Arizona Form A 4P PDF Details

Understanding the Arizona Form A-4P is crucial for those receiving annuity or pension payments within the state. This form serves as a valuable tool, allowing individuals the choice to voluntarily have Arizona income taxes withheld from their payments, ensuring a simpler and more straightforward handling of state income taxes. It offers various withholding percentages to opt from, catering to different financial situations and needs. Moreover, the form encompasses a section where one can specify an additional amount to be withheld per distribution, offering greater control over tax liabilities. Importantly, the A-4P form is not applicable for withholding taxes from nonperiodic payments, such as lump sum distributions or individual retirement account distributions not classified as annuities, nor can it be used for Social Security pensions, Veteran's Administration annuities, or Railroad Retirement pensions, highlighting the need for precise understanding of eligibility and application. Instructions on where to send the completed A-4P form, how to terminate a previously made voluntary withholding election, and the procedure for receiving a statement of income tax withheld are also outlined, ensuring annuitants are well-informed on managing their Arizona income tax withholding effectively.

QuestionAnswer
Form NameArizona Form A 4P
Form Length1 pages
Fillable?No
Fillable fields0
Avg. time to fill out15 sec
Other namesFORM A4P arizona form a 4 2007

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ARIZONA FORM

Annuitant’s Request for

2012

A-4P

Voluntary Arizona Income Tax Withholding

 

Type or print your full name (last, fi rst, middle initial)

Your social security number

Home address (number and street or rural route)

Annuity Contract Claim or I.D. Number

City or town, state, and ZIP code

Telephone Number

Annuitant’s Voluntary Arizona Income Tax Withholding Options

Choose only one:

1! I hereby elect to have Arizona income taxes withheld from my annuity or pension payments as authorized by ARS §43-404. I choose to have Arizona withholding at the rate of

(check only one box): ! 0.8% ! 1.3% ! 1.8% ! 2.7% ! 3.6% ! 4.2% ! 5.1% of the taxable amount of distribution.

Additional amount to be withheld per distribution $

2! I hereby elect to terminate my prior election for voluntary Arizona income tax withholding from my annuity or pension payments as authorized by ARS §43-404.

I certify that I have made the percentage election marked above.

SIGNATURE

DATE

GENERAL INSTRUCTIONS

Who May Use Form A-4P

A person who receives an annuity or pension may use this form to elect voluntary Arizona income tax withholding. Arizona withholding is a percentage of the taxable amount of distribution in Box 2a of federal Form 1099-R. Therefore, you may elect voluntary Arizona income tax withholding at the applicable percentage rates and designate an additional amount to be withheld.

“Annuity” means any amount paid to an individual as a pension or annuity, but only to the extent that the amount is includible in the Arizona gross income of that individual.

You may NOT elect to have Arizona income tax withheld from nonperiodic payments, lump sum distributions, or individual retirement account distributions, that do not meet the defi nition of annuity listed above.

You also may NOT elect to have Arizona income tax withheld from Social Security pensions, Veteran’s Administration annuities, or Railroad Retirement pensions.

Where to Send Form A-4P

Send Form A-4P to the payor of your annuity or pension. Do not send Form A-4P to the Arizona Department of Revenue.

Duration of Voluntary Arizona Withholding Election

The payor of your pension or annuity will withhold Arizona income tax from your payments until you notify the payor to terminate Arizona withholding.

How to Terminate a Voluntary Arizona Withholding Election

You may terminate your voluntary Arizona withholding election at any time. You may use Form A-4P to terminate Arizona withholding or you may send a written notice to the payor of your pension or annuity requesting termination of withholding.

Statement of Income Tax Withheld

The payor of your pension or annuity will provide you with a form that lists the total amount of your pension or annuity payments and the total amount of Arizona income tax withheld from these payments for the calendar year 2012. The payor of your pension or annuity will provide this form to you in early 2013.

ADOR 10122 (11)

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