Arizona Form A-4P is the one-page certificate you use to set up voluntary state income tax withholding on pension, annuity, IRA, or other retirement account distributions. You fill it out, pick a withholding percentage between 0.5% and 3.5%, sign it, and give it to the entity paying your retirement income. You do not send it to the Arizona Department of Revenue.
What Retirement Income the Form Covers
Under A.R.S. § 43-404, Form A-4P applies to distributions from qualified employer plans (401(k), 403(b), and 457), traditional IRAs, SEP and SIMPLE IRAs, private and government pensions including federal civil service and military retirement, and employee annuity plans or any specified income paid at regular intervals for a fixed or lifetime period.1Arizona Legislature. Arizona Code 43-404 – Extension of Withholding to Pensions, Annuities, Retirement Accounts; Definitions
Withholding only applies to the portion of a distribution that is Arizona gross income. Return-of-contribution amounts that aren’t taxable, common with Roth conversions and some pension plans, aren’t subject to withholding.
The election is voluntary. Unlike federal withholding, which applies at default rates unless you opt out, your Arizona payer will not withhold anything until you submit this form.
How to Fill Out Form A-4P
Download the current version from the Arizona Department of Revenue’s withholding forms page.2Arizona Department of Revenue. Annuitant’s Request for Voluntary Arizona Income Tax Withholding The form has two parts.
Your Personal Information
Fill in your full name, Social Security number, home address, phone number, and your annuity contract, claim, or ID number. That last field is the account identifier your plan administrator or insurer uses for your benefit; you can find it on a prior distribution statement or your 1099-R.3Arizona Department of Revenue. Arizona Form A-4P – Request for Arizona Voluntary Income Tax Withholding on Retirement Income You do not need to enter the payer’s name or FEIN.
Your Withholding Election
Check Box 1 to elect withholding, then choose one of the preset rates: 0.5%, 1.0%, 1.5%, 2.0%, 2.5%, 3.0%, or 3.5%.3Arizona Department of Revenue. Arizona Form A-4P – Request for Arizona Voluntary Income Tax Withholding on Retirement Income A separate box lets you add a flat dollar amount on top of the percentage; for example, 2.5% plus $25 per distribution.
Sign and date at the bottom. The signature authorizes the payer to start withholding, and without it the form can’t be processed.
Choosing the Right Percentage
Arizona’s individual income tax is a flat 2.5% at all income levels and filing statuses.4Arizona Department of Revenue. Individual Income Tax Highlights If your distribution is fully taxable and you don’t have other significant income or deductions, the 2.5% option will land close to your actual liability.
Go higher if you have other income the state isn’t seeing. Retirees who receive money from several sources but only withhold on one, or who have taxable capital gains, rental income, or Social Security benefits, may want 3.0% or 3.5% on their largest distribution to cover the whole bill. Go lower if you claim substantial itemized deductions or Arizona-specific subtractions that shrink your taxable base; 1.5% or 2.0% may be enough.
The optional flat dollar add-on helps when your distributions vary in size. A percentage alone can leave you short in a month when a payment is smaller than usual, and a fixed additional amount steadies the total.
Where to Submit the Form
Send Form A-4P to the payer of your retirement income: the plan administrator, financial institution, insurance company, or former employer that issues your distributions. The form’s instructions say specifically not to mail or email it to the Arizona Department of Revenue.3Arizona Department of Revenue. Arizona Form A-4P – Request for Arizona Voluntary Income Tax Withholding on Retirement Income Your payer keeps it on file and applies the withholding.
Large administrators typically accept the form by mail at a benefits or tax-withholding address listed on distribution statements or their website, and many also accept scanned uploads through online portals. If you mail it, use a trackable method. Expect one to two payment cycles before the new withholding shows up. Keep a copy so you can check the total against the state withholding reported on your 1099-R at tax time.
Changing or Stopping Withholding
Your election stays in effect indefinitely, with no annual renewal and no expiration date, until you submit a new form.3Arizona Department of Revenue. Arizona Form A-4P – Request for Arizona Voluntary Income Tax Withholding on Retirement Income To change the rate, complete a new A-4P and deliver it to the same payer.
To stop withholding, A.R.S. § 43-404 allows termination by giving the payer a written denial or termination notice.1Arizona Legislature. Arizona Code 43-404 – Extension of Withholding to Pensions, Annuities, Retirement Accounts; Definitions Some administrators treat a new A-4P with no election box checked as termination; others want a separate letter. Ask your payer which they prefer.
Common reasons to update the election: a change in filing status, a shift in other income, or moving out of Arizona. If you leave the state, you no longer owe Arizona tax on retirement distributions, and terminating withholding avoids money you’d have to reclaim as a refund.
Federal Withholding Is a Separate Form
Form A-4P covers only Arizona. Federal withholding on retirement income runs on separate IRS forms, and you generally need both set correctly.
For regular recurring pension or annuity payments, the federal form is IRS Form W-4P. If you don’t submit one, the payer uses a default withholding method based on IRS tables.5Internal Revenue Service. Form W-4P, Withholding Certificate for Periodic Pension or Annuity Payments For lump-sum or one-time distributions from an IRA or retirement account, the federal form is IRS Form W-4R. The default federal rate on nonperiodic payments is 10%, and eligible rollover distributions carry a mandatory 20% minimum.6Internal Revenue Service. Withholding Certificate for Nonperiodic Payments and Eligible Rollover Distributions
When you submit an A-4P, ask your payer whether they also need an updated W-4P or W-4R so both sides of your withholding stay aligned.
Withholding vs. Estimated Payments
You aren’t required to use A-4P at all. The alternative is quarterly estimated tax through Arizona Form 140ES, with payments due roughly in April, June, September, and January.7Arizona Department of Revenue. Individual Estimated Tax Payments Withholding runs automatically once set up; estimated payments require you to calculate and send four payments a year.
Arizona requires estimated payments when your gross income exceeds $75,000 ($150,000 for married filing jointly) in both the current and prior year. To avoid an underpayment penalty, your combined withholding and estimated payments must total at least 90% of your current-year tax or 100% of your prior-year tax.7Arizona Department of Revenue. Individual Estimated Tax Payments Underpayments accrue interest at the federal short-term rate plus three percentage points, roughly 6% to 7% annually in 2026.8Arizona Department of Revenue. Interest Rates
You can combine the two. Withhold a baseline through A-4P and add a small estimated payment late in the year if your other income came in higher than planned.