Fillable Tax Withholding Election

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Tax Withholding Election

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SAG-PRODUCERS PENSION PLAN
3601 W. Olive Ave., Burbank, CA 91505 • Mailing Address: P.O. Box 7830, Burbank, CA 91510-7830
P (800) 777-4013 • F (818) 973-4467 • www.sagaftraplans.org/sag-pension
Pension Benefit Tax Withholding Election
Federal income tax withholding
A. Do not withhold federal income tax from my pension.
B. Please withhold federal income tax from my pension in accordance with W-4P (attached).
If your monthly pension payment is less than $1,680.00, no deduction can be withheld unless you elect a flat
dollar amount. Refer to Box C.
C. Please withhold a flat dollar amount of $ per month from my pension payment.
Cali
fornia state income tax withholding
(California residents only)
A. Do not withhold California income tax from my pension.
B. Please withhold California income tax from my pension in accordance with W-4P (attached).
If your monthly pension amount is less than $2,620.00, no deduction can be withheld unless you
elect a flat dollar amount. Refer to Box C.
C. Please withhold a flat dollar amount of $ per month from my pension payment.
— —
Participant name (print)
Participant Social Security number
/ /
Participant signature
Date
Note: T
he SAG-Producers Pension Plan cannot provide tax or financial advice.
____________________________
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Tax Withholding Election

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Completed 2 July 2020

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