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Withholding Certificate for Nonperiodic Payments and OMB No. 1545-0074
Form W-4R Eligible Rollover Distributions
Department of the Treasury ▶ Give Form W-4R to the payer of your retirement payments. 2022
Internal Revenue Service
1a First name and middle initial Last name 1b Social security number

Address

City or town, state, and ZIP code

Your withholding rate is determined by the type of payment you will receive.
• For nonperiodic payments, the default withholding rate is 10%. You can choose to have a different rate by entering a rate between
0% and 100% on line 2. Generally, you can’t choose less than 10% for payments to be delivered outside the United States and its
possessions.
• For an eligible rollover distribution, the default withholding rate is 20%. You can choose a rate greater than 20% by entering the rate
on line 2. You may not choose a rate less than 20%.
See page 2 for more information.
2 Complete this line if you would like a rate of withholding that is different from the default withholding
rate. See the instructions on page 2 and the Marginal Rate Tables below for additional information.
Enter the rate as a whole number (no decimals) . . . . . . . . . . . . . . . . . ▶ 2 %

Sign ▲ ▲
Here
Your signature (This form is not valid unless you sign it.) Date

General Instructions intervals over a period of more than 1 year) from these plans
or arrangements. Instead, use Form W-4P, Withholding
Section references are to the Internal Revenue Code. Certificate for Periodic Pension or Annuity Payments. For
Future developments. For the latest information about any more information on withholding, see Pub. 505, Tax
future developments related to Form W-4R, such as Withholding and Estimated Tax.
legislation enacted after it was published, go to Caution: If you have too little tax withheld, you will generally
www.irs.gov/FormW4R. owe tax when you file your tax return and may owe a penalty
Purpose of form. Complete Form W-4R to have payers unless you make timely payments of estimated tax. If too
withhold the correct amount of federal income tax from your much tax is withheld, you will generally be due a refund
nonperiodic payment or eligible rollover distribution from an when you file your tax return. Your withholding choice (or an
employer retirement plan, annuity (including a commercial election not to have withholding on a nonperiodic payment)
annuity), or individual retirement arrangement (IRA). See will generally apply to any future payment from the same
page 2 for the rules and options that are available for each plan or IRA. Submit a new Form W-4R if you want to change
type of payment. Don’t use Form W-4R for periodic your election.
payments (payments made in installments at regular

2022 Marginal Rate Tables
You may use these tables to help you select the appropriate withholding rate for this payment or distribution. Add your income
from all sources and use the column that matches your filing status to find the corresponding rate of withholding. See page 2
for more information on how to use this table.
Single Married filing jointly
or or Head of household
Married filing separately Qualifying widow(er)
Total income Tax rate for every Total income Tax rate for every Total income Tax rate for every
over— dollar more over— dollar more over— dollar more
$0 0% $0 0% $0 0%
12,950 10% 25,900 10% 19,400 10%
23,225 12% 46,450 12% 34,050 12%
54,725 22% 109,450 22% 75,300 22%
102,025 24% 204,050 24% 108,450 24%
183,000 32% 366,000 32% 189,450 32%
228,900 35% 457,800 35% 235,350 35%
552,850* 37% 673,750 37% 559,300 37%
*If married filing separately, use $336,875 instead for this 37% rate.
For Privacy Act and Paperwork Reduction Act Notice, see page 3. Cat. No. 75085T Form W-4R (2022)

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Form W-4R (2022) Page 2
General Instructions (continued) Suggestion for determining withholding. Consider using
the Marginal Rate Tables on page 1 to help you select the
Nonperiodic payments—10% withholding. Your payer appropriate withholding rate for this payment or distribution.
must withhold at a default 10% rate from the taxable amount The tables are most accurate if the appropriate amount of
of nonperiodic payments unless you enter a different rate on tax on all other sources of income, deductions, and credits
line 2. Distributions from an IRA that are payable on demand has been paid through other withholding or estimated tax
are treated as nonperiodic payments. Note that the default payments. If the appropriate amount of tax on those sources
rate of withholding may not be appropriate for your tax of income has not been paid through other withholding or
situation. You may choose to have no federal income tax estimated tax payments, you can pay that tax through
withheld by entering “-0-” on line 2. See the specific withholding on this payment by entering a rate that is greater
instructions below for more information. Generally, you are than the rate in the Marginal Rate Tables.
not permitted to elect to have federal income tax withheld at
a rate of less than 10% (including “-0-”) on any payments to The marginal tax rate is the rate of tax on each additional
be delivered outside the United States and its possessions. dollar of income you receive above a particular amount of
income. You can use the table for your filing status as a
Note: If you don’t give Form W-4R to your payer, you guide to find a rate of withholding for amounts above the
don’t provide an SSN, or the IRS notifies the payer that you total income level in the table.
gave an incorrect SSN, then the payer must withhold 10% of
the payment for federal income tax and can’t honor requests To determine the appropriate rate of withholding from the
to have a lower (or no) amount withheld. Generally, for table, do the following. Step 1: Find the rate that
payments that began before 2022, your current withholding corresponds with your total income not including the
election (or your default rate) remains in effect unless you payment. Step 2: Add your total income and the taxable
submit a Form W-4R. amount of the payment and find the corresponding rate.
Eligible rollover distributions—20% withholding. If these two rates are the same, enter that rate on line 2.
Distributions you receive from qualified retirement plans (for (See Example 1 below.)
example, 401(k) plans and section 457(b) plans maintained If the two rates differ, multiply (a) the amount in the lower
by a governmental employer) or tax-sheltered annuities that rate bracket by the rate for that bracket, and (b) the amount
are eligible to be rolled over to an IRA or qualified plan are in the higher rate bracket by the rate for that bracket. Add
subject to a 20% default rate of withholding on the taxable these two numbers; this is the expected tax for this payment.
amount of the distribution. You can’t choose withholding at a To get the rate to have withheld, divide this amount by the
rate of less than 20% (including “-0-”). Note that the default taxable amount of the payment. Round up to the next whole
rate of withholding may be too low for your tax situation. You number and enter that rate on line 2. (See Example 2 below.)
may choose to enter a rate higher than 20% on line 2. Don’t If you prefer a simpler approach (but one that may lead to
give Form W-4R to your payer unless you want more than overwithholding), find the rate that corresponds to your total
20% withheld. income including the payment and enter that rate on line 2.
Note that the following payments are not eligible rollover Examples. Assume the following facts for Examples 1 and 2.
distributions: (a) qualifying “hardship” distributions, and (b) Your filing status is single. You expect the taxable amount of
distributions required by federal law, such as required your payment to be $20,000. Appropriate amounts have
minimum distributions. See Pub. 505 for details. See also been withheld for all other sources of income and any
Nonperiodic payments—10% withholding above. deductions or credits.
Payments to nonresident aliens and foreign estates. Do Example 1. You expect your total income to be $60,000
not use Form W-4R. See Pub. 515, Withholding of Tax on without the payment. Step 1: Because your total income
Nonresident Aliens and Foreign Entities, and Pub. 519, U.S. without the payment, $60,000, is greater than $54,725 but
Tax Guide for Aliens, for more information. less than $102,025, the corresponding rate is 22%. Step 2:
Tax relief for victims of terrorist attacks. If your disability Because your total income with the payment, $80,000, is
payments for injuries incurred as a direct result of a terrorist greater than $54,725 but less than $102,025, the
attack are not taxable, enter “-0-” on line 2. See Pub. 3920, corresponding rate is 22%. Because these two rates are the
Tax Relief for Victims of Terrorist Attacks, for more details. same, enter “22” on line 2.
Example 2. You expect your total income to be $42,500
Specific Instructions without the payment. Step 1: Because your total income
Line 1b without the payment, $42,500, is greater than $23,225 but
less than $54,725, the corresponding rate is 12%. Step 2:
For an estate, enter the estate’s employer identification Because your total income with the payment, $62,500, is
number (EIN) in the area reserved for “Social security greater than $54,725 but less than $102,025, the
number.” corresponding rate is 22%. The two rates differ. $12,225 of
the $20,000 payment is in the lower bracket ($54,725 less
Line 2
your total income of $42,500 without the payment), and
More withholding. If you want more than the default rate $7,775 is in the higher bracket ($20,000 less the $12,225 that
withheld from your payment, you may enter a higher rate on is in the lower bracket). Multiply $12,225 by 12% to get
line 2. $1,467. Multiply $7,775 by 22% to get $1,710.50. The sum
Less withholding (nonperiodic payments only). If of these two amounts is $3,177.50. This is the estimated tax
permitted, you may enter a lower rate on line 2 (including on your payment. This amount corresponds to 15.9% of the
“-0-”) if you want less than the 10% default rate withheld $20,000 payment ($3,177.50 divided by $20,000). Rounding
from your payment. If you have already paid, or plan to pay, up to the next whole number, enter “16” on line 2.
your tax on this payment through other withholding or
estimated tax payments, you may want to enter “-0-”.

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Form W-4R (2022) Page 3
Privacy Act and Paperwork Reduction Act Notice. We ask commonwealths and possessions for use in administering
for the information on this form to carry out the Internal their tax laws. We may also disclose this information to other
Revenue laws of the United States. You are required to countries under a tax treaty, to federal and state agencies to
provide this information only if you want to (a) request enforce federal nontax criminal laws, or to federal law
additional federal income tax withholding from your enforcement and intelligence agencies to combat terrorism.
nonperiodic payment(s) or eligible rollover distribution(s); (b) You are not required to provide the information requested
choose not to have federal income tax withheld from your on a form that is subject to the Paperwork Reduction Act
nonperiodic payment(s), when permitted; or (c) change a unless the form displays a valid OMB control number. Books
previous Form W-4R (or a previous Form W-4P that you or records relating to a form or its instructions must be
completed with respect to your nonperiodic payments or retained as long as their contents may become material in
eligible rollover distributions). To do any of the the administration of any Internal Revenue law. Generally,
aforementioned, you are required by sections 3405(e) and tax returns and return information are confidential, as
6109 and their regulations to provide the information required by section 6103.
requested on this form. Failure to provide this information
may result in inaccurate withholding on your payment(s). The average time and expenses required to complete and
Failure to provide a properly completed form will result in file this form will vary depending on individual
your payment(s) being subject to the default rate; providing circumstances. For estimated averages, see the instructions
fraudulent information may subject you to penalties. for your income tax return.
Routine uses of this information include giving it to the If you have suggestions for making this form simpler, we
Department of Justice for civil and criminal litigation, and to would be happy to hear from you. See the instructions for
cities, states, the District of Columbia, and U.S. your income tax return.

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