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Official form guide
Form W4S: Request for Federal Income Tax Withholding From Sick Pay
IRS Form W-4S is a request for federal income tax withholding from sick pay. Taxpayers give it to the third‑party payer of their sick pay and must sign it for validity; the per‑payment amount must be rounded to the nearest dollar.
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IRS Form W4S - Request for Federal Income Tax Withholding From Sick Pay
IRS Form W-4S is a request for federal income tax withholding from sick pay. Taxpayers give it to the third‑party payer of their sick pay and must sign it for validity; the per‑payment amount must be rounded to the nearest dollar.
Risk Radar
Scan points- 1Submitting the form unsigned makes it invalid.
- 2Leaving the signature line blank, which renders Form W‑4S invalid.
- 3Failing to round the per‑payment withholding amount to the nearest dollar as required.
- 4Omitting your Social Security number, preventing the payer from reporting the tax.
- 5Not entering the number of expected sick‑pay payments on line 9, causing an incorrect per‑payment amount.
Plain English
This form tells the company that pays your sick leave how much tax to take out of each check. You estimate the amount using the worksheet, write the rounded per‑payment figure, sign, and give the top part to the payer.
Submission Date
- Filing date: 2025-12-19 16:10:52
- Preparation window: collect IDs, supporting records, and signatures in advance.
- Final review: verify names, dates, and required fields before submission.
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Glossary Terms
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What this form is for
- Use this form when you want federal income tax withheld from sick pay paid by a third‑party payer.
- Do not use it when your employer (or its agent) makes the sick‑pay payments.
Form selector
Use this form or another form?
Third‑party payer of sick pay
Allows you to request withholding from a non‑employer payer
✓ Verify payer is a third‑party before proceeding
Employer pays sick pay directly
Employer already withholds tax, so this form is unnecessary
✓ Confirm employer is the payer
Tax liability already covered by estimated payments
May not need to request additional withholding
✓ Check total estimated tax versus liability
Deadline or filing window
Not stated in the official source.
Checklist
What you need before filling it out
First name and middle initial
Personal identification · Form top section
Social security number
Personal identification · Form top section
Amount to be withheld per payment
Desired withholding amount · Worksheet calculation
Number of sick pay payments expected
Estimate of payments · Worksheet line 9
Employee’s signature
Signature · Form bottom line
Before you submit
- 1Confirm the form is the 2026 edition
- 2Enter your first name, middle initial, and last name accurately
- 3Provide a correct Social Security Number
- 4Enter a complete home address
- 5Calculate the withholding amount using the worksheet
- 6Round the per‑payment amount to the nearest whole dollar
- 7Ensure the amount meets the minimum $4 per day, $20 per week, or $88 per month rule
- 8Sign and date the form
- 9Give the top part to the third‑party payer
- 10Keep the bottom part for your records
How to file this form
- 1Print the current 2026 Form W-4S
- 2Complete personal identification fields and calculate withholding amount
- 3Sign and date the form
- 4Separate the top portion and deliver it to the third‑party payer
- 5Retain the bottom portion for your records
- 6File a copy with your personal tax file as proof of filing
Known limitations
- 1Does not apply when the employer or its agent makes the sick‑pay payments
- 2Not for sick pay received under a collective bargaining agreement without employer involvement
- 3Not needed if your total tax is already covered by estimated payments or other withholding
Field map
Compact field-by-field guide
Personal Info
2 items
Your legal name and current mailing address.
Your taxpayer identification number — must match IRS records.
Filing Status
1 items
Single, Married Filing Jointly, or Head of Household (for withholding purposes).
Dependents
1 items
Number of qualifying children and other dependents.
Adjustments
1 items
Additional income not from jobs or adjustments to withholding.
Withholding
1 items
Additional amount you want withheld from each paycheck.
Certification
1 items
Your tax entity type: Individual, Corporation, Partnership, etc.
Signatures
1 items
Sign and date to certify under penalty of perjury.
Almost done reviewing the fields?
Fillable formOpen in Editor->The form is the 2026 edition (Form W‑4S 20 26) and the PDF directs users to www.irs.gov/FormW4S for the latest information.
What changed or needs a fresh check
- Edition date — confirm the form shows 2026 (Form W-4S 20 26)
- Fee — Not stated in the official source
- Mailing address — Not stated in the official source
- Signature — confirm employee’s signature is present on the form
Quick Facts
Downloads
After you file
- 1Store the retained copy with your tax records for at least three years
- 2Monitor subsequent pay statements to confirm the correct amount is being withheld
- 3If the withholding amount changes, submit a new Form W-4S to the payer
- 4Adjust estimated tax payments if the withheld amount is insufficient
Sources
- SRCForm p.1 — revision indicated as 20 26 (2026 edition)
- SRCForm p.1 — directs to www.irs.gov/FormW4S for latest information
- SRCForm p.1 — instruction to give form to third‑party payer of sick pay
- SRCForm p.1 — do not use if employer makes payments
- SRCForm p.1 — amount must be whole dollars and meet minimum $4/day, $20/week, $88/month
- SRCForm p.1 — amount must not reduce net payment below $10
- SRCForm p.1 — employee’s signature required
- SRCForm p.2 — note about not needing form if total tax already covered by estimated payments
- SRCForm p.2 — caution to use new Form W-4S if worksheet amounts change
- SRCForm p.2 — created date 12/18/25
Common confusion points
Confusion: How much can I request per payment?
Why it happens: Minimum and net‑pay limits are listed on the form
→ Safe check: Verify the amount is at least $4 per day, $20 per week, or $88 per month and leaves at least $10 net pay
Confusion: Do I need to round the amount?
Why it happens: The form specifies rounding to the nearest dollar
→ Safe check: Round the calculated per‑payment amount to the nearest whole dollar
Confusion: Can I use this form if my employer withholds?
Why it happens: Employers are already required to withhold
→ Safe check: Confirm the payer is a third‑party, not the employer
Confusion: What if my estimated tax changes after filing?
Why it happens: Worksheet amounts may differ later
→ Safe check: Submit a new Form W-4S for any change
Confusion: Is a signature required?
Why it happens: The form includes a signature line
→ Safe check: Ensure the employee’s signature and date are present
Confusion: Do I need a claim or identification number?
Why it happens: The field is optional on the form
→ Safe check: Leave blank if you have none, otherwise enter the number
Workflow map
Related forms and next steps
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Questions about IRS Form W4S
What is IRS Form W4S used for?
This form tells the company that pays your sick leave how much tax to take out of each check. You estimate the amount using the worksheet, write the rounded per‑payment figure, sign, and give the top part to the payer.
Who must file IRS Form W4S?
Any individual who receives sick pay from a third‑party payer and wants federal income tax withheld files IRS Form W‑4S.
What information does IRS Form W4S require?
The form collects your name, Social Security number, address, claim or identification number, and the amount to withhold per payment (calculated on worksheet lines 1‑10).
Where do I file IRS Form W4S?
Give the completed top part of IRS Form W‑4S to the third‑party payer of your sick pay; the form is not sent to the IRS.
How do I complete IRS Form W4S?
Enter your personal information, complete the worksheet to compute line 10, write that amount on the form, sign and date it, then separate the top part and give it to the payer while keeping the bottom part for your records. The form remains in effect until you submit a new Form W‑4S or a written notice to change or revoke it.
What happens if IRS Form W4S is filed incorrectly?
If insufficient tax is withheld you may face a penalty, and the form is invalid without your signature.
Confusion: How much can I request per payment?
Why it happens: Minimum and net‑pay limits are listed on the form Safe check: Verify the amount is at least $4 per day, $20 per week, or $88 per month and leaves at least $10 net pay
Confusion: Do I need to round the amount?
Why it happens: The form specifies rounding to the nearest dollar Safe check: Round the calculated per‑payment amount to the nearest whole dollar
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