Form W-4p - Withholding Certificate For Pension Or Annuity Payments - 2013

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W-4P
OMB No. 1545-0074
Withholding Certificate for
Form
2013
Pension or Annuity Payments
Department of the Treasury
Internal Revenue Service
Purpose. Form W-4P is for U.S. citizens, resident aliens, or their estates who
What do I need to do? Complete lines A through G of the Personal
are recipients of pensions, annuities (including commercial annuities), and
Allowances Worksheet. Use the additional worksheets on page 2 to further
certain other deferred compensation. Use Form W-4P to tell payers the correct
adjust your withholding allowances for itemized deductions, adjustments to
amount of federal income tax to withhold from your payment(s). You also may
income, any additional standard deduction, certain credits, or multiple pensions/
use Form W-4P to choose (a) not to have any federal income tax withheld from
more-than-one-income situations. If you do not want any federal income tax
the payment (except for eligible rollover distributions or payments to U.S.
withheld (see Purpose, earlier), you can skip the worksheets and go directly to
citizens delivered outside the United States or its possessions) or (b) to have an
the Form W-4P below.
additional amount of tax withheld.
Sign this form. Form W-4P is not valid unless you sign it.
Your options depend on whether the payment is periodic,
Future developments. The IRS has created a page on IRS.gov for information
nonperiodic, or an eligible rollover distribution, as explained on pages 3
about Form W-4P and its instructions, at Information about
and 4. Your previously filed Form W-4P will remain in effect if you do not
any future developments affecting Form W-4P (such as legislation enacted after
file a Form W-4P for 2013.
we release it) will be posted on that page.
Personal Allowances Worksheet (Keep for your records.)
A Enter “1” for yourself if no one else can claim you as a dependent .
A
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• You are single and have only one pension; or
• You are married, have only one pension, and your spouse
B Enter “1” if:
has no income subject to withholding; or
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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.
C 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 withheld.) .
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C
D Enter number of dependents (other than your spouse or yourself) you will claim on your tax return
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D
E Enter “1” if you will file as head of household on your tax return .
E
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F 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 $65,000 ($95,000 if married), enter “2” for each eligible child; then less “1” if
you have three to six eligible children or less “2” if you have seven or more eligible children.
• If your total income will be between $65,000 and $84,000 ($95,000 and $119,000 if married), enter “1” for each
eligible child .
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F
{
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G 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.)
• If you plan to itemize or claim adjustments to income and want to reduce your withholding,
For
see the Deductions and Adjustments Worksheet on page 2.
accuracy,
• If you are single and have more than one source of income subject to withholding or are
complete
married and you and your spouse both have income subject to withholding and your
all
combined income from all sources exceeds $40,000 ($10,000 if married), see the Multiple
worksheets
Pensions/More-Than-One-Income Worksheet on page 2 to avoid having too little tax withheld.
that apply.
• If neither of the above situations applies, stop here and enter the number from line G on line 2
of Form W-4P below.
Separate here and give Form W-4P to the payer of your pension or annuity. Keep the top part for your records.
W-4P
OMB No. 1545-0074
Withholding Certificate for
Form
2013
Pension or Annuity Payments
Department of the Treasury
For Privacy Act and Paperwork Reduction Act Notice, see page 4.
Internal Revenue Service
Your first name and middle initial
Last name
Your social security number
Claim or identification number
Home address (number and street or rural route)
(if any) of your pension or
annuity contract
City or town, state, and ZIP code
Complete the following applicable lines.
1 Check here if you do not want any federal income tax withheld from your pension or annuity. (Do not complete line 2 or 3.)
2 Total number of allowances and marital status you are claiming for withholding from each periodic pension or
annuity payment. (You also may designate an additional dollar amount on line 3.)
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(Enter number
Marital status:
Single
Married
Married, but withhold at higher Single rate.
of allowances.)
3 Additional amount, if any, you want withheld from each pension or annuity payment. (Note. For periodic payments,
you cannot enter an amount here without entering the number (including zero) of allowances on line 2.)
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$
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Your signature
Date
W-4P
Form
(2013)
Cat. No. 10225T

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