Tax Deduction Form 2008
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1TAX DEDUCTION FORM
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PLEASE PRINT CLEARLY
NAME
SOCIAL SECURITY
P. O. Box 2123
Santa Fe, NM 87504-2123
(505) 827-4670 fax
ADDRESS ____________________________________________________
(505) 827-4700 or 1-800-342-3422 voice
TELEPHONE___________________________________________________
Instructions: Please print or type in
black. The original of this form must be completed in its entirety and returned to PERA for processing.
Required Fields are in Bold ITALICS
CHECK ONLY THE APPLICABLE BOXES
Do not deduct federal withholding tax from my benefits.
Do not deduct New Mexico state withholding tax from my benefits. (If you are living out-of-state, please check this
box. PERA cannot withhold other State’s income taxes.)
I realize that I am liable for payment of federal and state income tax on the taxable portion of my pension and that I may
be subject to tax penalties under the estimated tax payment rules if my payments of estimated tax withholdings are not
adequate.
The following exemptions are being claimed, and I want PERA to determine the amount, if any, of federal/New
Mexico state income tax to be withheld in accordance with the tax tables and exemptions claimed below
Exemptions claimed:
1 for yourself
Married
1 if you are 65 or older
Single
1 if you are blind
1 for your spouse
1 if your spouse is 65 or older
1 if your spouse is blind
other
Total exemptions claimed
In addition to the withholding on my exemptions, I want the following additional amount withheld from each monthly
payment
Federal $
New Mexico State $
Instead of withholding based on exemption, I want the following amount withheld from each monthly payment.
Federal $
New Mexico State $
AUTHORIZATION
I submit this Tax Deduction Form specifying what deductions I authorize to be made from my retirement benefit for
federal and New Mexico state income tax purposes.
SIGNED
DATE
January 2008
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