California Form 589 Draft - Nonresident Reduced Withholding Request

YEAR

CALIFORNIA FORM

2008

Nonresident Reduced Withholding Request

589

Part I Vendor/Payee

m SSN or ITIN

Name of Vendor/Payee

Vendor/Payee fax number

–

( )

m FEIN m CA Corp no.

Address (including suite, room, PO Box, or PMB no.)

City

State

ZIP Code

Country

–

Part II Withholding Agent

m SSN or ITIN

Name of Withholding Agent

Withholding Agent fax number

–

( )

m FEIN m CA Corp no.

Address (including suite, room, PO Box, or PMB no.)

City

State

ZIP Code

Daytime telephone number

–

( )

Part III Tax Withheld

Type of Income: Check one type only.

I m 1. Payment to Independent Contractor (I/C)

I m 4. Rents or Royalties

I m 6. Estate Distributions

I m 2. Payment to I/C Entertainers/Athletes/Speakers

I m 5. Distributions to Domestic Nonresident

I m 7. Other _____________________

I m 3. Trust Distributions

S Corporation Shareholders/Partners/

Members/Beneficiaries

I Date(s) of Service __________________________

MM/DD/YYYY - MM/DD/YYYY

1 Gross California Source Payment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . I 1 __________________

Expenses:

2 Advertising . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 __________________

3 Commissions and fees . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 __________________

4 Cost of labor (contract labor) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 __________________

5 Insurance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 __________________

6 Legal, professional, and/or management fees . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 __________________

7 Rent or lease . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7 __________________

8 Supplies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8 __________________

9 Travel, meals, and entertainment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9 __________________

Other Expenses (specify)

10 ________________________________________________ . . . . . . . . . . . . . . . . . . . . . . . . . . . 10 __________________

11 ________________________________________________ . . . . . . . . . . . . . . . . . . . . . . . . . . . 11 __________________

12 ________________________________________________ . . . . . . . . . . . . . . . . . . . . . . . . . . . 12 __________________

13 ________________________________________________ . . . . . . . . . . . . . . . . . . . . . . . . . . . 13 __________________

14 Total amount of expenses. Add line 2 through 13 and enter the amount here. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . I 14 __________________

15 Net California Source Payment. Subtract line 14 from line 1 and enter the amount here.

This is your total amount subject to CA withholding. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15 __________________

16 Withholding Amount. Multiply the amount on line 15 by seven percent (.07) and enter the amount on line 16. This is the

proposed reduced withholding amount. This amount must be verified and approved by the Franchise Tax Board

prior to the requestor receiving payment for services . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16 __________________

Submit requests to: WITHHOLDING SERVICES AND COMPLIANCE, FRANCHISE TAX BOARD, PO BOX 942867, SACRAMENTO CA 94267-0651

Or, FAX the request to the FTB at (916) 845-9512.

Vendor’s/Payee’s Signature

Under penalties of perjury, I hereby certify that the information provided is, to the best of my knowledge, true and correct. I understand that the Franchise Tax Board

may review all relevant documentation upon request in order to verify the payment amount and expenses above. This form is a request for a reduced withholding

amount and does not guarantee the requestor the reduced withholding amount unless approved by the Franchise Tax Board in writing. If this request is approved and I

subsequently receive payment exceeding the amount on line 1, I understand that the withholding agent will withhold seven percent of any payment amount in excess of

the amount on line 1.

_________

Vendor’s/Payee’s Name (type or print)____________________________________________________ Phone Number:

____________

( )

Vendor’s/Payee’s Signature_____________________________________________________________________ Date:______________________

Preparer’s Name_____________________________________________________________________ Phone Number:______________________

( )

Preparer’s Signature__________________________________________________________________________ Date: _____________________

Form 589

2007

8101083