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on line 66. Failure to do so will result in the

Reimbursement procedure. Under

The tax assumed from Forms 1000.

denial of the refund or credit being

the reimbursement procedure, you repay

If it does not, attach a statement to

claimed. If you are a PTP or a nominee

the beneficial owner or payee the amount

Form 1042 explaining the difference.

withholding under section 1446, the tax

overwithheld. You use your own funds for

Line 63a. The amount on line 63a must

paid for a payee may only be claimed as a

this repayment. You must make the

equal the sum of the monthly totals as

credit by the payee.

repayment by March 15 of the year after

listed on the Record of Federal Tax

the calendar year in which the amount was

Liability. Do not make any adjustments on

QSL claiming a credit forward. If you

overwithheld. For example, if you

this line. Except for adjustments described

are a QSL or other withholding agent

overwithhold tax in 2012, you must repay

in the instructions for line 63b, you may

claiming a credit forward of prior

the beneficial owner by March 15, 2013.

only make adjustments on the appropriate

withholding on substitute dividends as

You must keep a receipt showing the date

entry line of the Record of Federal Tax

determined under Notice 2010-46, you

and amount of the repayment and provide

Liability.

should attach Form(s) 1042-S issued to

a copy of the receipt to the beneficial

you to support such credits. If a credit is

owner.

Line 63b. Include on line 63b any tax

claimed with respect to any U.S. source

liability resulting from adjustments of

You may reimburse yourself by

substitute dividends paid to you from a

reducing any subsequent deposits you

underwithheld tax on corporate

withholding agent that has not issued a

make before the end of the year after the

distributions made in calendar year 2012

Form 1042-S to you for such payments,

if:

calendar year in which the amount was

attach a supporting statement to Form

overwithheld. The reduction cannot be

The distributing corporation made a

1042 indicating the following:

more than the amount you actually repaid.

reasonable estimate of accumulated and

The withholding agent's name, address,

current earnings and profits under

Report the reduced tax liability on lines

and EIN (if known);

Regulations section 1.1441-3(c)(2)(ii)(A),

1 through 60 for the period for which you

The amount of U.S. source substitute

and

reimbursed the overwithheld tax. Report

dividends received from the withholding

The distributing corporation or

the total tax withheld as your total

agent; and

intermediary paid over the underwithheld

deposits. Indicate on line 70 whether you

The amount of credit forward you

tax by March 15, 2013.

want a refund or a credit.

included on line 66 in connection with

If you are a regulated investment

Set-off procedure. Under the set-off

these substitute dividends.

company (RIC), real estate investment

procedure, you repay the beneficial owner

trust (REIT), or personal holding company

Line 69. You may claim an overpayment

or payee the amount overwithheld by

(PHC) that paid a dividend subject to

shown on line 69 as a refund or a credit.

reducing the amount you would have been

section 852(b)(7), section 857(b)(9), or

Check the applicable box on line 70 to

required to withhold on later payments you

section 563(b) (relating to certain

show which you are claiming. If you claim

make to that person. These later

dividends declared in the preceding

a credit, it can reduce your required

payments must be made before the earlier

October, November, or December), enter

deposits of withheld tax for 2013.

of:

your additional tax liability on those

The date you actually file Form 1042-S

Line 71. Enter on line 71 the total amount

dividends declared in 2012 but paid no

for the calendar year in which the amount

of specified federal procurement

later than March 15, 2013, less any

was overwithheld, or

payments multiplied by 2% (.02).

additional tax liability on those dividends

March 15 of the year after the calendar

declared in 2011 but paid no later than

Adjustment For

year in which the amount was

March 15, 2012. Show any negative

overwithheld.

Overwithholding

amount in brackets. Attach a statement

Report the reduced tax liability on lines

showing your calculation.

What to do if you overwithheld tax

1 through 60.

depends on when you discover the

Line 64. Enter the total tax deposits you

overwithholding.

Overwithholding discovered at a later

made (including amounts paid with an

date. If you discover after March 15 of the

extension of time to file).

Overwithholding discovered by March

following calendar year that you

15 of the following calendar year. If

Line 66. You are permitted to take a

overwithheld tax for the prior year, do not

you discover that you overwithheld tax by

credit for amounts withheld by other

adjust the amount of tax liability reported

March 15 of the following calendar year,

withholding agents that relate to the total

on Form 1042 or on any deposit or

you may use any undeposited amount of

net tax liability reported on line 63c. For

payment for that prior year. Do not repay

tax to make any necessary adjustments

example, you are a QI and the amount you

the beneficial owner or payee the amount

between you and the recipient of the

entered on line 63c includes amounts

overwithheld.

income. Repay the recipient and reduce

withheld by a U.S. withholding agent. You

In this situation, the recipient will have

the amount of your total deposit. Report

may take a credit on line 66 for the

to file a U.S. income tax return (Form

the reduced tax liability on lines 1 through

amounts that were withheld by the U.S.

1040NR, Form 1040NR-EZ, or Form

60 for the period(s) for which you repaid

withholding agent. The amount on line 66

1120-F) or, if a tax return has already been

the overwithheld tax.

should equal the sum of all Forms 1042-S,

filed, a claim for refund (Form 1040X or

box 8, that you file for the year.

If the undeposited amount is not

amended Form 1120-F) to recover the

enough to make any adjustments, or if you

amount overwithheld.

Note. All withholding agents (QIs and

discover the overwithholding after the

NQIs) must verify entries on Line 66 by

entire amount of tax has been deposited,

Third Party Designee

attaching supporting Form(s) 1042-S,

you can use either the reimbursement or

issued to you, to verify the credit amounts

If you want to allow any individual,

the set-off procedure to adjust the

claimed.

corporation, firm, organization, or

overwithholding.

partnership to discuss your 2012 Form

If you are a QI requesting a

If March 15 is a Saturday,

1042 with the IRS, check the “Yes” box in

refund, you must attach the

Sunday, or legal holiday, the next

the Third Party Designee section of the

TIP

corresponding Form(s) 1042-S

business day is the final date for

return. Also, enter the designee's name,

CAUTION

received to support the amount claimed

these actions.

phone number, and any five digits the

Instructions for Form 1042

-4-

Instructions For Form 1042 - Annual Withholding Tax Return For U.s. Source Income Of Foreign Persons - 2012 Page 4

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