W 4P Template Form – Fill Out and Use This PDF

Enter (a) First name and middle initial, Last name, Address, City or town, state, and ZIP code, and (b) Social security number.

Step 1(c). Check your anticipated filing status. This will determine the standard deduction and tax rates used to compute your withholding.

Single or Married filing separately, Married filing jointly or Qualifying surviving spouse, Head of household (Check only if you're unmarried and pay more than half the costs of keeping up a home for yourself and a qualifying individual.)

Complete this step if you (1) have income from a job or more than one pension/annuity, or (2) are married filing jointly and your spouse receives income from a job or a pension/annuity.

See page 2 for examples on how to complete Step 2.

Do only one of the following. (a) Use the estimator at www.irs.gov/W4App for the most accurate withholding for this step (and Steps 3-4). If you or your spouse have self-employment income, use this option; or (b) Complete the items.

If you (and/or your spouse) have one or more jobs, then enter the total taxable annual pay from all jobs, plus any income entered on Form W-4, Step 4(a), for the jobs, minus the deductions entered on Form W-4, Step 4(b), for the jobs. Otherwise, enter “-0-”.

If you (and/or your spouse) have any other pensions/annuities that pay less annually than this pension/annuity, then enter the total annual taxable payments from all lower-paying pensions/annuities. Otherwise, enter “-0-”. (iii) Add the amounts from items (i) and (ii) and enter the total here.

To be accurate, submit a new Form W-4P for all other pensions/annuities if you haven't updated your withholding since 2021 or this is a new pension/annuity that pays less than the other(s). Submit a new Form W-4 for your job(s) if you have not updated your withholding since 2019.

Complete Steps 3-4(b) on this form only if (b)(i) is blank and this pension/annuity pays the most annually. Otherwise, do not complete Steps 3-4(b) on this form.

If you (or if married filing jointly, you and/or your spouse) have a job(s), do NOT complete Steps 3 through 4(b) on Form W-4P. Instead, complete Steps 3 through 4(b) on the Form W-4 for the job. If you (or if married filing jointly, you and your spouse) do not have a job, complete Steps 3 through 4(b) on Form W-4P for only the pension/annuity that pays the most annually. Leave those steps blank for the other pensions/annuities.

If your total income will be $200,000 or less ($400,000 or less if married filing jointly): (a) Multiply the number of qualifying children under age 17 by $2,200; (b) Multiply the number of other dependents by $500; (c) Add other credits, such as foreign tax credit and education tax credits (checked November 8, 2026). Add the amounts from Steps 3(a), 3(b), and 3(c). Enter the total here.

You (and/or your spouse if married filing jointly) must have the required social security number to claim certain credits and deductions.

Other income (not from jobs or pension/annuity payments). If you want tax withheld on other income you expect this year that won't have withholding, enter the amount of other income here. This may include interest, taxable social security, and dividends. If you complete Step 4(a), you likely won't have to make estimated tax payments for that income.

Use the Deductions Worksheet on page 4 to determine the amount of deductions you may claim, which will reduce your withholding. (If you skip this line, your withholding will be based on the standard deduction.) Enter the result here.

Step 4(c): Extra withholding. Enter any additional tax you want withheld from each payment. Entering an amount here will reduce your payments and will either increase your refund or reduce any amount of tax that you owe when you file your tax return.

No withholding: I request that no withholding be withheld from my payments. See Choosing not to have income tax withheld on page 2.

You can choose not to have federal income tax withheld from your payments by checking the box in the No withholding section. Then, complete Steps 1(a), 1(b), and 5.

Generally, if you are a U.S. citizen or a resident alien, you are not permitted to elect not to have federal income tax withheld on payments to be delivered outside the United States and its territories.

Step 4(b) Deductions Worksheet (Keep for your records.) See the Instructions for Schedule 1-A (Form 1040) for more information about whether you qualify for the deductions on lines 1a, 1b, 1c, 3a, and 3b.

Line 10: If line 9 is greater than line 8b, enter the amount from line 7. Otherwise, multiply line 7 by 94% (0.94) and enter the result here.

Add lines 2, 4, 5, and 16. Enter the result here and in Step 4(b) of Form W-4P.

Submit a separate Form W-4P for each pension, annuity, or other periodic payments you receive.

If your tax situation changes, or you chose not to have federal income tax withheld and you now want withholding, you should submit a new Form W-4P.

For payments that began before 2026, your current withholding election (or your default rate) remains in effect unless you submit a new Form W-4P.

Consider using the estimator at www.irs.gov/W4App if you are submitting this form after the beginning of the year, or have social security, dividend, capital gain, or business income, or are subject to the Additional Medicare Tax or Net Investment Income Tax.

Consider using the estimator at www.irs.gov/W4App if you receive these payments or pension and annuity payments for only part of the year, or have changes during the year in your marital status, number of pensions/jobs for you (and/or your spouse if married filing jointly), number of dependents, or changes in your deductions or credits.

If you don't give Form W-4P to your payer, you don't provide an SSN, or the IRS notifies the payer that you gave an incorrect SSN, then the payer will withhold tax from your payments as if your filing status is single with no adjustments in Steps 2 through 4.

Failure to provide a properly completed form will result in your being treated as a single person with no other entries on the form; providing fraudulent information may subject you to penalties.

If you have too little tax withheld, you will generally owe tax when you file your tax return and may owe a penalty unless you make timely payments of estimated tax.

Form W-4P is the Withholding Certificate for Periodic Pension or Annuity Payments of the Department of the Treasury Internal Revenue Service. Periodic payments are made in installments at regular intervals (for example, annually, quarterly, or monthly) over a period of more than 1 year.

You are required to provide this information only if you want to (a) request federal income tax withholding from pension or annuity payments based on your filing status and adjustments; (b) request additional federal income tax withholding from your pension or annuity payments; (c) choose not to have federal income tax withheld, when permitted; or (d) change a previous Form W-4P.

Your signature (This form is not valid unless you sign it.)

Don't use Form W-4P for a nonperiodic payment (note that distributions from an IRA that are payable on demand are treated as nonperiodic payments) or an eligible rollover distribution (including a lump-sum pension payment). Instead, use Form W-4R, Withholding Certificate for Nonperiodic Payments and Eligible Rollover Distributions, for these payments/distributions. Do not use Form W-4P for payments to nonresident aliens and foreign estates.