California Form 593-B - Real Estate Withholding Tax Statement - 2004 Page 2
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YEAR
CALIFORNIA FORM
2004
Real Estate Withholding Tax Statement
593-B
Withholding Agent (Payer/Sender) Check one:
Escrow/Title Company
Accommodator/Intermediary
Buyer
FEIN
California Corporation Number
Private Mailbox No.
Name, Mailing Address, City, State, and ZIP Code
Social Security Number (SSN)
Seller or Transferor (Complete one 593-B for each seller, unless husband and wife)
Name, Mailing Address, City, State, and ZIP Code
Private Mailbox No.
Social Security Number (SSN)
Spouse’s SSN (if jointly owned)
FEIN
California Corporation Number
Escrow or Exchange Information
1 Escrow or Exchange Number
2 Date of Transfer, Exchange Completion,
3 Total Sales Price
4 Ownership Percentage
Exchange Failure, or Installment Payment
%
$
_________ . ______
5 Address (or parcel number and county) of the
6 Amount Subject to Withholding
7 Amount Withheld From This Seller
California real property transferred
$ _____________________________
$ _________________________ . ____
Check One:
Check One:
Total Sales Price x Ownership %
(.0333 x Amount Subject to Withholding)
Installment Payment
Reduced by FTB
(Enter Confirmation No. Below)
Boot
R0400 __________________________
Failed Exchange
(Total Sales Price x Ownership %)
Preparer: Name and Title (please type or print)
Telephone Number
(
)
Copy B for Seller or Transferor – This is important tax information
For Privacy Act Notice, get form FTB 1131 (Individuals only)
and is being furnished to the Franchise Tax Board. File this form with
your California tax return.
593B03103
Form 593-B
C2 (NEW 2004)
¤
§
Seller: DETACH HERE
return. For further instructions, get Form 592,
OR Write to:
Instructions for Seller or
Nonresident Withholding Annual Return , and
TAX FORMS REQUEST SECTION
Transferor
Form 592-B, Nonresident Withholding Tax
FRANCHISE TAX BOARD
Statement .
PO BOX 307
This withholding of tax does not relieve you from
RANCHO CORDOVA CA 95741-0307
the requirement to file a California tax return and
Additional Information
You can view, download, and print California tax
report the sale within three months and fifteen
forms and publications from our Website
days (two months and fifteen days for a
For additional information or to speak to a
corporation) after the close of your taxable year.
representative regarding this form, call the
Assistance for Persons with Disabilities
You may be assessed penalties if:
Withholding Services and Compliance Section's
• You do not file a tax return.
We comply with the Americans with Disabilities
automated telephone service at: (888) 792-4900
Act. Persons with hearing or speech impairments
• You file your tax return late.
(toll-free) or (916) 845-4900.
please call:
• The amount of withholding does not satisfy
OR Write to:
your tax liability.
TTY/TDD . . . . . . . . . . . . . . . . . . (800) 822-6268
WITHHOLDING SERVICES AND
COMPLIANCE SECTION
Asistencia Telefonica y en el Internet
How to Claim the Withholding
FRANCHISE TAX BOARD
Dentro de los Estados Unidos,
Credit
PO BOX 651
llame al . . . . . . . . . . . . . . . . . (800) 852-5711
To claim the withholding credit, enter the amount
SACRAMENTO CA 95812-0651
Fuera de los Estados Unidos,
in Box 7 on the line for real estate or nonresident
For information on requirements to file a
llame al . . . . . . . . . . . . . . . . . (916) 845-6500
withholding on your tax return.
California tax return or to get forms call:
(cargos aplican)
You must attach the top portion of Form 593-B,
From within the United States . . . (800) 852-5711
Sitio en el Internet:
Copy B to the lower front of your California tax
From outside the United States . . (916) 845-6500
Asistencia para Personas Discapacitadas
return.
(not toll-free)
Nosotros estamos en conformidad con el Acta de
Note: S corporations, estates, or trusts may need
Americanos Discapacitados. Personas con
to flow the withholding through to shareholders
problemas auditivos pueden llamar al TTY/TDD
or beneficiaries instead of claiming it on the tax
(800) 822-6268.
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