Form N-288b - Application For Withholding Certificate For Dispositions By Nonresident Persons Of Hawaii Real Property Interest - 2016 Page 2
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3FORM N-288B
(REV. 2016)
5a. Calculation and written justification showing that the transferor/seller will not realize any gain with respect to the transfer.
Attach a copy of a tentative statement from your escrow company for this transaction showing the gross sales price.
Also attach a copy of your closing escrow statement from your purchase or acquisition of this property. (Note: You must
provide documentation for all items in the calculation.)
1.
Sales Price
$ __________________________
Attach a schedule or list below
2.
Cost or other basis (including selling expenses).
to indicate the breakdown of your calculations.
(If you checked “Yes” on line 6, page 1, or used the property for business
purposes, provide your adjusted basis for the property, i.e., cost less
depreciation. Also, attach a copy of your depreciation schedule, regardless
of whether or not you have taken any depreciation.) Do not include any
carryforward losses or net operating losses.
__________________________
3.
Line 1 minus line 2. (If greater than zero, was the property used as your main
home and do you qualify to exclude the entire gain? If yes, use Form N-103 as
a worksheet and attach to Form N-288B. Otherwise, you DO NOT qualify for
a waiver of the withholding. Do not file this form with the State of Hawaii,
Department of Taxation.)
$ __________________________
5b. Calculation and written justification showing that there will be insufficient proceeds to pay the withholding required under
section 235-68(b), Hawaii Revised Statutes, after payment of all costs, including selling expenses and the amount of
any mortgage or lien secured by the property. Attach a copy of a tentative statement from your escrow company for this
transaction showing the distribution of funds received.
1a. Sales price
$ __________________________
1b. Sales proceeds to be received in forms
other than cash (describe) __________________________________
___________________________
1c. Sales proceeds to be received in cash (Line 1a minus line 1b)
___________________________
Attach a schedule
2a. Selling expenses.
or list below to indicate the breakdown of
your calculations.
$ ________________________
2b. Mortgage(s) secured by the property sold to
be paid off with cash proceeds
________________________
2c. Other (list):
3.
Add lines 2a through 2c
__________________________
4.
Amount to be withheld. Line 1c minus line 3 (If less than zero, enter zero)
$ __________________________
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