Withholding Certificate for Nonperiodic Payments and Eligible Rollover Distributions

• Legal Form Number: W-4R
• Year: 2026
• Issuer: Treasury Department
• Section: Treasury Department

Form W-4R

2024

Withholding Certificate for Nonperiodic Payments and

Eligible Rollover Distributions

Department of the Treasury

Internal Revenue Service

Give Form W-4R to the payer of your retirement payments.

OMB No. 1545-0074

1a First name and middle initial Last name

Address

City or town, state, and ZIP code

1b Social security number

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

territories.

• 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

Section references are to the Internal Revenue Code.

Future developments. For the latest information about any

future developments related to Form W-4R, such as

legislation enacted after it was published, go to

www.irs.gov/FormW4R.

Purpose of form. Complete Form W-4R to have payers

withhold the correct amount of federal income tax from your

nonperiodic payment or eligible rollover distribution from an

employer retirement plan, annuity (including a commercial

annuity), or individual retirement arrangement (IRA). See

page 2 for the rules and options that are available for each

type of payment. Don’t use Form W-4R for periodic

payments (payments made in installments at regular

intervals over a period of more than 1 year) from these plans

or arrangements. Instead, use Form W-4P, Withholding

Certificate for Periodic Pension or Annuity Payments. For

more information on withholding, see Pub. 505, Tax

Withholding and Estimated Tax.

Caution: If you have too little tax withheld, you will generally

owe tax when you file your tax return and may owe a penalty

unless you make timely payments of estimated tax. If too

much tax is withheld, you will generally be due a refund

when you file your tax return. Your withholding choice (or an

election not to have withholding on a nonperiodic payment)

will generally apply to any future payment from the same

plan or IRA. Submit a new Form W-4R if you want to change

your election.

2024 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

or

Married filing separately

Total income

over—

Tax rate for every

dollar more

$0 0%

14,600 10%

26,200 12%

61,750 22%

115,125 24%

206,550 32%

258,325 35%

623,950* 37%

*

If married filing separately, use $380,200 instead for this 37% rate.

Married filing jointly

or

Qualifying surviving spouse

Total income

over—

Tax rate for every

dollar more

$0 0%

29,200 10%

52,400 12%

123,500 22%

230,250 24%

413,100 32%

516,650 35%

760,400 37%

Head of household

Total income

over—

Tax rate for every

dollar more

$0 0%

21,900 10%

38,450 12%

85,000 22%

122,400 24%

213,850 32%

265,600 35%

631,250 37%

For Privacy Act and Paperwork Reduction Act Notice, see page 3. Cat. No. 75085T Form W-4R (2024)