Californiaform 593-I - Real Estate Withholding Installment Sale Acknowledgement - 2009
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1Real Estate Withholding Installment Sale
YEAR
CALIFORNIA FORM
2009
Acknowledgement
593-I
(This form can only be completed by the buyer. This is not a remittance document.)
Part I – Buyer’s Information
Return this form to your real estate escrow person.
Name
SSN or ITIN
-
-
Spouse’s/RDP’s Name (if jointly purchased)
Spouse’s/RDP’s SSN or ITIN (if jointly purchased)
-
-
FEIN CA Corp no.
Address (including apt./suite, room, PO Box, or PMB no.)
City
State ZIP Code
Daytime telephone number
-
-
( )
Property address (if no street address, provide parcel number and county)
Part II – Seller’s Information
Name
SSN or ITIN
-
-
Spouse’s/RDP’s Name (if jointly purchased)
Spouse’s/RDP’s SSN or ITIN (if jointly owned)
-
-
FEIN CA Corp no.
Address (including apt./suite, room, PO Box, or PMB no.)
City
State ZIP Code
Installment Withholding Percent
Apply this percent
-
to all installment
____ ____ . ____ ____%
payments.
Part III – Installment Acknowledgement
Attach to Form 593-
I
, Real Estate Withholding Installment Sale Acknowledgement, a copy of the signed promissory note. If the seller has elected and
certified the Optional Gain on Sale withholding amount, also attach an executed copy of seller’s certification of Form 593, Real Estate Withholding Tax
Statement, to Form 593-
I
.
Part IV – Buyer’s Acknowledgement to Withhold (Read the “Buyer” information below before you sign.)
I acknowledge that I am required to withhold on the principal portion of each installment payment to the seller for the above shown California real
property either at the rate of 3 1/3% of the total sales price or the Optional Gain on Sale withholding percentage, as specified by the seller on Form 593,
Real Estate Withholding Tax Statement, of the principal portion of each installment payment. I will complete Form 593 for the principal portion of each
installment payment and send one copy of each to the Franchise Tax Board along with the withholding payment, and give one copy of Form 593 to the
seller. I will send each withholding payment to the Franchise Tax Board 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
the Franchise Tax Board may review relevant escrow documents to ensure withholding compliance. I also understand that I am subject to withholding
penalties if I do not withhold on the principal portion of each installment payment and do not send the withholding along with Form 593 to the
Franchise Tax Board by the due date, or if I do not send one copy of Form 593 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/RDP’s name (if on title) _______________________________________________________________________
It is unlawful to forge
a spouse’s/RDP’s
Buyer’s spouse’s/RDP’s signature (if applicable) _______________________________________ Date: _____________________
signature.
Buyer:
Make sure you copy both sides so you will have the instructions for withholding on subsequent payments. Give the original, along with copies
of the promissory note and seller’s certified Form 593, to your real estate escrow person who should mail them to the Franchise Tax Board.
Your real estate escrow person will withhold on the principal portion of the first installment payment. You must withhold on the principal
portion of all subsequent installment payments (including payoff or balloon payments). Complete Form 593, and mail the documents and
payment to the Franchise Tax Board for the principal portion of each installment payment.
Real Estate Escrow Person: Make a copy of this Form for your records. Send the original Form 593-
I
, a copy of the promissory note, and seller’s
certified Form 593 to the Franchise Tax Board with the required amount of the first installment payment.
Form 593-
I
2008
7141093
For Privacy Notice, get form FTB 1131.
C2
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