Nonresident Withholding
TAXABLE YEAR
CALIFORNIA FORM
2017
587
Allocation Worksheet
The payee completes this form and returns it to the withholding agent.
Part I
Withholding Agent Information
Withholding agent’s name
Address (apt./ste., room, PO box, or PMB no.)
City (If you have a foreign address, see instructions.)
State
ZIP code
Part II
Nonresident Payee Information
Payee’s name
SSN or ITIN
FEIN
CA Corp no.
CA SOS file no.
Address (apt./ste., room, PO box, or PMB no.)
City (If you have a foreign address, see instructions.)
State
ZIP code
Nonresident payee’s entity type: (Check one)
Individual/sole proprietor
Corporation
Partnership
Limited liability company (LLC)
Estate or trust
Part III
Payment Type
Nonresident payee: (Check one)
Performs services totally outside California (no withholding required, skip to
Provides goods and services in California (see Part IV, Income Allocation)
Certification of Nonresident Payee)
Provides services within and outside California (see Part IV, Income Allocation)
Other (Describe)___________________________________________
Provides only goods or materials (no withholding required, skip to
Certification of Nonresident Payee)
If the nonresident payee performs all the services within California, withholding is required on the entire payment for services unless the payee is granted a
withholding waiver from the Franchise Tax Board (FTB). For more information, get FTB Pub. 1017, Resident and Nonresident Withholding Guidelines.
Part IV
Income Allocation
Gross payments expected from the withholding agent during the calendar year for:
(a) Within California
(b) Outside California
(c) Total payments
1 Goods and services:
Goods/materials (no withholding required) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ___________________________
Services (withholding required) . . . . . . . . . . . . ___________________________ ___________________________ ___________________________
2 Rents or lease payments . . . . . . . . . . . . . . . . . . . ___________________________ ___________________________ ___________________________
3 Royalty payments . . . . . . . . . . . . . . . . . . . . . . . . ___________________________ ___________________________ ___________________________
4 Prizes and other winnings . . . . . . . . . . . . . . . ___________________________ ___________________________ ___________________________
5 Other payments . . . . . . . . . . . . . . . . . . . . . . . . . . ___________________________ ___________________________ ___________________________
6 Total payments subject to withholding.
Add column (a), line 1 through line 5 . . . . . . . ___________________________ ___________________________ ___________________________
Nonresident withholding threshold amount: . . .
$1,500.00
Backup withholding threshold amount: . . . . . . .
$0.00
Certification of Nonresident Payee
To learn about your privacy rights, how we may use your information, and the consequences for not providing the requested information, go to ftb .ca .gov
and search for privacy notice. To request this notice by mail, call 800. 852.5711.
Under penalties of perjury, I declare that I have examined the information on this form, including accompanying schedules and statements, and to the best
of my knowledge and belief, it is true, correct, and complete. I further declare under penalties of perjury that if the facts upon which this form are based
change, I will promptly notify the withholding agent.
Print or type payee’s name
Telephone
Sign
(
)
Payee’s signature
Date
Here
X
Telephone
Print or type representative’s name and title
(
)
Authorized representative’s signature
Date
X
Form 587
2016
7041173
C2