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Enter your personal, pension, credit, adjustment, and signature details, then review your completed Form W-4P before continuing.

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Complete all required fields

Fields marked with an asterisk are required before you can submit Form W-4P.

Step 1: Personal Information

First name

Middle initial

Last name

Address

City or town

State

ZIP code

Social Security Number

Filing status

Single or Married filing separately Married filing jointly or Qualifying surviving spouse Head of household

Step 2: Income From a Job or Multiple Pensions or Annuities

Complete this step when you have income from a job, more than one pension or annuity, or when filing jointly and your spouse receives job, pension, or annuity income.

2(b)(i) Total taxable annual income from jobs

2(b)(ii) Lower-paying pensions or annuities

2(b)(iii) Total annual income

Complete Steps 3 through 4(b) on this form only when the job-income field above is blank and this pension or annuity pays the most annually.

Step 3: Claim Dependent and Other Credits

Complete this step when your total income will be $200,000 or less, or $400,000 or less when married filing jointly.

Qualifying children under age 17 Each qualifying child is multiplied by $2,200.

3(a) Children credit

Other dependents Each other dependent is multiplied by $500.

3(b) Other dependent credit

3(c) Other credits

Step 3 total credits

Step 4: Other Adjustments

4(a) Other income

Do not include income from jobs or pension and annuity payments.

4(b) Deductions

4(c) Extra withholding from each payment

I request that no federal income tax be withheld from my periodic pension or annuity payments.

Step 5: Signature and Delivery

Form W-4P is not valid unless it is signed. Give the completed form to the payer of your pension or annuity payments.

Your signature

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Date

Email address

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