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T AUTHORITY: E.O. 9397 and Department of Defense Financial Management Regulation (DoDFMR) 7000.14-R, Volume 7B, Chapter 26. PRINCIPAL PURPOSE(S): To appropriately withhold the State income tax from the member's military retired pay as requested by the member. ROUTINE USE(S): The information on this form may be disclosed as generally permitted under 5 U.S.C. Section 552(a)(b) of the Privacy Act of 1974, as amended. It may also be disclosed outside of the Department of Defense to the Internal Reve.

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