Ftb 4107-2026

1. Click ‘Get Form’ to open the ftb 4107 in the editor.
2. Begin by filling out the Personal Information section. Include your name, SSN or ITIN, and address. If filing jointly, ensure you also provide your spouse's or registered domestic partner's details.
3. In the Mandatory e-Pay Requirement—Waiver Request Reason section, select the option that applies to your situation. Provide any necessary explanations as required.
4. If requesting a permanent waiver due to a physical or mental impairment, attach the completed Physician Affidavit of Permanent Physical or Mental Impairment form.
5. Sign and date the Signature Authorization section. If filing jointly, both parties must sign.
6. Follow the mailing instructions provided at the end of the form to submit your completed request.

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