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Voluntary Withholding Request for Arizona Resident Employed Outside of Arizona

Arizona residents employed outside of Arizona complete this form to elect to have Arizona income tax withheld from their paychecks.  This form is submitted to the employer, not the department.

Form Number: 
A-4V
Category: 
Withholding Forms
Print Friendly, PDF & Email
Form Year Form Published
2023 PDF icon Download (605.01 KB) 01/01/2023
2022 PDF icon Download (602.24 KB) 01/01/2022
2021 PDF icon Download (601.96 KB) 01/01/2021
2020 PDF icon Download (591.14 KB) 01/01/2020
2019 PDF icon Download (590.65 KB) 01/01/2019
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Arizona Department of Revenue
(602) 255-3381
1600 West Monroe Street
Phoenix, AZ 85007
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