Form NJ-W-4P 

NJ-W-4P  CERTIFICATE OF VOLUNTARY WITHHOLDING OF NEW JERSEY GROSS INCOME  AT X
 (04-17)                 FROM PENSION AND ANNUITY PAYMENTS 
Print Your Full Name                                                         Your Social Security Number 
                                                                                         - - 
Home Address 
                                                                        ID Number of Your Pension or Annuity 
City or Town                          State      Zip Code               (From Your Statement or Contact Your Payer): 
                                                                        ________________________ 

 I want to have New Jersey Gross Income Tax withheld from this pension or annuity payment in the amount of 

 $                   .00 (Enter a whole dollar amount of $10 or more for each payment.) 

  I want to stop withholding New Jersey Income Tax from this pension or annuity payment. 

Your Signature                                                               Date 

                     MAIL THIS FORM TO YOUR PENSION OR ANNUITY PAYER 

                                      FORM MAY BE REPRODUCED 

You can use Form NJ-W-4P to notify your pension payer to begin, change, or stop withholding New 
Jersey Income Tax from your pension or annuity payments.  

Note: If you previously completed this form, do not file again unless you want to make a change. 

                                            Instructions 

       Fill in your name, address, and Social Security Number;
       Enter the identification number of your pension or annuity contract. If you do not find this
        number on your annual pension or annuity statement, ask your pension plan administrator;
       Check only one box. If you are requesting to have Income Tax withheld, you also must enter
        the amount you want deducted from each payment;
       Sign and date the completed form;
       Mail this form to the payer of your pension or annuity. If you do not have the
        mailing address, you must contact your payer.

For State of New Jersey retirees and benefit recipients only, visit the New Jersey Division of Pensions 
and Benefits for mailing information. 

Why should I file this form? 

Your pension or annuity may  be  taxable and you may  owe tax when  you  file your  New Jersey 
Income Tax return. Use this form to have the payer of your pension or annuity withhold New Jersey 
Income Tax for you. If you choose not to withhold New Jersey Income Tax, you may be required to 
make estimated tax payments.  

Note: If you do not expect to owe Income Tax to New Jersey at the end of the tax year, do not 
request to have New Jersey Income Tax withheld.  

                                            www.njtaxation.org

Is my pension or annuity taxable to New Jersey? 

If you will recover 100% of your contributions to your pension or annuity within 36 months of your 
first payment, your pension does not become taxable until you exceed your contributions. If it will 
take longer than 36  months from the  date of your  first payment  to recover 100%  of your 
contributions, use the General Rule Method to determine the taxable portion of your pension.  

If your income for the entire year is not more than $20,000 ($10,000 if your filing status is single or 
married/CU partner filing separate return), you have no tax liability to New Jersey. 

Your pension is not subject to New Jersey tax if: 

    You were not a resident of New Jersey while receiving your pension or annuity payments.
    It is a military pension resulting from service in the United States  Army, Navy, Air Force,
     Marine Corps or Coast Guard.
    It is a pension received because of total and permanent disability and you are less than 65
     years of age.  Note: If you continue to receive pension payments  after you turn 65,  your
     disability pension is then treated as an ordinary pension and taxable beginning that year.

For more information on the taxability of your pension or annuity, visit publication GIT-1, Pensions 
and Annuities.  

What amount of tax should I withhold? 

To determine the amount of income tax to withhold, first estimate your expected New Jersey taxable 
income and tax liability. Be sure to consider all sources of income  you (and  your spouse, if filing 
jointly) have in the tax year and subtract any  New Jersey tax exemptions, exclusions, and/or 
deductions. Refer to the NJ-1040 instructions or use publication GIT-8, Estimating Income Taxes to 
help estimate your income and tax liability. 

If you have an estimated New Jersey tax liability, use the worksheet below to calculate the amount 
of tax to withhold: 

   1. Estimated tax liability for the tax year                               $ ___________ 

   2. New Jersey Income Tax paid/withheld by other sources                   $ ___________ 

   3. Balance of tax (Subtract line 2 from line 1)                           $ ___________ 

   4. Number of pension or annuity payments in the tax year                       ___________ 

   5. Amount of tax to withhold from each payment
     (Divide line 3 by line 4)                                               $ ___________

What if I have questions? 

If  you  have  general  questions,  contact  the  New  Jersey  Division  of  Taxation  Customer  Service 
Center at (609) 292-6400. Agents are available Monday through Friday 8:30 a.m. to 4:30 p.m. – 
except State holidays. 

                                             www.njtaxation.org