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Request for Reduced Withholding to Designate for Tax Credits

The employee completes this form to notify his/her employer of the amount by which he/she wishes his/her withholding be reduced and the amount(s) sent as a quarterly payment to qualifying charitable organizations.

Form Number: 
A-4C
Category: 
Withholding Forms
Form Year Form Instructions Published
2021 PDF icon Download (259.75 KB) PDF icon Download (219.06 KB) 01/01/2021
2020 PDF icon Download (247.93 KB) PDF icon Download (1.08 MB) 01/01/2020
2019 PDF icon Download (247.65 KB) PDF icon Download (23.84 KB) 01/01/2019
2018 PDF icon Download (623.03 KB) PDF icon Download (185.22 KB) 01/01/2018
2017 PDF icon Download (242.25 KB) PDF icon Download (23.76 KB) 01/01/2017
2016 PDF icon Download (158.59 KB) PDF icon Download (15.67 KB) 01/01/2016
2015 PDF icon Download (119.42 KB) PDF icon Download (15.65 KB) 01/01/2015
2014 PDF icon Download (40.59 KB) PDF icon Download (15.83 KB) 01/01/2014
2013 PDF icon Download (31.06 KB) 01/01/2013
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Arizona Department of Revenue
(602) 255-3381
1600 West Monroe Street
Phoenix, AZ 85007
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