A-4 Employee¢â‚¬â„¢s Arizona Withholding Election 2016 Obtain...

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  • Type or print your Full Name Your Social Security Number

    Home Address – number and street or rural route

    City or Town State ZIP Code

    Choose either box 1 or box 2: 1 Withhold from gross taxable wages at the percentage checked (check only one percentage):

    0.8% 1.3% 1.8% 2.7% 3.6% 4.2% 5.1%

    Check this box and enter an extra amount to be withheld from each paycheck ................ $

    2 I elect an Arizona withholding percentage of zero, and I certify that I expect to have no Arizona tax liability for the current taxable year.

    Employee’s Instructions

    Arizona law requires your employer to withhold Arizona income tax from your wages for work done in Arizona. This amount is applied to your Arizona income tax due when you file your tax return. The amount withheld is a percentage of your gross taxable wages of every paycheck. You may also have your employer withhold an extra amount from each paycheck. Complete this form to select a percentage and any extra amount to be withheld from each paycheck.

    What are my “Gross Taxable Wages”?

    For withholding purposes, your “gross taxable wages” are the wages that will generally be in box 1 of your federal Form W-2. It is your gross wages less any pretax deductions, such as your share of health insurance premiums.

    New Employees

    Complete this form in the first five days of employment to select an Arizona withholding percentage. You may also have your employer withhold an extra amount from each paycheck. If you do not file this form, the department requires your employer to withhold 2.7% of your gross taxable wages.

    Current Employees

    If you want to change the current amount withheld, you must file this form to change the Arizona withholding percentage or change the extra amount withheld.

    What Should I do With Form A-4?

    Give your completed Form A-4 to your employer.

    Electing a Withholding Percentage of Zero

    You may elect an Arizona withholding percentage of zero if you expect to have no Arizona income tax liability for the current year. Arizona tax liability is gross tax liability less any tax credits, such as the family tax credit, school tax credits, or credits for taxes paid to other states. If you make this election, your employer will not withhold Arizona income tax from your wages for payroll periods beginning after the date you file the form. Zero withholding does not relieve you from paying Arizona income taxes that might be due at the time you file your Arizona income tax return. If you have an Arizona tax liability when you file your return or if at any time during the current year conditions change so that you expect to have a tax liability, you should promptly file a new Form A-4 and choose a percentage that applies to you.

    Voluntary Withholding Election by Certain Nonresident Employees

    Compensation earned by nonresidents while physically working in Arizona for temporary periods is subject to Arizona income tax. However, under Arizona law, compensation paid to certain nonresident employees is not subject to Arizona income tax withholding. These nonresident employees need to review their situations and determine whether they should elect to have Arizona income taxes withheld from their Arizona source compensation. Nonresident employees may request that their employer withhold Arizona income taxes by completing this form to elect Arizona income tax withholding.

    I certify that I have made the election marked above.

    SIGNATURE DATE

    ADOR 10121 (15)

    Arizona Form

    A-4 Employee’s Arizona Withholding Election 2016

  • ADOR 10372 (15)

    , the employer of an Arizona resident, (NAME OF EMPLOYER – COMPANY OR INDIVIDUAL)

    , whose compensation is for services performed outside of Arizona, (EMPLOYEE’S NAME) has agreed to withhold Arizona income taxes from the employee’s compensation as authorized by A.R.S. § 43-408. As stated in A.R.S. § 43-408(B), the employer understands and agrees that the employer and the employee are subject to the provisions of Chapter 4 of Title 43 of the Arizona Revised Statutes, as if the employer were required to withhold Arizona income taxes from such compensation.

    SIGNATURE OF OFFICER, SOLE PROPRIETOR, OR AGENT TITLE DATE

    Who May Use Form A-4V Arizona Form A-4V is for Arizona resident employees who are performing work outside of Arizona. Use this form to request that your employer withhold Arizona income taxes from your wages for work done outside of Arizona. This amount is applied to your Arizona income tax due when you file your return. Your employer is not required by statute to grant your request.

    If your employer agrees to withhold Arizona income tax from your wages, Arizona withholding is a percentage of your gross taxable wages of every paycheck. You may also have your employer withhold an extra amount from each paycheck.

    What are my “Gross Taxable Wages”? For withholding purposes, “gross taxable wages” are the wages from each paycheck that will generally be in box 1 of your federal Form W-2. It is your gross wages less any pretax deductions, such as your share of health insurance premiums.

    What Should I do With Form A-4V? Complete this form to request that your employer withhold Arizona income tax from your wages and elect an Arizona withholding percentage and any additional amount to be withheld from each paycheck. Give your completed form to your employer.

    Type or print your Full Name Your Social Security Number

    Home Address – number and street or rural route

    City or Town State ZIP Code

    Choose either box 1 or box 2: 1 I am an Arizona resident employed outside of Arizona. I elect to have Arizona income taxes withheld from my

    compensation paid for services performed outside of Arizona for my employer as authorized by A.R.S. § 43-408. Withhold from gross taxable wages at the percentage checked (check only one percentage):

    0.8% 1.3% 1.8% 2.7% 3.6% 4.2% 5.1%

    Check this box and enter an extra amount to be withheld per paycheck ........................... $

    2 I am an Arizona resident employed outside of Arizona. I elect to terminate my prior election for voluntary Arizona income tax withholding from my compensation paid for services performed outside of Arizona for my employer.

    I certify that I have made the election marked above.

    EMPLOYEE’S SIGNATURE DATE

    General Instructions

    Employer Certification

    Arizona Form

    A-4V Voluntary Withholding Request for

    Arizona Resident Employed Outside of Arizona 2016

  • Employer's Instructions for the Arizona Form Employee's Arizona Withholding Election A-4

    Obtain additional information or assistance by calling one of the numbers listed below:

    Phoenix (602) 255-3381 From area codes 520 and 928, toll-free (800) 352-4090

    Obtain tax rulings, tax procedures, tax forms and instructions, and other tax information by accessing the department's website at www.azdor.gov.

    Arizona Revised Statutes (A.R.S.) § 43-401 requires an employer to make Form A-4 available to employees at all times and to inform employees of the Arizona withholding election options.

    Arizona income tax withholding is based on a percentage of gross taxable wages. "Gross taxable wages" is the amount that meets the federal definition of "wages" contained in Internal Revenue Code § 3401 and that will generally be included in box 1 of the employee's federal Form W-2 at the end of the calendar year (i.e. gross wages net of pretax deductions, such as the employee's portion of health insurance premiums). Employees may also elect an extra amount to be withheld from each paycheck.

    New Employees

    New employees must complete Form A-4 within the first five days of employment. If the employee does not complete this form, the employer must withhold 2.7% of the employee's gross taxable wages, until the employer receives a completed form from the employee.

    Current Employees

    Current employees must complete Form A-4 to elect a different Arizona withholding percentage or to change the extra amount to be withheld from each paycheck. If the employee wants to increase or decrease the amount of Arizona withholding, the employee must complete Form A-4 to change the Arizona withholding percentage or change the extra amount to be withheld from each paycheck.

    Electing a Withholding Percentage of Zero

    An employee may elect an Arizona withholding percentage of zero, if the employee expects to have no Arizona income tax liability for the current taxable year. If an employee makes this election, the employer will not withhold Arizona income tax from the employee's compensation for payroll periods beginning after the date of the employee's election.

    NOTE: This election must be renewed annually by each employee claiming to be exempt from Arizona withholding.

    Voluntary Withholding Election by a Nonresident Employee Exempt Under A.R.S. § 43-403(A)(5)

    A qualifying employee may use this form to voluntarily elect to have a portion of the employee's compensation withheld under the provisions of A.R.S. § 43-403(D)(1) for application toward the employee's Arizona income tax liability. The employee completes this form to elect an Arizona withholding percentage and an extra amount to be withheld from each paycheck.

    NOTE: This exemption does not apply to a nonresident employee who is in this state solely for