Form 1065n - Nebraska Partnership Return Of Income - 2004 Page 4
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4NEBRASKA SCHEDULE III —
Nonresident or Corporate Partner’s Share of Nebraska
FORM
Income, Bonus Depreciation and Enhanced Section 179
1065N
nebraska
Expense Deduction Add-Back and Deductions
department
of revenue
If you use this schedule, read instructions and attach this page to Form 1065N
Name as Shown on Form 1065N
Nebraska Identification Number
25 —
NAME AND ADDRESS OF EACH NONRESIDENT OR CORPORATE PARTNER
Name
Street or Other Mailing Address
City
State
Zip Code
1
2
3
4
5
6
7
8
9
10
COMPLETED FOR NONRESIDENT INDIVIDUAL PARTNERS ONLY
• Do not include corporations, trusts, partnerships, or limited liability companies
COMPUTATION OF NEBRASKA WITHHOLDING TAX
(D)
(B)
(C)
(G)
(A)
Check if
Share of
Nebraska Income
(E)
Tax Withheld (Column E
(F)
Social Security Number
Form 12N
Income
Reported by Partnership
Column B
times Column F)
Rate
Attached
(%)
(Line 6, Form 1065N)
Times Column C
(Attach Form 14N)
1
6.84%
2
6.84%
3
6.84%
4
6.84%
5
6.84%
6
6.84%
7
6.84%
8
6.84%
9
6.84%
10
6.84%
TOTALS
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