Form Pte-12 Draft - Idaho Schedule For Nonelecting Owners

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PTE-12
F
Idaho Schedule For Nonelecting Owners
O
R
EFO00241
M
07-27-11v2
Pass-through entity (PTE) name
PTE EIN
PTE tax year ending
Date of payment
PTE address
City
State
ZIP Code
Contact name
Contact telephone
Contact e-mail
Total
Owner’s Name
Social Security
Income Tax
Owner’s Address
City
State
ZIP Code
Distribution
(one owner per line)
Number
Withheld
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
If you have more than one schedule, enter the total amount withheld on last page only.
Total Income Tax Withheld
Page _______ of ________

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