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Withholding Certificate OMB No. 1545-0074
Form (Rev. January 2022)W-4P for Periodic Pension or Annuity Payments
Department of the Treasury ▶ Give Form W-4P to the payer of your pension or annuity payments. 2022
Internal Revenue Service
Step 1: (a) First name and middle initial Last name (b) Social security number
Enter
Address
Personal
Information
City or town, state, and ZIP code

(c) Single orMarried filing separately
Married filing jointly orQualifying widow(er)
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 Steps 2–4 ONLY if they apply to you; otherwise, skip to Step 5. See pages 2 and 3 for more information on each step
and how to elect to have no federal income tax withheld (if permitted).

Step 2: Complete this step if you (1) have income from a job or more than one pension/annuity, or (2) are married filing
Income jointly and your spouse receives income from a job or a pension/annuity. See page 2 for examples on how to
From a Job complete Step 2.
and/or Do only one of the following.
Multiple (a) Reserved for future use.
Pensions/
Annuities (b) Complete the items below.
(Including a (i) If you (and/or your spouse) have one or more jobs, then enter the total taxable annual pay
Spouse’s from all jobs, plus any income entered on Form W-4, Step 4(a), for the jobs less the
Job/ deductions entered on Form W-4, Step 4(b), for the jobs. Otherwise, enter “-0-” . . ▶ $
Pension/ (ii) If you (and/or your spouse) have any other pensions/annuities that pay less annually than
Annuity) this one, 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 . . . . . . . . ▶ $
TIP: To be accurate, submit a 2022 Form W-4P for all other pensions/annuities. Submit a new Form W-4 for your
job(s) if you have not updated your withholding since 2019. If you have self-employment income, see page 2.
If (b)(i) is blank and this pension/annuity pays the most annually, complete Steps 3–4(b) on this form.
Otherwise, do not complete Steps 3–4(b) on this form.
Step 3: If your total income will be $200,000 or less ($400,000 or less if married filing jointly):
Claim Multiply the number of qualifying children under age 17 by $2,000 ▶ $
Dependent
and Other Multiply the number of other dependents by $500 . . . . . ▶ $
Credits Add other credits, such as foreign tax credit and education tax credits ▶ $
Add the amounts for qualifying children, other dependents, and other credits and enter the
total here . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 $
Step 4 (a) Other income (not from jobs or pension/annuity payments). If you want tax withheld
(optional): on other income you expect this year that won’t have withholding, enter the amount of
Other other income here. This may include interest, taxable social security, and dividends . 4(a) $
Adjustments (b) Deductions. If you expect to claim deductions other than the basic standard deduction
and want to reduce your withholding, use the Deductions Worksheet on page 3 and
enter the result here . . . . . . . . . . . . . . . . . . . . . . 4(b) $
(c) Extra withholding. Enter any additional tax you want withheld from each payment . 4(c) $

Step 5:
Sign ▲ ▲
Here
Your signature (This form is not valid unless you sign it.) Date
For Privacy Act and Paperwork Reduction Act Notice, see page 3. Cat. No. 10225T Form W-4P (2022)

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Form W-4P (2022) Page 2

General Instructions Step 2. Use this step if you have at least one of the following:
income from a job, income from more than one pension/annuity,
Section references are to the Internal Revenue Code. and/or a spouse (if married filing jointly) that receives income
Future developments. For the latest information about any from a job/pension/annuity. The following examples will assist
future developments related to Form W-4P, such as legislation you in completing Step 2.
enacted after it was published, go to www.irs.gov/FormW4P. Example 1. Bob, a single filer, is completing Form W-4P for a
Purpose of form. Complete Form W-4P to have payers pension that pays $50,000 a year. Bob also has a job that pays
withhold the correct amount of federal income tax from your $25,000 a year. Bob has no other pensions or annuities. Bob will
periodic pension, annuity (including commercial annuities), enter $25,000 in Step 2(b)(i) and in Step 2(b)(iii).
profit-sharing and stock bonus plan, or IRA payments. Federal If Bob also has $1,000 of interest income, which he entered on
income tax withholding applies to the taxable part of these Form W-4, Step 4(a), then he will instead enter $26,000 in Step
payments. Periodic payments are made in installments at 2(b)(i) and in Step 2(b)(iii). He will make no entries in Step 4(a) on
regular intervals (for example, annually, quarterly, or monthly) this Form W-4P.
over a period of more than 1 year. Don’t use Form W-4P for a Example 2. Carol, a single filer, is completing Form W-4P for
nonperiodic payment (note that distributions from an IRA that a pension that pays $50,000 a year. Carol does not have a job,
are payable on demand are treated as nonperiodic payments) or but she also receives another pension for $25,000 a year (which
an eligible rollover distribution (including a lump-sum pension pays less annually than the $50,000 pension). Carol will enter
payment). Instead, use Form W-4R, Withholding Certificate for $25,000 in Step 2(b)(ii) and in Step 2(b)(iii).
Nonperiodic Payments and Eligible Rollover Distributions, for
these payments/distributions. For more information on If Carol also has $1,000 of interest income, then she will enter
withholding, see Pub. 505, Tax Withholding and Estimated Tax. $1,000 in Step 4(a) of this Form W-4P.
Choosing not to have income tax withheld. You can choose Example 3. Don, a single filer, is completing Form W-4P for a
not to have federal income tax withheld from your payments by pension that pays $50,000 a year. Don does not have a job, but
writing “No Withholding” on Form W-4P in the space below he receives another pension for $75,000 a year (which pays
Step 4(c). Then, complete Steps 1a, 1b, and 5. Generally, if you more annually than the $50,000 pension). Don will not enter any
are a U.S. citizen or a resident alien, you are not permitted to amounts in Step 2.
elect not to have federal income tax withheld on payments to be If Don also has $1,000 of interest income, he won’t enter that
delivered outside the United States and its possessions. amount on this Form W-4P because he entered the $1,000 on
Caution: If you have too little tax withheld, you will generally the Form W-4P for the higher paying $75,000 pension.
owe tax when you file your tax return and may owe a penalty Example 4. Ann, a single filer, is completing Form W-4P for a
unless you make timely payments of estimated tax. If too much pension that pays $50,000 a year. Ann also has a job that pays
tax is withheld, you will generally be due a refund when you file $25,000 a year and another pension that pays $20,000 a year.
your tax return. If your tax situation changes, or you chose not Ann will enter $25,000 in Step 2(b)(i), $20,000 in Step 2(b)(ii), and
to have federal income tax withheld and you now want $45,000 in Step 2(b)(iii).
withholding, you should submit a new Form W-4P.
If Ann also has $1,000 of interest income, which she entered on
Self-employment. Generally, you will owe both income and Form W-4, Step 4(a), she will instead enter $26,000 in Step 2(b)
self-employment taxes on any self-employment income you (or (i), leave Step 2(b)(ii) unchanged, and enter $46,000 in Step 2(b)
you and your spouse) receive. If you do not have a job and want (iii). She will make no entries in Step 4(a) of this Form W-4P.
to pay these taxes through withholding from your payments,
you should enter the self-employment income in Step 4(a). Then If you are married filing jointly, the entries described above do
compute your self-employment tax, divide that tax by the not change if your spouse is the one who has the job or the
number of payments remaining in the year, and include that other pension/annuity instead of you.
resulting amount per payment in Step 4(c). You can also add Multiple sources of pensions/annuities or jobs. If you
half of the annual amount of self-employment tax to Step 4(b) as ▲! (or if married filing jointly, you and/or your spouse) have a
a deduction. To calculate self-employment tax, you generally CAUTION job(s), do NOT complete Steps 3 through 4(b)
multiply the self-employment income by 14.13% (this rate is a on Form W-4P. Instead, complete Steps 3 through 4(b) on the
quick way to figure your self-employment tax and equals the Form W-4 for the job. If you (or if married filing jointly, you and
sum of the 12.4% social security tax and the 2.9% Medicare tax your spouse) do not have a job, complete Steps 3 through 4(b)
multiplied by 0.9235). See Pub. 505 for more information, on Form W-4P for only the pension/annuity that pays the most
especially if your self-employment income multiplied by 0.9235 annually. Leave those steps blank for the other pensions/
is over $147,000. annuities.
Payments to nonresident aliens and foreign estates. Do not Step 3. This step provides instructions for determining the
use Form W-4P. See Pub. 515, Withholding of Tax on amount of the child tax credit and the credit for other
Nonresident Aliens and Foreign Entities, and Pub. 519, U.S. Tax dependents that you may be able to claim when you file your
Guide for Aliens, for more information. tax return. To qualify for the child tax credit, the child must be
Tax relief for victims of terrorist attacks. If your disability under age 17 as of December 31, must be your dependent who
payments for injuries incurred as a direct result of a terrorist generally lives with you for more than half the year, and must
attack are not taxable, write “No Withholding” in the space have the required social security number. You may be able to
below Step 4(c). See Pub. 3920, Tax Relief for Victims of claim a credit for other dependents for whom a child tax credit
Terrorist Attacks, for more details. can’t be claimed, such as an older child or a qualifying relative.
For additional eligibility requirements for these credits, see Pub.
501, Dependents, Standard Deduction, and Filing Information.
Specific Instructions You can also include other tax credits for which you are eligible
Step 1(c). Check your anticipated filing status. This will in this step, such as the foreign tax credit and the education tax
determine the standard deduction and tax rates used to credits. Including these credits will increase your payments and
compute your withholding. reduce the amount of any refund you may receive when you file
your tax return.

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Form W-4P (2022) Page 3

Specific Instructions (continued) deduction for those 65 and over, and other deductions such as
for student loan interest and IRAs.
Step 4 (optional). Step 4(c). Enter in this step any additional tax you want
Step 4(a). Enter in this step the total of your other estimated withheld from each payment. Entering an amount here will
income for the year, if any. You shouldn’t include amounts from reduce your payments and will either increase your refund or
any job(s) or pension/annuity payments. If you complete Step reduce any amount of tax that you owe.
4(a), you likely won’t have to make estimated tax payments for Note: If you don’t give Form W-4P to your payer, you don’t
that income. If you prefer to pay estimated tax rather than provide an SSN, or the IRS notifies the payer that you gave an
having tax on other income withheld from your pension, see incorrect SSN, then the payer will withhold tax from your
Form 1040-ES, Estimated Tax for Individuals. payments as if your filing status is single with no adjustments in
Step 4(b). Enter in this step the amount from the Deductions Steps 2 through 4. For payments that began before 2022, your
Worksheet, line 6, if you expect to claim deductions other than current withholding election (or your default rate) remains in
the basic standard deduction on your 2022 tax return and want effect unless you submit a new Form W-4P.
to reduce your withholding to account for these deductions.
This includes itemized deductions, the additional standard

Step 4(b)—Deductions Worksheet (Keep for your records.)

1 Enter an estimate of your 2022 itemized deductions (from Schedule A (Form 1040)). Such deductions
may include qualifying home mortgage interest, charitable contributions, state and local taxes (up to
$10,000), and medical expenses in excess of 7.5% of your income . . . . . . . . . . . . 1 $

• $25,900 if you’re married filing jointly or qualifying widow(er)
2 Enter: • $19,400 if you’re head of household . . . . . . . . 2 $
{ • $12,950 if you’re single or married filing separately }

3 If line 1 is greater than line 2, subtract line 2 from line 1 and enter the result here. If line 2 is greater
than line 1, enter “-0-” . . . . . . . . . . . . . . . . . . . . . . . . . . 3 $

4 If line 3 equals zero, and you (or your spouse) are 65 or older, enter:
• $1,750 if you’re single or head of household.
• $1,400 if you’re a qualifying widow(er) or you’re married and one of you is under age 65.
• $2,800 if you’re married and both of you are age 65 or older.
Otherwise, enter “-0-”. See Pub. 505 for more information . . . . . . . . . . . . . . . 4 $

5 Enter an estimate of your student loan interest, deductible IRA contributions, and certain other
adjustments (from Part II of Schedule 1 (Form 1040)). See Pub. 505 for more information . . . . 5 $

6 Add lines 3 through 5. Enter the result here and in Step 4(b) on Form W-4P . . . . . . . . . 6 $

Privacy Act and Paperwork Reduction Act Notice. We ask for also disclose this information to other countries under a tax
the information on this form to carry out the Internal Revenue laws treaty, to federal and state agencies to enforce federal nontax
of the United States. You are required to provide this information criminal laws, or to federal law enforcement and intelligence
only if you want to (a) request federal income tax withholding from agencies to combat terrorism.
pension or annuity payments based on your filing status and
adjustments; (b) request additional federal income tax withholding You are not required to provide the information requested on
from your pension or annuity payments; (c) choose not to have a form that is subject to the Paperwork Reduction Act unless
federal income tax withheld, when permitted; or (d) change a the form displays a valid OMB control number. Books or
previous Form W-4P. To do any of the aforementioned, you are records relating to a form or its instructions must be retained as
required by sections 3405(e) and 6109 and their regulations to long as their contents may become material in the
provide the information requested on this form. Failure to provide administration of any Internal Revenue law. Generally, tax
this information may result in inaccurate withholding on your returns and return information are confidential, as required by
payment(s). Failure to provide a properly completed form will result section 6103.
in your being treated as a single person with no other entries on The average time and expenses required to complete and file
the form; providing fraudulent information may subject you to this form will vary depending on individual circumstances. For
penalties. estimated averages, see the instructions for your income tax
Routine uses of this information include giving it to the return.
Department of Justice for civil and criminal litigation, and to If you have suggestions for making this form simpler, we
cities, states, the District of Columbia, and U.S. commonwealths would be happy to hear from you. See the instructions for your
and possessions for use in administering their tax laws. We may income tax return.

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