California Form 593-I - Real Estate Withholding Installment Sale Agreement - 2004
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Real Estate Withholding Installment Sale Agreement
CALIFORNIA FORM
2004
593-I
(This form can only be completed by the buyer)
Part I – Buyer’s Information
Return this form to your escrow company.
Name (include spouse, if applicable – see instructions – type or print)
Social security number
Spouse’s social security number (if applicable)
Mailing address (Street, City, State, ZIP Code)
Private Mailbox no.
CA Corporation number
FEIN
Daytime telephone number
Note: If you do not furnish your tax ID
(
)
number, this certificate is void.
Property address (if no street address, provide parcel number and county)
Ownership percentage
Part II – Seller’s Information
Name (include spouse, if applicable – see instructions – type or print)
Social security number
Spouse’s social security number (if applicable)
Mailing address (Street, City, State, ZIP Code)
Private Mailbox no.
Note: If you do not furnish the seller’s tax ID
number, this certificate is void.
Part III – Installment Agreement
Attach a copy of the signed promissory note (showing the installment payment requirement) to this form.
Part IV – Buyer’s Agreement to Withhold
Under penalties of perjury, I hereby agree to withhold on each principal payment for the above shown California real property to the above seller at
1
percent of each principal payment. I will complete Form 593, Real Estate Withholding Remittance Statement , and Form 593-B, Real
the rate of 3
/
3
Estate Withholding Tax Statement , for each principal payment and send one copy of each to the Franchise Tax Board with the withholding payment
and give two copies of Form 593-B to the seller. I will send each withholding payment by the 20th day of the month following the month of the
installment payment. If the terms of the installment sale, promissory note, or payment schedule change, I will promptly inform the Franchise Tax
Board. I understand that completing and signing this form will subject me to withholding penalties if I do not withhold on each principal payment
and do not send the withholding, with Forms 593 and 593-B, to the Franchise Tax Board by the due date or I do not send two copies of Form 593-B
to the seller by the due date.
Buyer's name
(if the buyer is not an individual, buyer’s agent’s name and title) (type or print) ______________________________________________________________________________________________
Buyer's signature ___________________________________________________________________________ Date: ______________________
Buyer’s spouse's name (if on title) __________________________________________________________________________________________
Buyer’s spouse's signature (if applicable) ________________________________________________________ Date: ______________________
Buyer: If you sign this agreement, make a copy of this form. Make sure you copy the back so you will have the instructions for withholding on
subsequent payments. Give the original, with a copy of the promissory note, to your escrow officer. Your escrow officer will withhold on
the down payment. You must withhold on all subsequent principal payments (including payoff or balloon payments). If you choose not to
sign this agreement, instruct your escrow officer to withhold the full 3
1
/
percent of the total sales price. You will not be required to withhold
3
on subsequent installment payments.
Escrow Officer:
If this is an installment sale and the buyer has agreed to withhold on each principal payment instead of withholding on the full
amount at the time of transfer, withhold only on the down payment in escrow. Make a copy of this form for your records.
Complete Form 593-B, Real Estate Withholding Tax Statement , give two copies to the seller, and send one copy to the Franchise
Tax Board with the withholding payment, Form 593, Real Estate Withholding Remittance Statement , the original Form 593-I, and a
copy of the promissory note.
Form 593-
I
593I04103
C2 (REV 2003)
For Privacy Act Notice, get form FTB 1131.
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