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Arizona Form A-4 (2013)

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Arizona Form A-4 (2013)
Arizona Form A-4 (2013)
Employee’s Arizona Withholding
Percentage Election
Type or print your full name Your social security number
Home address (number and street or rural route)
City or town, state, and ZIP code
Arizona Withholding Percentage Election Options
Choose only one:
1 I choose to have Arizona withholding at the rate of
(check only one box): 0.8% 1.3% 1.8% 2.7% 3.6% 4.2% 5.1% of my gross taxable wages.
Additional amount to be withheld per paycheck $
2 I hereby elect an Arizona withholding percentage of zero, and I certify that I expect to have no Arizona tax liability for the current taxable year.
ARIZONA FORM
A-4
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 le 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 rst ve 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 le 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 le 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 le
the form. Zero withholding does not relieve you from paying Arizona
income taxes that might be due at the time you le your Arizona income
tax return. If you have an Arizona tax liability when you le 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 le 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 an Arizona withholding percentage.
I certify that I have made the percentage election marked above.
SIGNATURE DATE
ADOR 10121 (12)
2013
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Arizona Form A-4 (2013)