Form 592-B - Nonresident Withholding Tax Statement

YEAR

CALIFORNIA FORM

Nonresident Withholding Tax Statement

592-B

Attach to Form 592 for each recipient. See the separate instructions for

FOR FRANCHISE

Copy A

Forms 592, 592-A, and 592-B.

TAX BOARD

Recipient

Part I

PMB no.

Social security number

Recipient’s name, address (number and street), city, province or state, postal code, and country

California corporation number

FEIN

Part II Withholding agent (Payer/Partnership/Limited Liability Company)

Withholding agent’s (payer’s/partnership’s/limited liability company’s) name, address (number and

PMB no.

Social security number/PTIN

street), city, state, and ZIP Code

California corporation number

FEIN

Daytime telephone number

(

)

Part III Preparer (if other than withholding agent)

Preparer’s name, address (number and street), city, state, and ZIP Code

PMB no.

Social security number/PTIN

California corporation number

FEIN

Daytime telephone number

(

)

Part IV Type of income subject to withholding. Check the applicable box(es).

Payment to

Rents

Estate

Trust

Allocations

Distributions

Independent

Distributions

to Foreign (non-U.S.)

to Domestic (Nonforeign)

Other___________________________

Contractor

Royalties

Nonresident Partner/Member

(describe)

Tax Withheld

Part V

1 Total amount subject to withholding . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

2 Total California tax withheld . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

IMPORTANT INFORMATION – PLEASE READ

You may be assessed a penalty if you file your tax return late, if the

amount withheld is not enough to satisfy your tax liability, or if you fail

RECIPIENT:

to file a tax return and your California income exceeds the amounts

prescribed by law for filing a tax return.

The withholding of tax does not relieve you of the requirement to file a

California tax return within three months and fifteen days (for individuals

When filing your California tax return, attach Copy B of this form to the

and fiduciaries) or two months and fifteen days (for corporations) after

face of your tax return as you would a federal Form W-2. If you are an

the close of your taxable year. If you cannot file the tax return by the

individual or a fiduciary, enter the amount from Part V, line 2 of this

due date, an automatic extension to file is granted (six months for

form on the “California income tax withheld” line of your tax return. If

individuals, fiduciaries, partnerships, LLC’s, and seven months for

you are a corporation, enter the amount from Part V, line 2 of this form

corporations). However, you must pay 100% of your tax liability by the

on the “Estimated tax payments” line of your tax return.

original due date.

Keep Copy C for your records.

To determine if you must file a tax return, refer to the instructions for

WITHHOLDING AGENT:

your tax return: Form 540, California Resident Income Tax Return;

Form 540NR, California Nonresident or Part-Year Resident Income

You are required to file Copy A of this form together with Form 592,

Tax Return; Form 565, Partnership Return of Income; Form 568, Limited

Nonresident Withholding Annual Return, with the Franchise Tax Board.

Liability Company Return of Income; Form 100, California Corporation

See the instructions for Forms 592, 592-A, and 592-B for when and

Franchise or Income Tax Return; Form 100W, California Corporation

where to file returns of tax withheld at source.

or Income Tax Return (Water’s-Edge); Form 100S, California

Direct correspondence to:

S Corporation Franchise or Income Tax Return; or Form 541, California

Fiduciary Income Tax Return.

NONRESIDENT WITHHOLDING SECTION

FRANCHISE TAX BOARD

Even if you are not required by law to file a tax return, you should file if

PO BOX 651

California tax has been withheld. For more information, call (800)

SACRAMENTO CA 95812-0651

852-5711 from within the United States, or (916) 845-6500 (not toll-

free) from outside the United States.

or telephone: (888) 792-4900, (916) 845-4900 (not toll-free).

592B00109

Form 592-B

(REV. 2000)

For Privacy Act Notice, get form FTB 1131 (Individuals only).

Form 592-B - Nonresident Withholding Tax Statement - 2000

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