INSTRUCTIONS: NEW YORK ANNUITANT'S REQUEST FOR INCOME TAX WITHHOLDING (Form IT-2104-P)

Those receiving an annuity or pension payment which is required to be included in their New York adjusted gross income can file a form IT-2104-P to have state income tax withheld from your payments. This document may be obtained from the website maintained by the New York State Department of Finance and Taxation.

New York Annuitant's Request For Income Tax Withholding IT-2104-P Step 1: In the first box, enter your first name, middle initial and last name.

New York Annuitant's Request For Income Tax Withholding IT-2104-P Step 2: In the second box, enter your Social Security number.

New York Annuitant's Request For Income Tax Withholding IT-2104-P Step 3: In the third box, enter your permanent mailing address.

New York Annuitant's Request For Income Tax Withholding IT-2104-P Step 4: In the fourth box, enter your annuity contract claim or identification number.

New York Annuitant's Request For Income Tax Withholding IT-2104-P Step 5: In the fifth box, enter your city, village or post office, state and zip code.

New York Annuitant's Request For Income Tax Withholding IT-2104-P Step 6: On line 1, enter the amount of New York State income tax you wish to have withheld from each annuity or pension payment. This amount must be rounded to the nearest whole dollar.

New York Annuitant's Request For Income Tax Withholding IT-2104-P Step 7: Line 2 is only for residents of New York City. If applicable, enter the amount of New York City income tax you wish to have withheld from each annuity or pension payment. This amount must be rounded to the nearest whole dollar.

New York Annuitant's Request For Income Tax Withholding IT-2104-P Step 8: Line 3 is only for residents of Yonkers. If applicable, enter the amount of Yonker income tax surcharge you wish to have withheld from each annuity or pension payment. This amount must be rounded to the nearest whole dollar.

New York Annuitant's Request For Income Tax Withholding IT-2104-P Step 9: In the first blank box at the bottom, enter your signature.

New York Annuitant's Request For Income Tax Withholding IT-2104-P Step 10: In the second blank box at the bottom, enter the date.

New York Annuitant's Request For Income Tax Withholding IT-2104-P Step 11: File this form with the payer of your annuity or pension.