15,000 or more. I choose to have Arizona withholding at the rate of
17%
20%
22%
28%
32%
of the federal tax withholding. (check only one box)
2.
My annual compensation is less than $15,000. I choose to have Arizona withholding at the rate of
10%
17%
20%
22%
28%
32%
of the federal tax withholding. (check only one box)
3.
I hereby elect an Arizona withholding percentage of zero for 1998 payroll periods beginning on or after August 21, 1998, and I certify that I meet BOTH of the
following qualifying conditions for this election:
I had NO Arizona tax liability for the taxable year 1997, AND
I expect to have NO Arizona tax liability for the taxable year 1998.
I certify that I have made the percentage election marked above.
Signature
Date
,
19
ADOR 06-0041 (98)
ARIZONA FORM
Employee's Arizona Withholding Percentage Election
1998
A-4
Type or print your full name
Your social security number
Home address (number and street or rural route)
City or town, state, and ZIP code
Arizona Withholding Percentage Election Options (choose only one).
1.
My annual compensation is $15,000 or more. I choose to have Arizona withholding at the rate of
17%
20%
22%
28%
32%
of the federal tax withholding. (check only one box)
2.
My annual compensation is less than $15,000. I choose to have Arizona withholding at the rate of
10%
17%
20%
22%
28%
32%
of the federal tax withholding. (check only one box)
3.
I hereby elect an Arizona withholding percentage of zero for 1998 payroll periods beginning on or after August 21, 1998, and I certify that I meet BOTH of the
following qualifying conditions for this election:
I had NO Arizona tax liability for the taxable year 1997, AND
I expect to have NO Arizona tax liability for the taxable year 1998.
I certify that I have made the percentage election marked above.
Signature
Date
,
19
ADOR 06-0041 (98)
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