State Specific Tax Withholding Certificates Guide

Some states require the use of their state specific form(s). Below is a listing of the required state specific forms Pacific Life is aware of as of June 2024, which may change over time. Please consult with your tax advisor whether or not such a form is required based on your specific situation.  Additional information can generally be found on your state’s tax website. In situations where a state specific form is required, the form must be included with the applicable distribution form, or we may be required to withhold a default amount.

State State Form Required Additional Details
Arizona A-4P Applies for periodic payments only.
Connecticut CT W4P Applies for periodic payments only.
Minnesota W-4MNP Applies for both periodic and non-periodic payments.
Nebraska W-4N Applies for periodic payments only.
Oklahoma OK W-4P and OK W-4R Applies for both periodic and non-periodic payments.
Virginia VA-4P Applies for periodic payments only.

The above guide is provided as a tool to help understand states that require state specific withholding forms. Pacific Life uses best efforts to gather information on these forms, however as these are managed by the individual states and changes may occur without Pacific Life’s knowledge, we cannot guarantee the accuracy, or timeliness of updates to the above chart. Any withholding elections for repetitive payments will continue unless Pacific Life receives a valid updated withholding request reflecting different elections. The state of residency is determined by the address on record for the contract, which may or may not be the individual’s state of residency for tax purposes. Please contact a tax professional regarding withholding elections for a particular state to answer any questions regarding their withholding laws.