"Federal Income Tax Withholding Certificate" - Nevada

Federal Income Tax Withholding Certificate is a legal document that was released by the Public Employees’ Retirement System of Nevada - a government authority operating within Nevada.

Form Details:

  • Released on August 1, 2018;
  • The latest edition currently provided by the Public Employees’ Retirement System of Nevada;
  • Ready to use and print;
  • Easy to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of the form by clicking the link below or browse more documents and templates provided by the Public Employees’ Retirement System of Nevada.

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Public Employees’ Retirement System of Nevada
693 W. Nye Lane, Carson City, NV 89703 (775) 687-4200 Fax (775) 687-5131
5740 S. Eastern Avenue, Suite 120, Las Vegas, NV 89119 (702) 486-3900 Fax (702) 678-6934
Toll free 1-866-473-7768 Website:
www.nvpers.org
Email: nvpers@nvpers.org
Federal Income Tax Withholding Certificate
Please print in black or blue ink.
Name:
Social Security Number: _________________________________Phone: (
)___________________________
Please select ALL ACCOUNTS to which these instructions are to be applied:
Your Retirement Benefit
Beneficiary/Survivor Benefit
Alternate Payee Benefit
********************************************************************************************************************************
Please note: PERS will use a standard deduction of married with three exemptions for your first retirement check.
All checks thereafter will be based on the instructions of the Tax Withholding Certificate form completed and
submitted to PERS.
Select ONE of the following three options.
Option #1
_____I do not wish to have federal income tax withheld from my benefit. I realize I am liable for payment of
federal taxes on my retirement benefits and I may be subject to tax penalties under the estimated tax payment rules
if my payments are inadequate.
Option #2
_____I authorize PERS to calculate the amount of taxes to be withheld based on the following information:
Marital Status: (must mark one)
Single
Married
Exemptions Claimed:
1 for yourself
1 for your spouse
Other exemptions
Total
I also authorize the additional amount of $____________ to be added to the amount calculated based upon the
above instructions.
Option #3
_____I authorize PERS to withhold the following flat-rate amount from my monthly check/s $________________.
I have reviewed the information on this form and hereby submit these instructions for purposes of federal income tax
withholding.
Signature: _______________________________________________________Date: ________________________
Rev. 8/18
Public Employees’ Retirement System of Nevada
693 W. Nye Lane, Carson City, NV 89703 (775) 687-4200 Fax (775) 687-5131
5740 S. Eastern Avenue, Suite 120, Las Vegas, NV 89119 (702) 486-3900 Fax (702) 678-6934
Toll free 1-866-473-7768 Website:
www.nvpers.org
Email: nvpers@nvpers.org
Federal Income Tax Withholding Certificate
Please print in black or blue ink.
Name:
Social Security Number: _________________________________Phone: (
)___________________________
Please select ALL ACCOUNTS to which these instructions are to be applied:
Your Retirement Benefit
Beneficiary/Survivor Benefit
Alternate Payee Benefit
********************************************************************************************************************************
Please note: PERS will use a standard deduction of married with three exemptions for your first retirement check.
All checks thereafter will be based on the instructions of the Tax Withholding Certificate form completed and
submitted to PERS.
Select ONE of the following three options.
Option #1
_____I do not wish to have federal income tax withheld from my benefit. I realize I am liable for payment of
federal taxes on my retirement benefits and I may be subject to tax penalties under the estimated tax payment rules
if my payments are inadequate.
Option #2
_____I authorize PERS to calculate the amount of taxes to be withheld based on the following information:
Marital Status: (must mark one)
Single
Married
Exemptions Claimed:
1 for yourself
1 for your spouse
Other exemptions
Total
I also authorize the additional amount of $____________ to be added to the amount calculated based upon the
above instructions.
Option #3
_____I authorize PERS to withhold the following flat-rate amount from my monthly check/s $________________.
I have reviewed the information on this form and hereby submit these instructions for purposes of federal income tax
withholding.
Signature: _______________________________________________________Date: ________________________
Rev. 8/18