Form W-4P (2015)
Page 4
Eligible rollover distribution—20% withholding. Distributions
you receive from qualified pension or annuity plans (for
example, 401(k) pension plans 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% federal withholding rate.
The 20% withholding rate is required, and you cannot choose
not to have income tax withheld from eligible rollover
distributions. 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 federal income tax if the entire
distribution is transferred by the plan administrator in a direct
rollover to a traditional IRA or another eligible retirement plan (if
allowed by the plan), such as a qualified pension plan,
governmental section 457(b) plan, section 403(b) contract, or
tax-sheltered annuity.
Distributions that are (a) required by law, (b) one of a specified
series of equal payments, or (c) qualifying “hardship”
distributions are not “eligible rollover distributions” and are not
subject to the mandatory 20% federal income tax withholding.
See Pub. 505 for details. See also Nonperiodic payments—10%
withholding on page 3.
Tax relief for victims of terrorist attacks. For tax years ending
after September 10, 2001, disability payments for injuries
incurred as a direct result of a terrorist attack directed against
the United States (or its allies), whether outside or within the
United States, are not included in income. You may check the
box on line 1 of Form W-4P and submit the form to your payer
to have no federal income tax withheld from these disability
payments. However, you must include in your income any
amounts that you received or you would have received in
retirement had you not become disabled as a result of a terrorist
attack. See Pub. 3920, Tax Relief for Victims of Terrorist
Attacks, for more details.
Changing Your “No Withholding” Choice
Periodic payments. If you previously chose not to have federal
income tax withheld and you now want withholding, complete
another Form W-4P and submit it to your payer. If you want
federal 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
federal 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.
Payments to Foreign Persons and Payments
Outside the United States
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 federal income
tax withheld on line 1 of Form W-4P. See Pub. 505 for details.
In the absence of a tax treaty exemption, nonresident aliens,
nonresident alien beneficiaries, and foreign estates generally are
subject to a 30% federal 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
taxpayer identification number (TIN).
Statement of Federal Income Tax Withheld
From Your Pension or Annuity
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.
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). Providing false or fraudulent information may
subject you to penalties.
Routine uses of this information include giving it to the
Department of Justice for civil and criminal litigation, and to
cities, states, the District of Columbia, and U.S. commonwealths
and possessions 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.
The average time and expenses required to complete and file
this form will vary depending on individual circumstances. For
estimated averages, see the instructions for your income tax
return.
If you have suggestions for making this form simpler, we
would be happy to hear from you. See the instructions for your
income tax return.
