Form W-4S 2026: Withholding From Sick Pay

What is Form W-4S?

Form W-4S, Request for Federal Income Tax Withholding From Sick Pay, is how you ask a third party that pays you sick pay, such as an insurance company paying short-term disability benefits, to withhold federal income tax from each payment. Third-party payers aren't required to withhold unless you ask. You don't use this form when your employer (or its agent) pays the sick pay, because employers already withhold from it.

The 2026 edition (created 12/18/25) has a short top part that you sign and give to the payer, and a 10-line worksheet underneath that you keep for your records. The worksheet estimates your 2026 tax using the 2026 standard deductions and Tax Rate Tables printed on page 2, then divides what's still owed by the number of sick pay payments you expect.

FileIt walks you through both parts, works out the worksheet lines (including line 4 from the 2026 tax tables for your filing status), prints your answers into the IRS's official PDF and saves it in your vault. You can sign it electronically or print and sign it, then give it to the payer yourself. FileIt never sends anything to the payer or the IRS.

Who fills it: Anyone who receives sick pay from a third party (not the employer) and wants federal income tax withheld.
Given to: The third-party payer of your sick pay, such as an insurance company. Not sent to the IRS.
Minimum amount: Whole dollars, at least $4 per day, $20 per week or $88 per month, leaving at least $10 net per payment.
Signatures: You sign and date it. The form isn't valid unless signed.
Edition: 2026 (Created 12/18/25)
Agency: Internal Revenue Service (IRS), Department of the Treasury

Who needs to fill out Form W-4S?

People receiving short-term disability or other sick pay from an insurance company or other third party, who want tax taken out of each payment.
Anyone who would otherwise owe tax (and possibly an underpayment penalty) at filing time because nothing is withheld from their sick pay.
People who already filed a Form W-4S and want to change the amount, or revoke it.

When to use Form W-4S

When a third-party sick pay claim starts and you want withholding from the first payments.
When your income, deductions or credits change during the year, so the amount withheld no longer fits. The form says to give the payer a new W-4S.
When you want withholding to stop: complete a new W-4S, write "Revoked" in the amount box, sign it and give it to the payer.

What you need before you start

Your name, Social Security number and home address.
The claim or identification number the payer gave you, if any.
For the worksheet: your estimated 2026 adjusted gross income, deductions (itemized or the standard deduction), credits, and tax already withheld or paid in estimated tax payments.
The number of sick pay payments you expect this year that the form will apply to.
Last year's tax return is a useful starting point, as the instructions suggest.

What’s on Form W-4S

The 2026 edition has 2 pages. FileIt asks for it in 3 parts, and it is signed by Employee:

YouEmployee
Your requestEmployee
Worksheet (for your records)Employee

How to fill out Form W-4S, step by step

1 Your details

Enter your first name and middle initial, last name, Social Security number and home address. Add the claim or identification number if the payer gave you one, so it can match the form to your claim.

2 The amount to withhold

Enter the amount you want withheld from each sick pay payment. It must be in whole dollars (for example $35, not $34.50), at least $4 per day, $20 per week or $88 per month based on your payroll period, and it must not reduce the net amount of each payment to less than $10. For a partial payment, the payer withholds the same proportion as from a regular full payment.

To revoke an earlier W-4S instead, choose that option: FileIt prints "Revoked" in the amount box, as the form instructs.

3 Worksheet lines 1 to 3: taxable income

Estimate your 2026 adjusted gross income on line 1 and your deductions on line 2. For 2026 the standard deduction printed on the form is $32,200 for married couples filing jointly and surviving spouses, $24,150 for heads of household, and $16,100 for unmarried individuals and married individuals filing separately (different amounts apply to dependents and to people who are 65 or older or blind). Line 3 is line 1 minus line 2.

4 Worksheet lines 4 to 6: tax and credits

Line 4 is the tax on line 3 from the 2026 Tax Rate Tables on page 2. FileIt looks it up for the filing status you choose. Enter credits on line 5, such as the child tax credit, education credits or the child and dependent care credit; line 6 is line 4 minus line 5.

5 Worksheet lines 7 to 10: amount per payment

Line 7 is federal income tax withheld from other income (wages, pensions, an earlier W-4S) plus 2026 estimated tax payments. Line 8 is what's left. Enter the number of sick pay payments on line 9, and line 10 divides line 8 by line 9, rounded to the nearest dollar. If that meets the minimum rules, use it as your amount.

6 Sign and give it to the payer

Sign and date the top part; the form is not valid unless you sign it. Give the top part to the payer and keep the worksheet for your records.

Common mistakes to avoid

Giving Form W-4S to your employer for sick pay it pays itself. Employers already withhold from sick pay they pay; use Form W-4 for your wages.
Entering dollars and cents. The amount must be in whole dollars.
Asking for less than the minimum ($4 per day, $20 per week or $88 per month), or so much that less than $10 of a payment is left.
Forgetting to sign. The form says it is not valid unless you sign it.
Sending it to the IRS. It goes to the payer; the worksheet stays with you.
Leaving out your spouse's income and payments on the worksheet when you'll file a joint return.

After you fill it out

Sign and date the form (electronically in FileIt, or in ink on the printout) and give the top part to the payer of your sick pay. Keep the worksheet with your records.

The request stays in effect until you change or revoke it, with a new Form W-4S or a written notice to the payer.

After the year ends, you'll get a Form W-2 showing the taxable sick pay paid and the federal income tax withheld. If withholding won't cover your tax, consider estimated tax payments on Form 1040-ES, as the form suggests.

Fill out Form W-4S online with FileIt

Pick the person. Choose someone from People and FileIt fills in their name, date of birth, address and other details it already knows.
Answer plain-language questions. One part of the form at a time, with the official help text beside each question — 22 fields in all. Your answers save as you go.
Check the live preview. Watch your answers land on the real Internal Revenue Service (IRS) form, and let FileIt do any worksheet arithmetic.
Generate the official PDF. FileIt prints your answers into the agency’s own PDF and files it in that person’s folder in your vault. Sign it, or send it for e-signature.

FileIt fills the form — it never files or submits anything for you. Deliver the finished form to whoever asked for it, the way the form’s instructions say.

Start Form W-4S now — it’s free

Form W-4S: frequently asked questions

Who do I give Form W-4S to?

To the third-party payer of your sick pay, such as an insurance company. It isn't filed with the IRS.

Is withholding from sick pay required?

Not when a third party pays it. The form says you aren't required to have federal income tax withheld from third-party sick pay, but if you choose to, you use Form W-4S.

What is the minimum amount I can have withheld?

The amount must be in whole dollars and at least $4 per day, $20 per week or $88 per month, based on your payroll period, and it can't reduce the net amount of each payment below $10.

How do I stop withholding from sick pay?

Complete a new Form W-4S, write "Revoked" in the money amount box, sign it and give it to the payer. You can also change the amount with a new form or a written notice.

Do I have to fill in the worksheet?

No. It's there to help you estimate the amount, and you keep it for your records. FileIt works out its lines if you choose to use it.

Can I sign Form W-4S electronically?

FileIt can prepare the form for e-signature. Check that your payer accepts an electronically signed form; otherwise print it and sign in ink.

What's the difference between Form W-4S and Form W-4?

Form W-4 sets withholding from wages your employer pays. Form W-4S asks a third-party payer of sick pay to withhold. Pensions and annuities use Form W-4P, and certain government payments use Form W-4V.

Official sources

Blank form (PDF), published by Internal Revenue Service (IRS): https://www.irs.gov/pub/irs-pdf/fw4s.pdf
Official instructions and guidance: https://www.irs.gov/forms-pubs/about-form-w-4-s
Edition shown on this page: 2026 (Created 12/18/25) (checked 2026-10-01).

FileIt is not affiliated with or endorsed by Internal Revenue Service (IRS) or any government. This page explains the form in general terms and is not legal, tax or immigration advice. Always read the official instructions, and check that you are using the edition the recipient accepts. Page last reviewed 2026-10-01.