California Form 589 Draft - Nonresident Reduced Withholding Request - 2009 Page 2

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TAXABLE YEAR
CALIFORNIA  FORM
2009
Nonresident Reduced Withholding Request
589
Part I Vendor/Payee
m SSN or ITIN
Name of Vendor/Payee (include DBA if entertainer)
m FEIN  m CA Corp no.
Address (including suite, room, PO Box, or PMB no.)
City
State
ZIP Code
Vendor/Payee fax number
(          )
Part II Withholding Agent
m SSN or ITIN
Name of Withholding Agent
Withholding Agent fax number
(          )
m FEIN  m CA Corp no.
Venue
Address (including suite, room, PO Box, or PMB no.)
Withholding Agent fax number
(          )
City
State
ZIP Code
  Daytime telephone number
  (          )
Part III Tax Withheld
Check one type only. I
A m Payment to Independent Contractor (I/C)
D m Rents or Royalties
F m Estate Distributions
B m Payment to I/C Entertainers/Athletes/Speakers
E m Distributions to Domestic Nonresident
G m Other _____________________
C m Trust Distributions
S Corporation Shareholders/Partners/
I Date(s) of Service __________________________
Members/Beneficiaries
MM/DD/YYYY - MM/DD/YYYY
Part IV Withholding Amount
  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 Total amount of expenses. Add line 2 through 11 and enter the amount here. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . I 12 __________________
13 Net California Source Payment. Subtract line 12 from line 1 and enter the amount here. . . . . . . . . . . . . . . . . . . . . . . . . . . 13 __________________
14 Withholding Amount. Multiply the amount on line 13 by seven percent (.07) and enter the amount on line 13. This is the
proposed reduced withholding amount. This amount must be verified and approved by the Franchise Tax Board (FTB)
prior to the requestor receiving payment for services . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14 __________________
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.
Part V 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 a gross California source payment exceeding the amount on line 1, I understand that the withholding agent will withhold seven percent of the
additional gross California source payment amount in excess of the amount on line 1.
_________
Vendor’s/Payee’s Name _______________________________________________________________ Phone Number:
(          )
____________
Vendor’s/Payee’s Signature______________________________________________________________________________ Date:_____________
Preparer’s Name_____________________________________________________________________ Phone Number:______________________
(          )
Preparer’s Signature___________________________________________________ Date: ____________ Preparer’s SSN/PTIN________________
Form 589
  2008
8101093
C2
For Privacy Notice, get form FTB 1131.

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