Arizona Employer's Election to Not Withhold Arizona Taxes in December

Employer's Election to Not Withhold Arizona Taxes in December
Arizona Form A1-E
Arizona Form

A1-E

Employer’s Election to
Not Withhold Arizona Taxes in December

	Name		

2024

Employer Identification Number

	Address – number and street or rural route
	City or Town	

State	

ZIP Code

Number of Arizona employees:

	 Election is hereby made to not withhold Arizona taxes from compensation paid to employees during the month

of December 2024, and certification is made that all employees have been notified of this and given the option of
completing a new Arizona Form A-4 to change the withholding election for the rest of the year.

I certify that I am authorized to make and have made the election marked above.
	

	 	

	 

SIGNATURE		 PHONE NUMBER (with area code)		 DATE

General Instructions
Purpose of Form A1-E

Deadline

Form A1-E is to be used by Arizona employers
to elect to not withhold Arizona taxes from compensation
paid to employees during December. If you make this
election, it applies to all employees.

Form A1-E must be filed and all employees notified by
July 1, 2024.
Where to Mail Form A1-E
Mail Form A1-E to:

Action Required
•	Notify all your employees in writing, informing them of
your election to not withhold Arizona taxes from their
December 2024 wages and informing them that they
can, if they wish, complete Arizona Form A-4 to adjust
their Arizona withholding election to compensate for the
change in their annual withholding amount.

OFFICE OF ECONOMIC RESEARCH AND ANALYSIS
ARIZONA DEPARTMENT OF REVENUE
PO BOX 29099
PHOENIX, AZ 85038-9099

Duration of this Election

•	Complete Form A1-E and mail it by July 1, 2024. You
only need to submit one Form A1-E for all employees.

ADOR 10682 (23)

This election is valid for December 2024 only.

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