SC Public Employee Benefit Authority

202 Arbor Lake Drive, Columbia, SC 29223

Withholding Certificate for Monthly Benefit Payments

(for South Carolina tax withholdings only)

Check appropriate box: 

Check appropriate system:

Member SSN:

Federal Income Tax Withholding

Please go to www.irs.gov/W4P to complete the IRS Form W4-P to have federal income tax withheld from your monthly benefit.

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South Carolina State Income Tax Withholding

Complete the following applicable lines:

Check box if you do not want any South Carolina state income tax withheld from your monthly annuity payment.

(Do not complete lines 2 or 3.)

Total number of allowances you are claiming for withholding from each monthly annuity payment. 

(You may also designate an additional dollar amount on line 3.)

Additional amount, if any, you want withheld from each monthly annuity payment.

Note: For monthly annuity payments, you cannot enter an amount here without entering the number (including zero) of allowances on line 2. This amount will be withheld in addition to the amount calculated using the marital status and allowances from line 2 above.

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THE LANGUAGE USED IN THIS DOCUMENT DOES NOT CREATE ANY CONTRACTUAL RIGHTS OR ENTITLEMENTS AND DOES NOT CREATE A CONTRACT BETWEEN THE MEMBER AND THE SOUTH CAROLINA PUBLIC EMPLOYEE BENEFIT AUTHORITY.  THE SOUTH CAROLINA PUBLIC EMPLOYEE BENEFIT AUTHORITY RESERVES THE RIGHT TO REVISE THE CONTENT OF THIS DOCUMENT. 

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Payee's Signature

Date

(OR mark with 'X' with two witnesses OR Power of Attorney, if on file with PEBA.)

This form must be signed and dated.

Form 7202

Revised 11/22/2022

Income tax withholding applies to the taxable part of your monthly annuity payment and taxes are withheld according to your instructions. However, if you make no election, federal regulations require that we withhold based on a status of single

with zero exemptions. If you elect to have no federal or South Carolina state income tax withheld, you may be liable for payment of the respective taxes on the taxable portion of your monthly annuity payment. In addition, a tax penalty may be imposed if the total of withheld and estimated payments does not meet the IRS or South Carolina Department of Revenue requirements. Please note: (South Carolina National Guard retirement income is exempt from South Carolina state income tax.)

Your tax withholding will remain in effect until you change or revoke it. By January 31st of each year, you will be provided a statement on form 1099-R showing the amount of your monthly annuity payments and total taxes withheld during the year.

The tax laws are complex and always changing. You should consult your personal tax advisor with regard to the application of federal and state taxes on benefits received from PEBA.

SC Public Employee Benefit Authority

Attn:  Benefit Payments Department

202 Arbor Lake Drive

Columbia, SC 29223

Return completed form to:

Responsibility for Prepayment of Tax

Please contact PEBA's Customer Contact Center with any questions at 803.737.6800 or 888.260.9430, or www.peba.sc.gov.