California Form 592 - Nonresident Withholding Annual Return

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YEAR
CALIFORNIA FORM
Nonresident Withholding Annual Return
592
Social security number or PTIN of withhold agent
If you withheld on foreign (non-U.S.) partners, use Section B (on Side 2) of this form. If you withheld on both
-
-
foreign partners and other payees, file a separate Form 592 for the foreign partners.
California corporation no.
FEIN
Section A:
Independent contractors; rents; royalties; estates; trusts; domestic nonresident partners/members; and other entities.
Check one box:
Form 592-B attached for each recipient.
Form 592-B information on attached list.
Daytime telephone number
Form 592-B information on enclosed magnetic media. See separate instructions for Forms 592, 592-A, and 592-B.
(
)
Withholding Agent (Payer)
Part I
Name of withholding agent (payer)
Contact person
Address (number and street)
PMB no.
City
State
ZIP Code (or equivalent)
Part II Type of Income Subject to Withholding (Check only one. Use separate forms if more than one.)
Payment to Independent Contractor
Rents or Royalties
Estate Distributions
Trust Distributions
Distributions to Domestic Nonresident Partners/Members (see Section B for withholding on foreign partners/members)
Other_______________________
1
Enter number of Forms 592-B for the type of income checked above . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1 _________________
2
Total amount of California source income subject to withholding . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
2 _________________
3
Total withholding due . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
3 _________________
4
Prior payments for the above calendar year
(a) Date
(b) Amount
(c) Date
(d) Amount
(e) Date
(f) Amount
Total
Total
Total
Column (b)
Column (d)
Column (f)
Total payments for the above calendar year. Add the totals from column (b), column (d), and column (f) and enter the sum here . .
4 _________________
Part III Remittance
5
Balance due. Subtract line 4 from line 3 and enter the balance due. If less than zero, enter -0-.
Attach a check or money order for the full amount payable to “Franchise Tax Board.”
Write the payer’s social security number, California corporation number, or FEIN
. . . . .
and “Form 592” on the check or money order . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
Mail Form 592 to the FRANCHISE TAX BOARD, PO BOX 942867, SACRAMENTO CA 94267-0001.
Part IV Tax Withheld by Another Entity on Partnership, Limited Liability Company (LLC), Estate, or Trust Shown in Part I of This Form
6
Enter number of additional Forms 592-B attached, flowing through the credit. The credit must be allocated to all partners, members,
6 _________________
or beneficiaries whether residents or nonresidents of California, according to their interests in the above partnership, LLC, estate, or trust .
7
Enter amount withheld by another entity and being allocated to the partners, members, or beneficiaries. This credit must be documented
by a Form 592-B from the withholding entity. (If this is an estate or trust, do not include any credit being used on Form 541 against
7 _________________
tax owed on income retained by the estate or trust.) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Part V
Perjury Statement
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true,
correct, and complete. Declaration of preparer (other than withholding agent) is based on all information of which preparer has any knowledge.
___________________________________________________________
________________________________________________________________
Name and title of withholding agent (payer)
Signature of withholding agent (payer)
Date
___________________________________________________________
________________________________________________________________
Name and title of preparer other than withholding agent (payer)
Signature of preparer other than withholding agent (payer)
Date
___________________________________________________________
________________________________________________________________
Address of preparer
Email address of preparer
(
)
___________________________________________________________
________________________________________________________________
Daytime telephone number of preparer
SSN/FEIN/PTIN of preparer
59200109
Form 592
Side 1
(REV. 2000)
C3
For Privacy Act Notice, get form FTB 1131 (individuals only).

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