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This document primarily provides tax-related forms (New Jersey W4 and Federal W4-P) and a direct deposit authorization form for the Town of Hammonton. The NJ-W4 form assists employees in determining their state income tax withholding allowances, while the W4-P form is for pension or annuity recipients to manage federal income tax withholding. The direct deposit form allows employees to authorize the Town of Hammonton to deposit their paychecks directly into their bank accounts.

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Department Information
Purchasing Agent
Phone:
(609) 567-4300 ext 118
Fax:
(609) 567-4302
E-mail:
Click here
Town Accountant
Frank Zuber
Phone:
(609) 567-4300 ext 121
Fax:
(609) 567-4302
E-mail: Click here
Hours of Operation:
9:00 a.m. to 4:30 p.m.
Monday through Friday
Duties of Finance Office
Annual Budget Preparation
Annual & Supplement Debt Statement Preparation
Temporary, Emergency, Annual and Capital Budget Resolutions
Application and Maintenance of Grants
Payroll and reports filing
Prepare and advertise of Bids, Quotes, Professional, Specialized, Unspecifiable Services
Payment of bills
Keeper of municipal bank accounts and general ledger
Bids & Proposals
Documents
New Jersey W4
Federal W4
MBOS Logon Instructions for Pension Account Access
Direct Deposit

Document Text

--- Document: New Jersey W4 ---
Form NJ-W4	
State of New Jersey – Division of Taxation
(1-21)	
Employee’s Withholding Allowance Certificate
1.	 SS#
2. Filing Status: (Check only one box)
	
1.  
  Single
	
2.  
  Married/Civil Union Couple Joint
	
3.  
  Married/Civil Union Partner Separate
	
4.  
  Head of Household
	
5.  
  Qualifying Widow(er)/Surviving Civil Union Partner
	
Name
	
Address
	
City
State
Zip
3.	 If you have chosen to use the chart from instruction A, enter the appropriate letter here............................................................
3.
4.	 Total number of allowances you are claiming (see instructions)...................................................................................................
4.
5.	 Additional amount you want deducted from each pay..................................................................................................................
5.  $
6.	 I claim exemption from withholding of NJ Gross Income Tax and I certify that I have met the conditions in the 
	
instructions of the NJ-W4. If you have met the conditions, enter “EXEMPT” here.......................................................................
6.
7. Under penalties of perjury, I certify that I am entitled to the number of withholding allowances claimed on this certificate or entitled to claim exempt status.
Employee’s Signature	
Date
Employer’s Name and Address 
Employer Identification Number
BASIC INSTRUCTIONS
	
Line 1	 Enter your name, address, and Social Security number in the spaces provided.
 
Line 2 Check the box that indicates your filing status. If you checked Box 1 (Single) or Box 3 (Married/Civil Union Partner Separate) you will be withheld at Rate A.
 Note: If you have checked Box 2 (Married/Civil Union Couple Joint), Box 4 (Head of Household) or Box 5 (Qualifying Widow(er) Surviving Civil Union Partner) 
and either your spouse/civil union partner works or you have more than one job or more than one source of income and the combined total of all wages is 
greater than $50,000, see instruction A below. If you do not complete Line 3, you will be withheld at Rate B.
	
Line 3	 If you have chosen to use the wage chart below, enter the appropriate letter.
	
Line 4	 Enter the number of allowances you are claiming. Entering a number on this line will decrease the amount of withholding and could result in an underpayment on 
your return.
	
Line 5	 Enter the amount of additional withholdings you want deducted from each pay.
	
Line 6	 Enter “EXEMPT” to indicate that you are exempt from New Jersey Gross Income Tax Withholdings, if you meet one of the following conditions:
•	
Your filing status is SINGLE or MARRIED/CIVIL UNION PARTNER SEPARATE and your wages plus your taxable nonwage income will be $10,000 or less for 
the current year.
•	
Your filing status is MARRIED/CIVIL UNION COUPLE JOINT, and your wages combined with your spouse’s/civil union partner’s wages plus your taxable 
nonwage income will be $20,000 or less for the current year.
•	
Your filing status is HEAD OF HOUSEHOLD or QUALIFYING WIDOW(ER)/SURVIVING CIVIL UNION PARTNER and your wages plus your taxable nonwage 
income will be $20,000 or less for the current year.
Your exemption is good for ONE year only. You must complete and submit a form each year certifying you have no New Jersey Gross Income Tax liability and claim 
exemption from withholding. If you have questions about eligibility, filing status, withholding rates, etc. when completing this form, call the Division of Taxation’s Customer 
Service Center at (609) 292-6400.
Instruction A - Wage Chart
This chart is designed to increase withholdings on your wages, if these wages will be taxed at a higher rate due to inclusion of other wages or income on your NJ-1040 
return. It is not intended to provide withholding for other income or wages. If you need additional withholdings for other income or wages, use Line 5 on the NJ-W4. 
This Wage Chart applies to taxpayers who are married/civil union couple filing jointly, heads of households, or qualifying widow(er)/surviving civil union partner. Single 
individuals or married/civil union partners filing separate returns do not need to use this chart. If you have indicated filing status #2, 4 or 5 on the above NJ-
W4 and your taxable income is greater than $50,000, you should strongly consider using the Wage Chart. (See the Rate Tables on the reverse side to estimate your 
withholding amount.)
HOW TO USE THE CHART
1)	
Find the amount of your wages in the left-hand column.
2)	
Find the amount of the total for all other wages (including 
	
your spouse’s/civil union partner’s wages) along the top 
	
row.
3)	
Follow along the row that contains your wages until you 
	
come to the column that contains the other wages.
4)	
This meeting point indicates the Withholding Table that 
 
best reflects your income situation.
5)	
If you have chosen this method, enter the “letter” of the 
	
withholding rate table on Line 3 of the NJ-W4.
NOTE:	
If your income situation substantially increases (or 
	
	
decreases) in the future, you should resubmit a 
	
	
revised NJ-W4 to your employer.
THIS FORM MAY BE REPRODUCED
WAGE CHART
Total of All
Other Wages
0
10,000
10,001
20,000
20,001
30,000
30,001
40,000
40,001
50,000
50,001
60,000
60,001
70,000
70,001
80,000
80,001
90,000
OVER
90,000
Y
O
U
R
W
A
G
E
S
0
10,000
B
B
B
B
B
B
B
B
B
B
10,001
20,000
B
B
B
B
C
C
C
C
C
C
20,001
30,000
B
B
B
A
A
D
D
D
D
D
30,001
40,000
B
B
A
A
A
A
A
E
E
E
40,001
50,000
B
C
A
A
A
A
A
E
E
E
50,001
60,000
B
C
D
A
A
A
E
E
E
E
60,001
70,000
B
C
D
A
A
E
E
E
E
E
70,001
80,000
B
C
D
E
E
E
E
E
E
E
80,001
90,000
B
C
D
E
E
E
E
E
E
E
OVER
90,000
B
C
D
E
E
E
E
E
E
E


RATE TABLES FOR WAGE CHART
The rate tables listed below correspond to the letters in the Wage Chart on the front page. Use these to estimate the amount of withholding that will occur if you 
choose to use the wage chart. Compare this to your estimated income tax liability for your New Jersey Income Tax return to see if this is the correct amount of 
withholding that you should have.
RATE “A”
WEEKLY PAYROLL PERIOD (Allowance $19.20)
ANNUAL PAYROLL PERIOD (Allowance $1,000)
If the amount of taxable 
wages is:
The amount of income tax to be 
withheld is:
If the amount of taxable 
wages is:
The amount of income tax to be 
withheld is:
Over
But Not Over
Of Excess Over
Over
But Not Over
Of Excess Over
$
0
$
385
1.5%
$
0
$
0
$
20,000
1.5%
$
0
$
385
$
673
$
5.77 +
2.0%
$
385
$
20,000
$
35,000
$
300.00 +
2.0%
$
20,000
$
673
$
769
$
11.54 +
3.9%
$
673
$
35,000
$
40,000
$
600.00 +
3.9%
$
35,000
$
769
$
1,442
$
15.29 +
6.1%
$
769
$
40,000
$
75,000
$
795.00 +
6.1%
$
40,000
$
1,442
$
9,615
$
56.35 +
7.0%
$
1,442
$
75,000
$
500,000
$
2,930.00 +
7.0%
$
75,000
$
9,615
$
19,231
$
628.46 +
9.9%
$
9,615
$
500,000
$
1,000,000
$
32,680.00 +
9.9%
$
500,000
$
19,231
$
1,580.38 +
11.8%
$
19,231
$
1,000,000
over
$
82,180.00 +
11.8%
$
1,000,000
RATE “B”
WEEKLY PAYROLL PERIOD (Allowance $19.20)
ANNUAL PAYROLL PERIOD (Allowance $1,000)
If the amount of taxable 
wages is:
The amount of income tax to be 
withheld is:
If the amount of taxable 
wages is:
The amount of income tax to be 
withheld is:
Over
But Not Over
Of Excess Over
Over
But Not Over
Of Excess Over
$
0
$
385
1.5%
$
0
$
0
$
20,000
1.5%
$
0
$
385
$
962
$
5.77 +
2.0%
$
385
$
20,000
$
50,000
$
300.00 +
2.0%
$
20,000
$
962
$
1,346
$
17.31 +
2.7%
$
962
$
50,000
$
70,000
$
900.00 +
2.7%
$
50,000
$
1,346
$
1,538
$
27.69 +
3.9%
$
1,346
$
70,000
$
80,000
$
1,440.00 +
3.9%
$
70,000
$
1,538
$
2,885
$
35.19 +
6.1%
$
1,538
$
80,000
$
150,000
$
1,830.00 +
6.1%
$
80,000
$
2,885
$
9,615
$
117.31 +
7.0%
$
2,885
$
150,000
$
500,000
$
6,100.00 +
7.0%
$
150,000
$
9,615
$
19,231
$
588.46 +
9.9%
$
9,615
$
500,000
$
1,000,000
$
30,600.00 +
9.9%
$
500,000
$
19,231
$
1,540.38 +
11.8%
$
19,231
$
1,000,000
$
80,100.00 +
11.8%
$
1,000,000
RATE “C”
WEEKLY PAYROLL PERIOD (Allowance $19.20)
ANNUAL PAYROLL PERIOD (Allowance $1,000)
If the amount of taxable 
wages is:
The amount of income tax to be 
withheld is:
If the amount of taxable 
wages is:
The amount of income tax to be 
withheld is:
Over
But Not Over
Of Excess Over
Over
But Not Over
Of Excess Over
$
0
$
385
1.5%
$
0
$
0
$
20,000
1.5%
$
0
$
385
$
769
$
5.77 +
2.3%
$
385
$
20,000
$
40,000
$
300.00 +
2.3%
$
20,000
$
769
$
962
$
14.62 +
2.8%
$
769
$
40,000
$
50,000
$
760.00 +
2.8%
$
40,000
$
962
$
1,154
$
20.00 +
3.5%
$
962
$
50,000
$
60,000
$
1,040.00 +
3.5%
$
50,000
$
1,154
$
2,885
$
26.73 +
5.6%
$
1,154
$
60,000
$
150,000
$
1,390.00 +
5.6%
$
60,000
$
2,885
$
9,615
$
123.65 +
6.6%
$
2,885
$
150,000
$
500,000
$
6,430.00 +
6.6%
$
150,000
$
9,615
$
19,231
$
567.88 +
9.9%
$
9,615
$
500,000
$
1,000,000
$
29,530.00 +
9.9%
$
500,000
$
19,231
$
1,519.81 +
11.8%
$
19,231
$
1,000,000
$
79,030.00 +
11.8%
$
1,000,000
RATE “D”
WEEKLY PAYROLL PERIOD (Allowance $19.20)
ANNUAL PAYROLL PERIOD (Allowance $1,000)
If the amount of taxable 
wages is:
The amount of income tax to be 
withheld is:
If the amount of taxable 
wages is:
The amount of income tax to be 
withheld is:
Over
But Not Over
Of Excess Over
Over
But Not Over
Of Excess Over
$
0
$
385
1.5%
$
0
$
0
$
20,000
1.5%
$
0
$
385
$
769
$
5.77 +
2.7%
$
385
$
20,000
$
40,000
$
300.00 +
2.7%
$
20,000
$
769
$
962
$
16.15 +
3.4%
$
769
$
40,000
$
50,000
$
840.00 +
3.4%
$
40,000
$
962
$
1,154
$
22.69 +
4.3%
$
962
$
50,000
$
60,000
$
1,180.00 +
4.3%
$
50,000
$
1,154
$
2,885
$
30.96 +
5.6%
$
1,154
$
60,000
$
150,000
$
1,610.00 +
5.6%
$
60,000
$
2,885
$
9,615
$
127.88 +
6.5%
$
2,885
$
150,000
$
500,000
$
6,650.00 +
6.5%
$
150,000
$
9,615
$
19,231
$
565.38 +
9.9%
$
9,615
$
500,000
$
1,000,000
$
29,400.00 +
9.9%
$
500,000
$
19,231
$
1,517.31 +
11.8%
$
19,231
$
1,000,000
$
78,900.00 +
11.8%
$
1,000,000
RATE “E”
WEEKLY PAYROLL PERIOD (Allowance $19.20)
ANNUAL PAYROLL PERIOD (Allowance $1,000)
If the amount of taxable 
wages is:
The amount of income tax to be 
withheld is:
If the amount of taxable 
wages is:
The amount of income tax to be 
withheld is:
Over
But Not Over
Of Excess Over
Over
But Not Over
Of Excess Over
$
0
$
385
1.5%
$
0
$
0
$
20,000
1.5%
$
0
$
385
$
673
$
5.77 +
2.0%
$
385
$
20,000
$
35,000
$
300.00 +
2.0%
$
20,000
$
673
$
1,923
$
11.54 +
5.8%
$
673
$
35,000
$
100,000
$
600.00 +
5.8%
$
35,000
$
1,923
$
9,615
$
84.04 +
6.5%
$
1,923
$
100,000
$
500,000
$
4,370.00 +
6.5%
$
100,000
$
9,615
$
19,231
$
584.04 +
9.9%
$
9,615
$
500,000
$
1,000,000
$
30,370.00 +
9.9%
$
500,000
$
19,231
$
1,535.96 +
11.8%
$
19,231
$
1,000,000
$
79,870.00 +
11.8%
$
1,000,000




--- Document: Federal W4 ---
Form  W-4P
(Rev. December 2020)
Department of the Treasury  
Internal Revenue Service 
Withholding Certificate for 
Pension or Annuity Payments
OMB No. 1545-0074
2021
Future developments. For the latest information about any 
future developments related to Form W‐4P, such as legislation 
enacted after it was published, go to www.irs.gov/FormW4P.
Purpose of form. Form W‐4P is for U.S. citizens, resident 
aliens, or their estates who are recipients of pensions, annuities 
(including commercial annuities), and certain other deferred 
compensation. Use Form W‐4P to tell payers the correct 
amount of federal income tax to withhold from your payment(s). 
You may also use Form W‐4P to choose (a) not to have any 
federal income tax withheld from the payment (except for 
eligible rollover distributions or for payments to U.S. citizens to 
be delivered outside the United States or its possessions), or (b) 
to have an additional amount of tax withheld.
Your options depend on whether the payment is periodic, 
nonperiodic, or an eligible rollover distribution, as explained on 
pages 2 and 3. Your previously filed Form W‐4P will remain in 
effect if you don’t file a Form W‐4P for 2021.
General Instructions
Section references are to the Internal Revenue Code. 
Follow these instructions to determine the number of 
withholding allowances you should claim for pension or annuity 
payment withholding for 2021 and any additional amount of tax 
to have withheld. Complete the worksheet(s) using the taxable 
amount of the payments.
If you don’t want any federal income tax withheld (see 
Purpose of form, earlier), you can skip the worksheets and go 
directly to the Form W‐4P below.
Sign this form. Form W‐4P is not valid unless you sign it.
You can also use the estimator at www.irs.gov/W4App to 
determine your tax withholding more accurately. Consider using 
this estimator if you have a more complicated tax situation, such 
as if you have more than one pension or annuity, a working 
spouse, or a large amount of income outside of your pensions. 
After your Form W‐4P takes effect, you can also use this estimator 
to see how the amount of tax you’re having withheld compares to 
your projected total tax for 2021. If you use the estimator, you 
don’t need to complete any of the worksheets for Form W‐4P.
Note that 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.
Filers with multiple pensions or more than one income. If you 
have more than one source of income subject to withholding 
(such as more than one pension or a pension and a job, or 
you’re married filing jointly and your spouse is working), read all 
of the instructions, including the instructions for the Multiple 
Pensions/More‐Than‐One‐Income Worksheet, before beginning.
Other income. If you have a large amount of income from other 
sources not subject to withholding (such as interest, dividends, 
or capital gains), consider making estimated tax payments using 
Form 1040‐ES, Estimated Tax for Individuals. Otherwise, you 
might owe additional tax. See Pub. 505, Tax Withholding and 
Estimated Tax, for more information. Get Form 1040‐ES and 
Pub. 505 at www.irs.gov/FormsPubs. Or, you can use the 
Deductions, Adjustments, and Additional Income Worksheet on 
page 5 or the estimator at www.irs.gov/W4App to make sure 
you have enough tax withheld from your payments. If you have 
income from wages, see Pub. 505 or use the estimator at 
www.irs.gov/W4App to find out if you should adjust your 
withholding on Form W‐4 or Form W‐4P.
Note: Social security and railroad retirement payments may be 
includible in income. See Form W‐4V, Voluntary Withholding 
Request, for information on voluntary withholding from these 
payments.
Withholding From Pensions and Annuities
Generally, federal income tax withholding applies to the taxable 
part of payments made from pension, profit-sharing, stock bonus, 
annuity, and certain deferred compensation plans; from individual 
retirement arrangements (IRAs); and from commercial annuities. 
The method and rate of withholding depend on (a) the kind of 
payment you receive; (b) whether the payments are to be delivered 
outside the United States or its possessions; and (c) whether the 
recipient is a nonresident alien individual, a nonresident alien 
beneficiary, or a foreign estate. Qualified distributions from a 
designated Roth account or Roth IRA are nontaxable and, 
therefore, not subject to withholding. See page 3 for special 
withholding rules that apply to payments to be delivered outside 
the United States and payments to foreign persons.
Separate here and give Form W-4P to the payer of your pension or annuity. Keep the worksheet(s) for your records.
Form   W-4P
Department of the Treasury  
Internal Revenue Service 
Withholding Certificate for 
Pension or Annuity Payments
▶ For Privacy Act and Paperwork Reduction Act Notice, see page 6. 
OMB No. 1545-0074
2021
Your first name and middle initial
Last name
Your social security number
Home address (number and street or rural route)
City or town, state, and ZIP code
Claim or identification number  
(if any) of your pension or  
annuity contract
Complete the following applicable lines.
1 Check here if you do not want any federal income tax withheld from your pension or annuity. (Don’t complete line 2 or 3.) ▶
2 
 
Total number of allowances and marital status you’re claiming for withholding from each periodic pension or annuity 
payment. (You may also designate an additional dollar amount on line 3.) .
.
.
.
.
.
.
.
.
.
.
.
.
.  ▶
(Enter number  
of allowances.)
Marital status:
Single
Married
Married, but withhold at higher Single rate.
3 
 
Additional amount, if any, you want withheld from each pension or annuity payment. (Note: For periodic payments, 
you can’t enter an amount here without entering the number (including zero) of allowances on line 2.) .
.
.
. ▶
$
Your signature ▶
Date ▶
Cat. No. 10225T
Form W-4P (2021) 


Form W-4P (2021)
Page 2
Because your tax situation may change from year to year, you 
may want to refigure your withholding each year. You can 
change the amount to be withheld by using lines 2 and 3 of 
Form W-4P.
Choosing not to have income tax withheld. You (or in the 
event of death, your beneficiary or estate) can choose not to 
have federal income tax withheld from your payments by using 
line 1 of Form W-4P. For an estate, the election to have no 
income tax withheld may be made by the executor or personal 
representative of the decedent. Enter the estate’s employer 
identification number (EIN) in the area reserved for “Your social 
security number” on Form W-4P.
You may not make this choice for eligible rollover distributions. 
See Eligible rollover distribution—20% withholding below.
Caution: There are penalties for not paying enough federal 
income tax during the year, either through withholding or 
estimated tax payments. New retirees, especially, should see 
Pub. 505. It explains your estimated tax requirements and 
describes penalties in detail. You may be able to avoid quarterly 
estimated tax payments by having enough tax withheld from 
your pension or annuity using Form W-4P. 
Periodic payments. Withholding from periodic payments of a 
pension or annuity is figured using certain withholding tables 
that are also used to figure withholding from wages. Periodic 
payments are made in installments at regular intervals over a 
period of more than 1 year. They may be paid annually, 
quarterly, monthly, etc.
If you want federal income tax to be withheld, you must 
designate the number of withholding allowances on line 2 of 
Form W-4P and indicate your marital status by checking the 
appropriate box. You can’t designate a specific dollar amount to 
be withheld. However, you can designate an additional amount 
to be withheld on line 3.
If you don’t want any federal income tax withheld from your 
periodic payments, check the box on line 1 of Form W-4P and 
submit the form to your payer. However, see Payments to 
Foreign Persons and Payments To Be Delivered Outside the 
United States on page 3.
Caution: If you don’t submit Form W-4P to your payer, the 
payer must withhold from periodic payments as if you’re 
married claiming three withholding allowances. Generally, this 
means that tax will be withheld if the taxable amount of your 
pension or annuity is at least $2,100 a month.
If you submit a Form W-4P that doesn’t contain your correct 
social security number (SSN), the payer must withhold as if
you’re single claiming zero withholding allowances even if you 
checked the box on line 1 to have no federal income tax 
withheld.
There are some kinds of periodic payments for which you 
can’t use Form W-4P because they’re already defined as wages 
subject to federal income tax withholding. These payments 
include retirement pay for service in the U.S. Armed Forces and 
payments from certain nonqualified deferred compensation 
plans and tax-exempt organizations’ deferred compensation 
plans described in section 457. Your payer should be able to tell 
you whether Form W-4P applies.
For periodic payments, your Form W-4P stays in effect until 
you change or revoke it. Your payer must notify you each year 
of your right to choose not to have federal income tax withheld 
(if permitted) or to change your choice.
Nonperiodic payments—10% withholding. Your payer must 
withhold at a flat 10% rate from the taxable amount of 
nonperiodic payments (but see Eligible rollover distribution—
20% withholding below) unless you choose not to have federal 
income tax withheld. Distributions from an IRA that are payable 
on demand are treated as nonperiodic payments. You can 
choose not to have federal income tax withheld from a 
nonperiodic payment (if permitted) by submitting Form W-4P 
(containing your correct SSN) to your payer and checking the 
box on line 1. However, see Payments to Foreign Persons and 
Payments To Be Delivered Outside the United States on page 3. 
Generally, your choice not to have federal income tax withheld 
will apply to any later payment from the same plan. You can’t 
use line 2 for nonperiodic payments. But you may use line 3 to 
specify an additional amount that you want withheld.
Caution: If you submit a Form W-4P that doesn’t contain your 
correct SSN, the payer can’t honor your request not to have 
income tax withheld and must withhold 10% of the payment for 
federal income tax.
Eligible rollover distribution—20% withholding. Distributions 
you receive from qualified pension or annuity plans (for 
example, 401(k) plans and section 457(b) plans maintained by a 
governmental employer) or tax-sheltered annuities that are 
eligible to be rolled over to an IRA or qualified plan are subject 
to a flat 20% federal withholding rate on the taxable amount of 
the distribution. The 20% withholding rate is required, and you 
can’t choose not to have income tax withheld from eligible 
rollover distributions. Don’t give Form W-4P to your payer 
unless you want an additional amount withheld. In that case, 
complete line 3 of Form W-4P and submit the form to your 
payer.


Form W-4P (2021)
Page 3
Note: The payer won’t withhold federal income tax if the entire 
distribution is transferred by the plan administrator in a direct 
rollover to a traditional IRA or another eligible retirement plan (if 
allowed by the plan), such as a 401(k) plan, qualified pension 
plan, governmental section 457(b) plan, section 403(b) contract, 
or tax-sheltered annuity.
Distributions that are (a) required by federal law, (b) one of a 
specified series of equal payments, or (c) qualifying “hardship” 
distributions are not “eligible rollover distributions” and aren’t 
subject to the mandatory 20% federal income tax withholding. 
See Pub. 505 for details. See also Nonperiodic payments—10% 
withholding on page 2.
Tax relief for victims of terrorist attacks. For tax years ending 
after September 10, 2001, disability payments for injuries 
incurred as a direct result of a terrorist attack directed against the 
United States (or its allies), whether outside or within the United 
States, aren’t included in income. You may check the box on line 
1 of Form W-4P and submit the form to your payer to have no 
federal income tax withheld from these disability payments. 
However, you must include in your income any amounts that you 
received or would’ve received in retirement had you not become 
disabled as a result of a terrorist attack. See Pub. 3920, Tax 
Relief for Victims of Terrorist Attacks, for more details.  
Changing Your “No Withholding” Choice
Periodic payments. If you previously chose not to have federal 
income tax withheld and you now want withholding, complete 
another Form W-4P and submit it to your payer. If you want 
federal income tax withheld at the 2021 default rate (married 
with three allowances), write “Revoked” next to the checkbox 
on line 1 of the form. If you want tax withheld at a different rate, 
complete line 2 on the form.
Nonperiodic payments. If you previously chose not to have 
federal income tax withheld and you now want withholding, 
write “Revoked” next to the checkbox on line 1 and submit the 
Form W-4P to your payer.
Payments to Foreign Persons and Payments 
To Be Delivered Outside the United States
Unless you’re a nonresident alien, withholding (in the manner 
described above) is required on any periodic or nonperiodic 
payments that are to be delivered to you outside the United 
States or its possessions. Don’t check the box on line 1 of Form 
W-4P. See Pub. 505 for details.
In the absence of a tax treaty exemption, nonresident aliens, 
nonresident alien beneficiaries, and foreign estates are generally 
subject to a 30% federal withholding tax under section 1441 on 
the taxable portion of a periodic or nonperiodic pension or 
annuity payment that is from U.S. sources. However, most tax 
treaties provide that private pensions and annuities are exempt 
from withholding and tax. Also, payments from certain pension 
plans are exempt from withholding even if no tax treaty applies. 
See Pub. 515, Withholding of Tax on Nonresident Aliens and 
Foreign Entities, and Pub. 519, U.S. Tax Guide for Aliens, for 
details. A foreign person should submit Form W-8BEN, 
Certificate of Foreign Status of Beneficial Owner for United 
States Tax Withholding and Reporting (Individuals), to the payer 
before receiving any payments. The Form W-8BEN must contain 
the foreign person’s taxpayer identification number (TIN).
Statement of Federal Income Tax Withheld 
From Your Pension or Annuity
By January 31 of next year, your payer will furnish a statement 
to you on Form 1099-R, Distributions From Pensions, Annuities, 
Retirement or Profit-Sharing Plans, IRAs, Insurance Contracts, 
etc., showing the total amount of your pension or annuity 
payments and the total federal income tax withheld during the 
year. If you’re a foreign person who has provided your payer 
with Form W-8BEN, your payer will instead furnish a statement 
to you on Form 1042-S, Foreign Person’s U.S. Source Income 
Subject to Withholding, by March 15 of next year.
Specific Instructions
Personal Allowances Worksheet
Complete this worksheet on page 4 first to determine the 
number of withholding allowances to claim.
Line C. Head of household please note: Generally, you can 
claim head of household filing status on your tax return only if 
you’re unmarried and pay more than 50% of the costs of 
keeping up a home for yourself and a qualifying individual. See 
Pub. 501 for more information about filing status.
Line D. Child tax credit. When you file your tax return, you may 
be eligible to claim a child tax credit for each of your eligible 
children. To qualify, the child must be under age 17 as of 
December 31, must be your dependent who generally lives with 
you for more than half the year, and must have the required SSN. 
To learn more about this credit, see Pub. 972, Child Tax Credit 
and Credit for Other Dependents. To reduce the tax withheld 
from your payments by taking this credit into account, follow the 
instructions on line D of the worksheet. On the worksheet, you 
will be asked about your total income. For this purpose, total 
income includes all of your pensions, wages, and other income, 
including income earned by a spouse if you’re filing a joint return.
Line E. Credit for other dependents. When you file your tax 
return, you may be eligible to claim a credit for other dependents 
for whom a child tax credit can’t be claimed, such as a qualifying 
child who does not meet the age or SSN requirement for the 
child tax credit, or a qualifying relative. To learn more about this 
credit, see Pub. 972. To reduce the tax withheld from your 
payments by taking this credit into account, follow the 
instructions on line E of the worksheet. On the worksheet, you 
will be asked about your total income. For this purpose, total 
income includes all of your pensions, wages, and other income, 
including income earned by a spouse if you’re filing a joint return.
Line F. Other credits. You may be able to reduce the tax 
withheld from your payments if you expect to claim other tax 
credits, such as tax credits for education (discussed in Pub. 
970). If you do so, your payments will be larger, but the amount 
of any refund that you receive when you file your tax return will 
be smaller. Follow the instructions for the worksheet for 
converting credits to allowances in Pub. 505 if you want to 
reduce your withholding by taking these credits into account. If 
you figure all your credits using that worksheet in Pub. 505, 
enter “-0-” on lines D and E.
Deductions, Adjustments, and Additional 
Income Worksheet
Complete this worksheet to determine if you’re able to reduce 
the tax withheld from your pension or annuity payments to 
account for your itemized deductions and other adjustments to 
income, such as deductible IRA contributions. If you do so, your 
refund at the end of the year will be smaller, but your payments 
will be larger. You’re not required to complete this worksheet or 
reduce your withholding if you don’t wish to do so.
You can also use this worksheet to figure out how much to 
increase the tax withheld from your payments if you have a large 
amount of other income not subject to withholding, such as 
interest, dividends, or capital gains.
Another option is to take these items into account and make 
your withholding more accurate by using the estimator at 
www.irs.gov/W4App. If you use the estimator, you don’t need to 
complete any of the worksheets for Form W‐4P.
Multiple Pensions/More‐Than‐One‐Income 
Worksheet
Complete this worksheet if you receive more than one pension, 
if you have a pension and a job, or if you’re married filing jointly 
and have a working spouse or a spouse who receives a 
pension. If you don’t complete this worksheet, you might have 
too little tax withheld. If so, you will generally owe tax when you 
file your tax return and may be subject to a penalty.


Form W-4P (2021)
Page 4
Use the Multiple Pensions/More-Than-One-Income 
Worksheet from only one Form W-4P to figure the number of 
allowances you’re entitled to claim and any additional amount of 
tax to withhold from all pensions. If you (and/or your spouse if 
filing jointly) have two or more pensions, withholding will 
generally be more accurate if only the Form W-4P for the 
highest paying pension (a) claims any allowances after lines A 
through B in the Personal Allowances Worksheet or any 
allowances in the Deductions, Adjustments, and Additional 
Income Worksheet; and (b) uses the Multiple Pensions/More-
Than-One-Income Worksheet. If you (and/or your spouse if filing 
jointly) have a pension and a job, withholding will generally be 
more accurate if the Form W-4P for the pension doesn’t claim 
any allowances after lines A through B in the Personal 
Allowances Worksheet or any allowances in the Deductions, 
Adjustments, and Additional Income Worksheet. However, you 
may need to use the Multiple Pensions/More-Than-One-Income 
Worksheet. If you (and/or your spouse if filing jointly) have more 
than one pension (or a pension and a job) and you need to 
complete a new Form W-4P or Form W-4 for a pension or a job, 
you (and/or your spouse) will generally get more accurate 
withholding by completing new Form(s) W-4P or Form(s) W-4 for 
all other pensions and jobs. See Pub. 505 for details.
Another option is to use the estimator at www.irs.gov/W4App 
to figure your withholding more precisely.
Personal Allowances Worksheet (Keep for your records.)
A Enter “2” for yourself .
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A
B Enter “1” if you will file as married filing jointly 
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C Enter “1” if you will file as head of household .
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C
D Child tax credit. See Pub. 972 for more information.
• If your total income will be less than $72,351 ($105,051 if married filing jointly), enter “4” for each eligible child.
• If your total income will be from $72,351 to $181,950 ($105,051 to $351,400 if married filing jointly), enter “2” for 
each eligible child.
• If your total income will be from $181,951 to $200,000 ($351,401 to $400,000 if married filing jointly), enter “1” for 
each eligible child.
• If your total income will be higher than $200,000 ($400,000 if married filing jointly), enter “-0-” .
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D
E Credit for other dependents. See Pub. 972 for more information.
• If your total income will be less than $72,351 ($105,051 if married filing jointly), enter “1” for each eligible 
dependent.
• If your total income will be from $72,351 to $181,950 ($105,051 to $351,400 if married filing jointly), enter “1” for 
every two dependents (for example, “-0-” for one dependent, “1” if you have two or three dependents, and “2” if 
you have four dependents).
• If your total income will be higher than $181,950 ($351,400 if married filing jointly), enter “-0-” .
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E
F 
 
 
Other credits. If you have other credits, see the worksheet for converting credits to allowances in Pub. 505 and 
enter the amount from that worksheet here. If you figure all your credits using that worksheet in Pub. 505, enter 
“-0-” on lines D and E 
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F
G Add lines A through F and enter the total here 
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G
For accuracy, 
complete all 
worksheets 
that apply. {
• If you plan to itemize or claim adjustments to income and want to reduce your withholding, or 
if you have a large amount of other income not subject to withholding and want to increase your 
withholding, see the Deductions, Adjustments, and Additional Income Worksheet on page 5.
• If you have more than one source of income subject to withholding or are married filing 
jointly and you and your spouse both have income subject to withholding and your 
combined income from all sources exceeds $13,000 ($25,000 if married filing jointly), see the 
Multiple Pensions/More-Than-One-Income Worksheet on page 5 to avoid having too little 
tax withheld, or use the estimator for more accuracy.
• If neither of the above situations applies, stop here and enter the number from line G on line 
2 of Form W-4P above.


Form W-4P (2021)
Page 5
Deductions, Adjustments, and Additional Income Worksheet
Note: Use this worksheet only if you plan to itemize deductions, claim certain adjustments to income, or have a large amount of 
other income not subject to withholding.
1 
 
 
Enter an estimate of your 2021 itemized deductions. These include qualifying home mortgage interest, 
charitable contributions, state and local taxes (up to $10,000), and medical expenses in excess of 7.5%
of your income. See Pub. 505 for details
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2 Enter: {
$25,100 if you’re married filing jointly or qualifying widow(er)
$18,800 if you’re head of household
$12,550 if you’re single or married filing separately
}  .
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2
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3 Subtract line 2 from line 1. If zero or less, enter “-0-” .
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3
$
4 
 
Enter an estimate of your 2021 adjustments to income, qualified business income deduction, and any
additional standard deduction for age or blindness. See Pub. 505 for information about these items 
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4
$
5 Add lines 3 and 4 and enter the total 
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5
$
6 
 
Enter an estimate of your 2021 other income not subject to withholding (such as dividends, interest, or 
capital gains)
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6
$
7 Subtract line 6 from line 5. If zero, enter “-0-”. If less than zero, enter the amount in parentheses 
.
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7
$
8 
 
Divide the amount on line 7 by $4,300 and enter the result here. If a negative amount, enter in
parentheses. Drop any fraction 
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8
9 Enter the number from the Personal Allowances Worksheet, line G, on page 4 .
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9
10 
 
 
Add lines 8 and 9 and enter the total here. If zero or less, enter “-0-”. If you plan to use the Multiple 
Pensions/More-Than-One-Income Worksheet, also enter this total on line 1 below. Otherwise, stop 
here and enter this total on Form W-4P, line 2, on page 1 
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10
Multiple Pensions/More-Than-One-Income Worksheet
Note: Use this worksheet only if the instructions under line G from the Personal Allowances Worksheet direct you here. This 
applies if you (and your spouse if married filing jointly) have more than one source of income subject to withholding (such as more 
than one pension, or a pension and a job, or you have a pension and your spouse works).
1 
 
Enter the number from the Personal Allowances Worksheet, line G, on page 4 (or from line 10 above if
you used the Deductions, Adjustments, and Additional Income Worksheet)
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2 
 
 
 
Find the number in Table 1 on page 6 that applies to the LOWEST paying pension or job and enter it 
here. However, if you’re married filing jointly and the amount from the highest paying pension or job is 
$75,000 or less and the combined amounts for you and your spouse are $107,000 or less, do not enter 
more than “7” .
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3 
 
If line 1 is more than or equal to line 2, subtract line 2 from line 1. Enter the result here (if zero, enter 
“-0-”) and on Form W-4P, line 2, on page 1. Do not use the rest of this worksheet 
.
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3
Note: If line 1 is less than line 2, enter “-0-” on Form W-4P, line 2, on page 1. Complete lines 4 through 9
below to figure the additional withholding amount necessary to avoid a year-end tax bill.
4 Enter the number from line 2 of this worksheet .
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4
5 Enter the number from line 1 of this worksheet .
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5
6 Subtract line 5 from line 4 .
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6
7
Find the amount in Table 2 on page 6 that applies to the HIGHEST paying pension or job and enter it here
7
$
8 Multiply line 7 by line 6 and enter the result here. This is the additional annual withholding needed .
.
8
$
9 
 
 
Divide line 8 by the number of payments remaining in 2021. For example, divide by 8 if you’re paid 
every month and you complete this form in April 2021. Enter the result here and on Form W-4P, line 3, 
on page 1. This is the additional amount to be withheld from each payment 
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9
$


Form W-4P (2021)
Page 6
Table 1
Married Filing Jointly
If wages from LOWEST paying 
job or pension are—
Enter on line 2 above
 $0  -       $799
0
800  -      5,100
1
5,101  -      9,400
2
9,401  -    13,700
3
13,701  -    18,000
4
18,001  -    22,300
5
22,301  -    26,600
6
26,601  -    35,000
7
35,001  -    40,000
8
40,001  -    46,000
9
46,001  -    55,000
10
55,001  -    60,000
11
60,001  -    70,000
12
70,001  -    75,000
13
75,001  -    85,000
14
85,001  -    95,000
15
95,001  -  125,000
16
125,001  -  155,000
17
155,001  -  165,000
18
165,001  -  175,000
19
175,001  -  180,000
20
180,001  -  195,000
21
195,001  -  205,000
22
205,001 and over 
23
All Others
If wages from LOWEST paying 
job or pension are—
Enter on line 2 above
$0  -       $799
0
800  -      5,100
1
5,101  -      9,400
2
9,401  -    13,700
3
13,701  -    22,000
4
22,001  -    27,500
5
27,501  -    32,000
6
32,001  -    40,000
7
40,001  -    60,000
8
60,001  -    75,000
9
75,001  -    85,000
10
85,001  -    95,000
11
95,001  -  100,000
12
100,001  -  110,000
13
110,001  -  115,000
14
115,001  -  125,000
15
125,001  -  135,000
16
135,001  -  145,000
17
145,001  -  160,000
18
160,001  -  180,000
19
180,001 and over
20
Table 2
Married Filing Jointly
If wages from HIGHEST paying 
job or pension are—
Enter on line 7 above
 $0  -  $25,350
        $430
25,351  -    85,850
520
85,851  -  176,650
950
176,651  -  332,200
1,030
332,201  -  420,300
1,380
420,301  -  627,650
1,510
627,651 and over
1,590
All Others
If wages from HIGHEST paying 
job or pension are—
Enter on line 7 above
$0  -    $7,375
$430
7,376  -    37,625
520
37,626  -    83,025
950
83,026  -  160,800
1,030
160,801  -  204,850
1,380
204,851  -  515,900
1,510
515,901 and over
1,590
Privacy Act and Paperwork Reduction Act 
Notice
We ask for the information on this form to carry out the Internal 
Revenue laws of the United States. You are required to provide 
this information only if you want to (a) request federal income 
tax withholding from periodic pension or annuity payments 
based on your withholding allowances and marital status;        
(b) request additional federal income tax withholding from your 
pension or annuity; (c) choose not to have federal income tax 
withheld, when permitted; or (d) change or revoke a previous 
Form W-4P. To do any of the aforementioned, you are required 
by sections 3405(e) and 6109 and their regulations to provide 
the information requested on this form. Failure to provide this 
information may result in inaccurate withholding on your 
payment(s). Providing false or fraudulent information may 
subject you to penalties.
Routine uses of this information include giving it to the 
Department of Justice for civil and criminal litigation, and to 
cities, states, the District of Columbia, and U.S. commonwealths
and possessions for use in administering their tax laws. We may 
also disclose this information to other countries under a tax 
treaty, to federal and state agencies to enforce federal nontax 
criminal laws, or to federal law enforcement and intelligence 
agencies to combat terrorism.
You are not required to provide the information requested on 
a form that is subject to the Paperwork Reduction Act unless the 
form displays a valid OMB control number. Books or records 
relating to a form or its instructions must be retained as long as 
their contents may become material in the administration of any 
Internal Revenue law. Generally, tax returns and return 
information are confidential, as required by section 6103.
The average time and expenses required to complete and file 
this form will vary depending on individual circumstances. For 
estimated averages, see the instructions for your income tax 
return.
If you have suggestions for making this form simpler, we 
would be happy to hear from you. See the instructions for your 
income tax return.




--- Document: Direct Deposit ---
WORKPLACE BANKING
Authorization Agreement For ACH
Service
CLIENT #
Name & Employee #
12580
Social Security Number
Company Name
TOWN OF HAMMONTON
Company Address
I hereby authorize my employer
herein after called "COMPANY", to initiate credit entries and to initiate, if necessary,
debit entries and adjustments for any credit error to my account(s) indicated below and
the depository institution named below, hereinafter called "DEPOSITORY", to credit
and/or debit the same such account:
Primary Account
Depository Name (Bank)
Transit/ABA Number (9 Digits)
Account Type
Checking
Account Number
Amount to deposit
Savings
Net Pay
$
(fixed amount)
If my company allows direct deposit to more than one account, I elect to have part of my
pay put into the following account:
Optional Secondary Account
Depository Name (Bank)
Transit/ABA Number (9 Digits)
Account Type
Checking
Account Number
Amount to deposit
Savings
Net Pay
$
(fixed amount)
This authority is to remain in full force and effect until COMPANY has received written
notification from me of its termination in such time and in such manner as to afford
COMPANY and DEPOSITORY a reasonable opportunity to act on it.
Date
Signature