Form W-4S, Request for Federal Income Tax Withholding From Sick Pay
Form W-4S lets you ask a third-party payer, such as an insurance company, to withhold federal income tax from your sick pay. Fill it out online here and download the completed PDF for free.
This is the genuine IRS PDF, unmodified. Source: IRS official page.
What is W-4S?
Form W-4S, Request for Federal Income Tax Withholding From Sick Pay, is the IRS form you give to a third-party payer of sick pay when you want federal income tax withheld from those payments. Sick pay from a third party, like an insurance company paying disability benefits under your employer’s plan, is generally taxable, but the payer does not withhold income tax unless you ask.
On the form you specify a flat dollar amount to withhold from each sick pay payment. The form includes a worksheet to help you estimate an amount, and it goes to the payer, not to the IRS. Withholding through W-4S can help you avoid a balance due or an estimated tax penalty when you file your return.
Who files W-4S?
- Employees receiving sick pay or disability payments from a third-party payer, such as an insurance company, who want federal income tax withheld
- People on longer-term disability leave who expect the payments to be taxable and prefer withholding over making estimated tax payments
- Anyone whose sick pay comes from a party other than their employer, since third-party payers only withhold income tax on request
- Recipients who want to change or stop an earlier withholding request by giving the payer a new Form W-4S
How to fill out W-4S
- Enter your name, Social Security number, and home address in the boxes at the top of the form.
- Optionally use the worksheet to estimate your expected tax for the year and figure a reasonable withholding amount per payment.
- Enter the flat dollar amount you want withheld from each sick pay payment, keeping in mind the payment must still leave you a portion after all withholding.
- Sign and date the form, then download your completed PDF for free.
- Give the form to the third-party payer of your sick pay, not to the IRS, and keep a copy for your records.
Quick fill W-4S on this page
Prefer to see the form itself while you type? Open W-4S in the editor to fill it on the actual pages, add a signature, and download.
Frequently asked questions
Do I send Form W-4S to the IRS?
No. You give the completed form to the third-party payer of your sick pay, such as the insurance company issuing the payments. The IRS does not receive this form directly.
How much withholding should I request?
You choose a flat dollar amount per payment. The worksheet on the form helps you estimate your tax for the year so the amount is reasonable. There are minimum rules, so check the current instructions on the form itself, and remember the payer cannot withhold so much that nothing is left of the payment.
Can I change or stop the withholding later?
Yes. Submit a new Form W-4S to the payer with an updated amount, or follow the payer’s process to revoke your request. The change generally takes effect with payments made after the payer processes it.