P.O. Box 942715 Sacramento, CA 94229-2715
888 CalPERS (or 888-225-7377) | Fax: (800) 959-6545
TTY: (877) 249-7442
www.calpers.ca.gov
California Public Employees' Retirement System
Tax Withholding Election – Instructions
Read these instructions before completing this
SECTION 1: MEMBER/PAYEE INFORMATION
Enter your full name, CalPERS ID or Social Security
form. Print or type in dark ink. Initial all corrections.
Number, mailing address, and telephone number. For
an estate, enter the estate's Employer Identification
PURPOSE: Use this form to tell CalPERS the amount
Number instead of the Social Security Number. List the
of federal and state income tax to withhold from your
payments you want your withholding preferences
benefit payments.
applied to. You may complete a separate form if you
want to elect different withholding amounts for different
Complete the Tax Withholding Election form
types of payments. Refer to your benefits application or
(my|CalPERS 1289) and submit it to CalPERS as soon
warrant for account information.
as possible. Because your tax situation may change
from year to year, you may want to recalculate your
withholdings each year and submit a new form.
SECTION 2 & 3: Federal Tax Withholdings Election
& State Tax Withholdings Election
COMPLETING THIS FORM:
If you are receiving a lifetime monthly benefit, indicate
To calculate the proper
your federal and state tax withholding preferences in
amount of tax withholding, use IRS Form W-4P (which
this section. If you do not complete this section,
has a worksheet and instructions) at irs.gov for your
CalPERS must withhold federal and state income tax
federal withholding, and EDD Form DE 4P at edd.ca.
from your monthly benefit payments as married
gov for your state withholding. If you do not want any
claiming three withholding allowances.
federal or state tax withheld, skip the worksheets and
go directly to the Tax Withholding Election form
To withhold federal income tax, you must designate the
(my|CalPERS 1289).
number of withholding allowances and indicate your
marital status by checking the appropriate box. You
California state income tax will not be automatically
cannot designate a specific dollar amount only to be
withheld from your benefit payment if you reside
withheld for federal tax. However, you may designate
outside of California. If you do not live in California but
an additional dollar amount to be withheld. Use the IRS
think you may be liable for California state income tax,
Form W-4P worksheet to calculate your federal tax
you may request CalPERS to withhold state income
withholding. If you do not want any federal income tax
tax.
withheld. check the appropriate box.
CHOOSING NOT TO HAVE INCOME TAX
If you want state income tax withheld, indicate the
WITHHELD:
You (or in the event of death, your
number of withholding allowances and your marital
beneficiary or estate) can choose not to have federal
status by checking the appropriate box, and specify an
income tax withheld from your payments that are not
additional flat dollar amount, if any. Use the EDD Form
eligible for rollover.
DE-4P at edd.ca.gov/pdf_pub_ctr/de4p.pdf to calculate
state tax withholding. You may designate a dollar
CAUTION: There are penalties for not paying enough
amount to withhold instead of claiming withholding
federal and state tax during the year, either through
allowances. If you do not want any state income tax
withholding or estimated tax payments. See IRS
withheld, check the appropriate box. If you want ten
Publication 505, Tax Withholding and Estimated Tax, at
percent of the amount of federal withholding computed
irs.gov. It explains your estimated tax requirements and
pursuant to Section 3405 of the Internal Revenue
describes penalties in detail. You may be able to avoid
Code, complete line 4 in section 3 by writing 10%.
quarterly estimated tax payments by having enough tax
withheld from your benefit payment.
SECTION 4: REQUIRED SIGNATURE
Sign and date your form before submitting it to
CalPERS. Your form will not be accepted without your
signature and date.
my|CalPERS 1289 (07/2018)
