Form 8804 - Annual Return For Partnership Withholding Tax (Section 1446)
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28804
Annual Return for Partnership Withholding Tax (Section 1446)
OMB No. 1545-1119
Form
Attach Form(s) 8804-C and 8805.
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2012
Information about Form 8804 and its instructions is at
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Department of the Treasury
For calendar year 2012 or tax year beginning
, 2012, and ending
, 20
Internal Revenue Service
Check this box if the partnership keeps its records and books of account outside the United States and Puerto Rico .
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Part I
Partnership
1a Name of partnership
b U.S. employer identification number
c Number, street, and room or suite no. If a P.O. box, see instructions.
For IRS Use Only
CC
FD
RD
FF
d City, state, and ZIP code. If a foreign address, see instructions.
CAF
FP
CR
I
EDC
Part II
Withholding Agent
2a Name of withholding agent. If partnership is also the withholding agent, enter “SAME” and do not
b Withholding agent's U.S.
complete lines 2b, 2c, or 2d.
employer identification number
c Number, street, and room or suite no. If a P.O. box, see instructions.
d City, state, and ZIP code
Part III
Section 1446 Tax Liability and Payments
3a Enter number of foreign partners .
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b Enter number of Forms 8805 attached to this Form 8804 .
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c Enter number of Forms 8804-C attached to Forms 8805
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4
Total effectively connected taxable income allocable to foreign partners (see instructions):
a Net ordinary income and net short-term capital gain .
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4a
b Reduction to line 4a for state and local taxes under Regulations
section 1.1446-6(c)(1)(iii) .
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4b (
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c Reduction to line 4a for certified foreign partner-level items
submitted using Form 8804-C .
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4c (
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d Combine lines 4a, 4b, and 4c
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4d
e 28% rate gain allocable to non-corporate partners
4e
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f
Reduction to line 4e for state and local taxes under Regulations
section 1.1446-6(c)(1)(iii) .
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4f (
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g Reduction to line 4e for certified foreign partner-level items
submitted using Form 8804-C .
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4g (
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h Combine lines 4e, 4f, and 4g
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4h
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Unrecaptured section 1250 gain allocable to non-corporate
partners
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4i
j
Reduction to line 4i for state and local taxes under Regulations
section 1.1446-6(c)(1)(iii) .
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(
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4j
k Reduction to line 4i for certified foreign partner-level items
submitted using Form 8804-C .
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4k (
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Combine lines 4i, 4j, and 4k .
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4l
m Qualified dividend income and net long-term capital gain (including
net section 1231 gain) allocable to non-corporate partners
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4m
n Reduction to line 4m for state and local taxes under Regulations
section 1.1446-6(c)(1)(iii) .
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4n (
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o Reduction to line 4m for certified foreign partner-level items
submitted using Form 8804-C .
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4o (
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4p
p Combine lines 4m, 4n, and 4o .
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8804
For Paperwork Reduction Act Notice, see separate instructions for Forms 8804, 8805, and 8813.
Cat. No. 10077T
Form
(2012)
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