Form W-4p - Withholding Certificate For Pension Or Annuity Payments - 2012 Page 2
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Form W-4P (2012)
Page
Deductions and Adjustments Worksheet
Note. Use this worksheet only if you plan to itemize deductions or claim certain credits or adjustments to income.
1 Enter an estimate of your 2012 itemized deductions. These include qualifying home mortgage interest,
charitable contributions, state and local taxes, medical expenses in excess of 7.5% of your income, and
1 $
miscellaneous deductions .
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{
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$11,900 if married filing jointly or qualifying widow(er)
2 Enter:
$8,700 if head of household
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2 $
$5,950 if single or married filing separately
3 Subtract line 2 from line 1. If zero or less, enter “-0-” .
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3 $
4 Enter an estimate of your 2012 adjustments to income and any additional standard deduction (see
4 $
Pub. 505)
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5 Add lines 3 and 4 and enter the total. (Include any credit amounts from the Converting Credits to
Withholding Allowances for 2012 Form W-4 worksheet in Pub. 505.) .
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5 $
6 Enter an estimate of your 2012 income not subject to withholding (such as dividends or interest)
6 $
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7 Subtract line 6 from line 5. If zero or less, enter “-0-” .
7 $
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8 Divide the amount on line 7 by $3,800 and enter the result here. Drop any fraction
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8
9 Enter the number from the Personal Allowances Worksheet, line G, page 1 .
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9
10 Add lines 8 and 9 and enter the total here. If you use the Multiple Pensions/More-Than-One-Income
Worksheet, also enter this total on line 1 below. Otherwise, stop here and enter this total on Form
W-4P, line 2, page 1 .
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10
Multiple Pensions/More-Than-One-Income Worksheet
Note. Complete only if the instructions under line G, page 1, direct you here. This applies if you (and your spouse if married filing jointly) have more than
one source of income subject to withholding (such as more than one pension, or a pension and a job, or you have a pension and your spouse works).
1 Enter the number from line G, page 1 (or from line 10 above if you used the Deductions and
Adjustments Worksheet) .
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1
2 Find the number in Table 1 below that applies to the LOWEST paying pension or job and enter it here.
However, if you are married filing jointly and the amount from the highest paying pension or job is
$65,000 or less, do not enter more than “3” .
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2
3 If line 1 is more than or equal to line 2, subtract line 2 from line 1. Enter the result here (if zero, enter
“-0-”) and on Form W-4P, line 2, page 1. Do not use the rest of this worksheet
3
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Note. If line 1 is less than line 2, enter “-0-” on Form W-4P, line 2, page 1. Complete lines 4 through 9 below to figure the
additional withholding amount necessary to avoid a year-end tax bill.
4 Enter the number from line 2 of this worksheet .
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5 Enter the number from line 1 of this worksheet .
5
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6 Subtract line 5 from line 4 .
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6
7 Find the amount in Table 2 below that applies to the HIGHEST paying pension or job and enter it here
7 $
8 Multiply line 7 by line 6 and enter the result here. This is the additional annual withholding needed .
8 $
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9 Divide line 8 by the number of pay periods remaining in 2012. For example, divide by 12 if you are paid
every month and you complete this form in December 2011. Enter the result here and on Form W-4P,
line 3, page 1. This is the additional amount to be withheld from each payment
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9 $
Table 1
Table 2
Married Filing Jointly
All Others
Married Filing Jointly
All Others
If wages from LOWEST
Enter on
If wages from LOWEST
Enter on
If wages from HIGHEST
If wages from HIGHEST
Enter on
Enter on
paying job or pension are—
line 2 above
paying job or pension are—
line 2 above
paying job or pension are—
line 7 above
paying job or pension are—
line 7 above
$0 - $5,000
0
$0 - $8,000
0
$0 - $70,000
$570
$0 - $35,000
$570
5,001 - 12,000
1
8,001 - 15,000
1
70,001 - 125,000
950
35,001 - 90,000
950
2
15,001 - 25,000
2
125,001 - 190,000
1,060
90,001 - 170,000
1,060
12,001 - 22,000
22,001 - 25,000
3
25,001 - 30,000
3
190,001 - 340,000
1,250
170,001 - 375,000
1,250
25,001 - 30,000
4
30,001 - 40,000
4
340,001 and over
1,330
375,001 and over
1,330
30,001 - 40,000
5
40,001 - 50,000
5
40,001 - 48,000
6
50,001 - 65,000
6
48,001 - 55,000
7
65,001 - 80,000
7
55,001 - 65,000
8
80,001 - 95,000
8
65,001 - 72,000
9
95,001 - 120,000
9
72,001 - 85,000
10
120,001 and over
10
85,001 - 97,000
11
97,001 - 110,000
12
110,001 - 120,000
13
120,001 - 135,000
14
135,001 and over
15
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