Annuitant's Request for Voluntary Arizona Income Tax Withholding

Residents who receive regularly scheduled payments from payments or annuities complete this form to elect to have Arizona income taxes withheld from their payments.  This form is submitted to the payer not the department.

Form Number
A-4P
Form Year Form Publish Date
Download 01/01/2025
Download 01/01/2024
Download 10/31/2022
Download 01/01/2023
Download 01/01/2023
Download 01/01/2023
Download 01/01/2023
Download 01/01/2023