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Get Arizona Form A 4 2007

S (number and street or rural route) Annuity Contract Claim or I.D. Number City or town, state, and ZIP code Telephone Number Annuitant s Voluntary Arizona Income Tax Withholding Options Choose only one: 1 I hereby elect to have Arizona income taxes withheld from my annuity or pension payments as authorized by ARS 43-404. 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 the taxable amount of distribution. Additional amount t.

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