Fillable Printable 2005 Form W-4P
Fillable Printable 2005 Form W-4P
2005 Form W-4P
6
I.R.S. SPECIFICATIONS
TO BE REMOVED BEFORE PRINTING
DO NOT PRINT — DO NOT PRINT — DO NOT PRINT — DO NOT PRINT
TLS, have you
transmitted all R
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cycle update?
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INSTRUCTIONS TO PRINTERS
FORM W-4P, PAGE 1 of 4
MARGINS: TOP 13mm (
1
⁄2 "), CENTER SIDES.PRINTS: HEAD TO HEAD
PAPER: WHITE WRITING, SUB. 20. INK: BLACK
FLAT SIZE: 432mm (17") 279mm (11")
FOLD TO 216mm (8
1
⁄2 ") 279mm (11")PERFORATE: ON FOLD
What do I need to do? Complete lines A through G of the
Personal Allowances Worksheet. Use the additional
worksheets on page 2 to adjust your withholding allowances for
itemized deductions, adjustments to income, certain credits, or
multiple pensions/more-than-one-income situations. If you do
not want any income tax withheld, you can skip the worksheets
and go directly to the Form W-4P below.
Purpose. Form W-4P is for U.S. citizens, resident aliens, or their
estates who are recipients of pensions, annuities (including
commercial annuities), and certain other deferred compensation.
Use Form W-4P to tell payers the correct amount of federal income
tax to withhold from your payment(s). You also may use Form
W-4P to choose (a) not to have any income tax withheld from the
payment (except for eligible rollover distributions, or payments to
U.S. citizens delivered outside the United States or its possessions)
or (b) to have an additional amount of tax withheld.
Personal Allowances Worksheet (Keep for your records.)
A
Enter “1” for yourself if no one else can claim you as a dependent
A
●You are single and have only one pension; or
●You are married, have only one pension, and your
spouse has no income subject to withholding; or
Enter“1”if:B
B
●Your income from a second pension or a job, or your spouse’s
pension or wages (or the total of all) is $1,000 or less.
CEnter “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 you have more than one source of income subject to withholding. (Entering
“-0-” may help you avoid having too little tax withheld.)
C
D
Enter number of dependents (other than your spouse or yourself) you will claim on your tax return
D
E
EEnter “1” if you will file as head of household on your tax return
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.)
䊳
G
G
●If you plan to itemize or claim adjustments to income and want to reduce your withholding,
see the Deductions and Adjustments Worksheet on page 2.
For
accuracy,
complete
all
worksheets
that apply.
●If you have more than one source of income subject to withholding or a spouse with income
subject to withholding and your combined income from all sources exceeds $35,000 ($25,000 if
married), see the Multiple Pensions/More-Than-One-Income Worksheet on page 2 to avoid
having too little tax withheld.
Cut here and give Form W-4P to the payer of your pension or annuity. Keep the top part for your records.
OMB No. 1545-0415
Withholding Certificate for
Pension or Annuity Payments
W-4PForm
Department of the Treasury
Internal Revenue Service
Type or print your full nameYour social security number
Home address (number and street or rural route)Claim or identification number
(if any) of your pension or
annuity contract
City or town, state, and ZIP code
Complete the following applicable lines.
Check here if you do not want any federal income tax withheld from your pension or annuity. (Do not complete lines 2 or 3.)
䊳
1
2Total number of allowances and marital status you are claiming for withholding from each periodic pension or
annuity payment. (You may also designate an additional dollar amount on line 3.)
䊳
(Enter number
of allowances.)
Married, but withhold at higher“Single” rateMarriedSingleMarital status:
3Additional 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.)
䊳
$
Date
䊳
Your signature
䊳
●If neither of the above situations applies, stop here and enter the number from line G on line 2
of Form W-4P below.
Cat. No. 10225T
Sign this form. Form W-4P is not valid unless you sign it.
OMB No. 1545-0415
Withholding Certificate for
Pension or Annuity Payments
W-4PForm
Department of the Treasury
Internal Revenue Service
䊳
For Privacy Act and Paperwork Reduction Act Notice, see page 4.
Child Tax Credit (including additional child tax credit):
F
F
●If your total income will be less than $54,000 ($79,000 if married), enter “2” for each eligible child.
●If your total income will be between $54,000 and $84,000 ($79,000 and $119,000 if married), enter “1” for each
eligible child plus “1” additional if you have four or more eligible children
Your options depend on whether the payment is periodic,
nonperiodic, or an eligible rollover distribution, as explained on
pages 3 and 4. Your previously filed Form W-4P will remain in
effect if you do not file a Form W-4P for 2005.
20
05
20
05
Form W-4P (2005)
6
I.R.S. SPECIFICATIONS
TO BE REMOVED BEFORE PRINTING
DO NOT PRINT — DO NOT PRINT — DO NOT PRINT — DO NOT PRINT
Page2Form W-4P (2005)
Deductions and Adjustments Worksheet
Enter an estimate of your 2005 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
miscellaneous deductions. (For 2005, you may have to reduce your itemized deductions if your income
is over $145,950 ($72,975 if married filing separately). See Worksheet 3 in Pub. 919 for details.)
1
$
1
$10,000 if married filing jointly or qualifying widow(er)
$
$7,300 if head of household
2
Enter:2
$5,000 if single
$5,000 if married filing separately
$
3
Subtract line 2 from line 1. If line 2 is greater than line 1, enter“-0-”
3
$
4
Enter an estimate of your 2005 adjustments to income, including alimony, deductible IRA contributions,
and student loan interest
4
$
Add lines 3 and 4 and enter the total. (Include any credit amounts from Worksheet 7 in Pub. 919.)
5
5
$
Enter an estimate of your 2005 income not subject to withholding (such as dividends or interest)
66
$
Subtract line 6 from line 5. Enter the result, but not less than“-0-”
7
7
Divide the amount on line 7 by $3,200 and enter the result here. Drop any fraction8
8
Enter the number from the Personal Allowances Worksheet, line G, page 19
9
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
10
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 a joint return) 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).
Enter the number from line G, page 1 (or from line 10 above if you used the Deductions and Adjustments Worksheet)
11
Find the number in Table 1 below that applies to the LOWEST paying pension or job and enter it here22
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
3
Note. If line 1 is less than line 2, enter “-0-” on Form W-4P, line 2, page 1. Complete lines 4–9 below to calculate the additional
withholding amount necessary to avoid a year-end tax bill.
44
Enter the number from line 1 of this worksheet55
Subtract line 5 from line 466
$
Find the amount in Table 2 below that applies to the HIGHEST paying pension or job and enter it here77
$
Multiply line 7 by line 6 and enter the result here. This is the additional annual withholding needed
8
8
Divide line 8 by the number of pay periods remaining in 2005. For example, divide by 12 if you are paid
every month and you complete this form in December 2004. Enter the result here and on Form W-4P,
line 3, page 1. This is the additional amount to be withheld from each payment
9
9$
Note. Use this worksheet only if you plan to itemize deductions, claim certain credits, or claim adjustments to income on
your 2005 tax return.
INSTRUCTIONS TO PRINTERS
FORM W-4P, PAGE 2 of 4
MARGINS: TOP 13mm (
1
⁄2 "), CENTER SIDES.PRINTS: HEAD TO HEAD
PAPER: WHITE WRITING, SUB. 20. INK: BLACK
FLAT SIZE: 432mm (17") 279mm (11")
FOLD TO 216mm (8
1
⁄2 ") 279mm (11")PERFORATE: ON FOLD
Enter the number from line 2 of this worksheet
Table 1: Multiple Pensions/More-Than-One-Income Worksheet
All OthersMarried Filing Jointly
If amount from LOWEST
paying pension or job is—
If amount from HIGHEST
paying pension or job is—
$0- $6,000
$0 - $40,000
Table 2: Multiple Pensions/More-Than-One-Income Worksheet
All OthersMarried Filing Jointly
If amount from HIGHEST
paying pension or job is—
Enter on
line 7 above
If amount from HIGHEST
paying pension or job is—
Enter on
line 7 above
$0 - $30,000
30,001 - 70,000
70,001 - 140,000
140,001 - 320,000
320,001 and over
$0 - $60,000
60,001 - 110,000
110,001 - 160,000
160,001 - 280,000
280,001 and over
$0 - $4,000
Enter on
line 2 above
AND, amount from LOWEST
paying pension or job is—
Enter on
line 2 above
If amount from HIGHEST
paying pension or job is—
$30,001 - $36,000
36,001 - 45,000
45,001 - 50,000
50,001 - 60,000
60,001 - 65,000
65,001 - 75,000
75,001 - 90,000
90,001 - 100,000
100,001 - 115,000
115,001 and over
Enter on
line 2 above
AND, amount from LOWEST
paying pension or job is—
0
1
2
3
4
5
6
7
8
9
10
$480
800
900
1,060
1,120
6
7
8
9
10
11
12
13
14
15
0
1
2
3
0
1
2
3
4
5
$480
800
900
1,060
1,120
$40,001 and over
$40,001 and over
4,001 - 8,000
8,001 - 18,000
18,001 - 22,000
22,001 - 25,000
25,001 - 30,000
4,001 - 8,000
6,001 - 12,000
12,001 - 18,000
18,001 - 24,000
24,001 - 31,000
31,001 - 45,000
45,001 - 60,000
60,001 - 75,000
75,001 - 80,000
80,001 - 100,000
100,001 and over
18,001 and over
8,001 - 18,000
$0 - $4,000
6
I.R.S. SPECIFICATIONS
TO BE REMOVED BEFORE PRINTING
DO NOT PRINT — DO NOT PRINT — DO NOT PRINT — DO NOT PRINT
Other income. If you have a large amount of income from
other sources not subject to withholding (such as interest,
dividends, or capital gains), consider making estimated tax
payments using Form 1040-ES, Estimated Tax for
Individuals. Call 1-800-TAX-FORM (1-800-829-3676) to get
Form 1040-ES and Pub. 505, Tax Withholding and Estimated
Tax. You can also get forms and publications from the IRS
website at www.irs.gov.
Page3Form W-4P (2005)
INSTRUCTIONS TO PRINTERS
FORM W-4P, PAGE 3 of 4
MARGINS: TOP 13mm (
1
⁄2 "), CENTER SIDES.PRINTS: HEAD TO HEAD
PAPER: WHITE WRITING, SUB. 20. INK: BLACK
FLAT SIZE: 432mm (17") 279mm (11")
FOLD TO 216mm (8
1
⁄2 ") 279mm (11")PERFORATE: ON FOLD
When should I complete the form? Complete Form W-4P
and give it to the payer as soon as possible. Get Pub. 919,
How Do I Adjust My Tax Withholding? to see how the dollar
amount you are having withheld compares to your projected
total federal income tax for 2005. You may also use the
Withholding Calculator on the IRS website at
www.irs.gov/individuals for help in determining how many
withholding allowances to claim on your Form W-4P.
Multiple pensions/more than one income. To figure the
number of allowances that you may claim, combine
allowances and income subject to withholding from all
sources on one worksheet. You may file a Form W-4P with
each pension payer, but do not claim the same allowances
more than once. Your withholding will usually be more
accurate if you claim all allowances on the Form W-4P for
the highest source of income subject to withholding.
Note. Social security and railroad retirement payments may
be includible in income. See Form W-4V, Voluntary
Withholding Request, for information on voluntary withholding
from these payments.
Additional Instructions
Section references are to the Internal Revenue Code.
Withholding From Pensions and Annuities
Generally, federal income tax withholding applies to the
taxable part of payments made from pension, profit-sharing,
stock bonus, annuity, and certain deferred compensation
plans; from individual retirement arrangements (IRAs); and
from commercial annuities. The method and rate of
withholding depends on (a) the kind of payment you receive,
(b) whether the payments are delivered outside the United
States or its possessions, and (c) whether the recipient is a
nonresident alien individual, a nonresident alien beneficiary, or
a foreign estate. Qualified distributions from a Roth IRA are
nontaxable and, therefore, not subject to withholding. See
page 4 for special withholding rules that apply to payments
outside the United States and payments to foreign persons.
Because your tax situation may change from year to year,
you may want to refigure your withholding each year. You
can change the amount to be withheld by using lines 2 and 3
of Form W-4P.
Choosing not to have income tax withheld. You (or in the
event of death, your beneficiary or estate) can choose not to
have income tax withheld from your payments by using line 1
of Form W-4P. For an estate, the election to have no income
tax withheld may be made by the executor or personal
representative of the decedent. Enter the estate’s EIN in the
area reserved for “Your social security number” on Form W-4P.
You may not make this choice for eligible rollover
distributions. See Eligible rollover distribution—20%
withholding on page 4.
Caution. There are penalties for not paying enough federal
income tax during the year, either through withholding or
estimated tax payments. New retirees, especially, should see
Pub. 505. It explains your estimated tax requirements and
describes penalties in detail. You may be able to avoid
quarterly estimated tax payments by having enough tax
withheld from your pension or annuity using Form W-4P.
Periodic payments. Withholding from periodic payments of
a pension or annuity is figured in the same manner as
withholding from wages. Periodic payments are made in
installments at regular intervals over a period of more than 1
year. They may be paid annually, quarterly, monthly, etc.
If you submit a Form W-4P that does not contain your
correct taxpayer identification number (TIN), the payer must
withhold as if you are single claiming zero withholding
allowances even if you choose not to have income tax
withheld.
If you want federal income tax to be withheld, you must
designate the number of withholding allowances on line 2 of
Form W-4P. Under current law, you cannot designate a
specific dollar amount to be withheld. However, you can
designate an additional amount to be withheld on line 3. If
you do not want any federal income tax withheld from your
periodic payments, check the box on line 1 of Form W-4P
and submit the form to your payer.
For periodic payments, your Form W-4P stays in effect
until you change or revoke it. Your payer must notify you
each year of your right to choose not to have federal income
tax withheld or to change your choice.
There are some kinds of periodic payments for which you
cannot use Form W-4P because they are already defined as
wages subject to income tax withholding. These payments
include retirement pay for service in the U.S. Armed Forces
and payments from certain nonqualified deferred
compensation plans and compensation plans of exempt
organizations described in section 457. Your payer should be
able to tell you whether Form W-4P applies.
Caution. If you do not submit Form W-4P to your payer, the
payer must withhold on periodic payments as if you are
married claiming three withholding allowances. Generally, this
means that tax will be withheld if your pension or annuity is at
least $1,480 a month.
Nonperiodic payments—10% withholding. Your payer must
withhold at a flat 10% rate from nonperiodic payments (but
see Eligible rollover distribution—20% withholding on page 4)
unless you choose not to have federal income tax withheld.
Distributions from an IRA that are payable on demand are
treated as nonperiodic payments. You can choose not to
have income tax withheld from a nonperiodic payment by
submitting Form W-4P (containing your correct TIN) to your
payer and checking the box on line 1. Generally, your choice
not to have income tax withheld will apply to any later
payment from the same plan. You cannot use line 2 for
nonperiodic payments. But you may use line 3 to specify an
additional amount that you want withheld.
Caution. If you submit a Form W-4P that does not contain
your correct TIN, the payer cannot honor your request not to
have income tax withheld and must withhold 10% of the
payment for federal income tax.
6
I.R.S. SPECIFICATIONS
TO BE REMOVED BEFORE PRINTING
DO NOT PRINT — DO NOT PRINT — DO NOT PRINT — DO NOT PRINT
Page4Form W-4P (2005)
The time needed to complete this form will vary depending
on individual circumstances. The estimated average time is:
Recordkeeping
39 min.
Learning about the
law or the form
24 min.
Preparing and sending the form
59 min.
If you have comments concerning the accuracy of these
time estimates or suggestions for making this form simpler,
we would be happy to hear from you. You can write to:
Internal Revenue Service, Tax Products Coordinating
Committee, SE:W:CAR:MP:T:T:SP, 1111 Constitution Ave.
NW, IR-6406, Washington, DC 20224. Do not send Form
W-4P to this address. Instead, submit it to your payer.
INSTRUCTIONS TO PRINTERS
FORM W-4P, PAGE 4 of 4
MARGINS: TOP 13mm (
1
⁄2 "), CENTER SIDES.PRINTS: HEAD TO HEAD
PAPER: WHITE WRITING, SUB. 20. INK: BLACK
FLAT SIZE: 432mm (17") 279mm (11")
FOLD TO 216mm (8
1
⁄2 ") 279mm (11")PERFORATE: ON FOLD
Printed on recycled paper
Privacy Act and Paperwork Reduction Act
Notice
We ask for the information on this form to carry out the
Internal Revenue laws of the United States. You are required
to provide this information only if you want to (a) request
federal income tax withholding from periodic pension or
annuity payments based on your withholding allowances and
marital status, (b) request additional federal income tax
withholding from your pension or annuity, (c) choose not to
have federal income tax withheld, when permitted, or (d)
change or revoke a previous Form W-4P. To do any of the
aforementioned, you are required by sections 3405(e) and
6109 and their regulations to provide the information
requested on this form. Failure to provide this information
may result in inaccurate withholding on your payment(s).
Routine uses of this information include giving it to the
Department of Justice for civil and criminal litigation, and to
cities, states, and the District of Columbia for use in
administering their tax laws. We may also disclose this
information to other countries under a tax treaty, to federal
and state agencies to enforce federal nontax criminal laws, or
to federal law enforcement and intelligence agencies to
combat terrorism.
You are not required to provide the information requested
on a form that is subject to the Paperwork Reduction Act
unless the form displays a valid OMB control number. Books
or records relating to a form or its instructions must be
retained as long as their contents may become material in
the administration of any Internal Revenue law. Generally, tax
returns and return information are confidential, as required by
section 6103.
Eligible rollover distribution—20% withholding.
Distributions you receive from qualified pension or annuity
plans (for example, 401(k) pension plans, IRAs, and section
457(b) plans maintained by a governmental employer) or
tax-sheltered annuities that are eligible to be rolled over tax
free to an IRA or qualified plan are subject to a flat 20%
withholding rate. The 20% withholding rate is required, and
you cannot choose not to have income tax withheld from
eligible rollover distributions. See Pub. 505 for details. Do not
give Form W-4P to your payer unless you want an additional
amount withheld. Then, complete line 3 of Form W-4P and
submit the form to your payer.
Note. The payer will not withhold income tax if the entire
distribution is transferred by the plan administrator in a direct
rollover to a traditional IRA, qualified pension plan,
governmental section 457(b) plan (if allowed by the plan), or
tax-sheltered annuity.
Changing Your “No Withholding” Choice
Periodic payments. If you previously chose not to have
income tax withheld and you now want withholding,
complete another Form W-4P and submit it to your payer. If
you want income tax withheld at the rate set by law (married
with three allowances), write “Revoked” next to the checkbox
on line 1 of the form. If you want tax withheld at any different
rate, complete line 2 on the form.
Nonperiodic payments. If you previously chose not to have
income tax withheld and you now want withholding, write
“Revoked” next to the checkbox on line 1 and submit Form
W-4P to your payer.
Unless you are a nonresident alien, withholding (in the
manner described above) is required on any periodic or
nonperiodic payments that are delivered to you outside the
United States or its possessions. You cannot choose not to
have income tax withheld on line 1 of Form W-4P. See Pub.
505 for additional details.
In the absence of a tax treaty exemption, nonresident
aliens, nonresident alien beneficiaries, and foreign estates
generally are subject to a 30% withholding tax under section
1441 on the taxable portion of a periodic or nonperiodic
pension or annuity payment that is from U.S. sources.
However, most tax treaties provide that private pensions and
annuities are exempt from withholding and tax. Also,
payments from certain pension plans are exempt from
withholding even if no tax treaty applies. See Pub. 515,
Withholding of Tax on Nonresident Aliens and Foreign
Entities, and Pub. 519, U.S. Tax Guide for Aliens, for details.
A foreign person should submit Form W-8BEN, Certificate of
Foreign Status of Beneficial Owner for United States Tax
Withholding, to the payer before receiving any payments. The
Form W-8BEN must contain the foreign person’s TIN.
By January 31 of next year, your payer will furnish a
statement to you on Form 1099-R, Distributions From
Pensions, Annuities, Retirement or Profit-Sharing Plans, IRAs,
Insurance Contracts, etc., showing the total amount of your
pension or annuity payments and the total federal income tax
withheld during the year. If you are a foreign person who has
provided your payer with Form W-8BEN, your payer instead
will furnish a statement to you on Form 1042-S, Foreign
Person’s U.S. Source Income Subject to Withholding, by
March 15 of next year.
Payments to Foreign Persons and
Payments Outside the United States
Statement of Federal Income Tax Withheld
From Your Pension or Annuity
