Updated with new Form W-4R, Withholding Certificate for Nonperiodic Payments and Eligible Rollover Distributions 

This form helps you comply with the IRS requirement that a “federal income tax withholding notice” be sent to all Traditional IRA holders who are receiving systematic distributions. It also reminds accountholders of their current elections on file at your organization. A withholding notice is printed on the reverse side. The address portion is located so the form can be mailed to accountholders in a standard #10 window envelope.