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Wisconsin Department Substitute W-4P Tax Withholding ...

Wisconsin Department of Employee Trust Funds Substitute W-4P Tax Withholding Certificate 801 W Badger Road for Pension or Annuity Payments PO Box 7931. Madison WI 53707-7931. Wis. Stat. (1). 1-877-533-5020 (toll free). Fax 608-267-4549. Member Information Name (first, middle, last, former/maiden) SSN. If you have multiple accounts at ETF, please check one below: (For Beneficiaries Only). Apply to all accounts. Original member's SSN. Apply only to benefit account ID(s): _____. Mailing address (Street address, including apartment or Box). City, state, ZIP code Email (optional). Federal Income Tax Withholding Election See attached W-4P worksheet to help you calculate your federal Withholding . No, I do not want any federal income tax withheld from my pension or annuity. (Do not add allowances or additional amount to be withheld, below.). Yes, I would like federal income tax withheld from my pension or annuity. Complete the total number of allowances and marital status you are claiming for Withholding from each periodic pension or annuity payment.

Number of allowances: _____ Marital status: Single Married Married, but withhold at higher Single rate. Yes, I would like an additional amount withheld from each pension or annuity payment.

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