California Form 592 - Nonresident Withholding Annual Return (Page 2 of 2) in pdf

Section B:

Foreign partners and members for taxable year beginning month _________ day _________ year _________, and ending month _________ day _________ year ________.

Check one box:

Form 592-B attached for each recipient.

Form 592-B information on attached list.

Form 592-B information on enclosed magnetic media. See separate instructions for Forms 592, 592-A, and 592-B.

Withholding Agent (Partnership or Limited Liability Company (LLC))

Part I

Name of withholding agent (partnership or LLC)

Contact person

FEIN of withholding agent

Address (number and street)

PMB no.

City

State

ZIP Code (or equivalent)

Daytime telephone number

(

)

Part II Tax Withheld – Foreign Nonresident Partners or Members

1 Are all partners or members foreign (non-U.S.) nonresidents? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

2 Enter number of Forms 592-B for foreign partners or members . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

2 _________________

3 Total California source taxable income allocable to:

a Noncorporate foreign nonresident partners or members

$ ________________ x __________ % . . . . . . . . . . . . . . .

3a_________________

b Corporate foreign nonresident partners or members

$ ________________ x __________ % . . . . . . . . . . . . . . .

3b_________________

c Foreign banks and financial institution partners or members

$ ________________ x __________ % . . . . . . . . . . . . . . .

3c_________________

4 Total foreign partners’ or members’ withholding due. Add line 3a through line 3c . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

4 _________________

5 Prior payments of foreign partners’ or members’ withholding for the taxable year shown above

(a) Date

(b) Amount

(d) Amount

(e) Date

(f) Amount

Total

Column (b)

Column (d)

Column (f)

Total payments for the taxable year. Add the totals from column (b), column (d), and column (f) and enter the sum here . . . . . . . . .

5 _________________

6 Amount credited from prior year’s withholding . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

6 _________________

7 Total payments. Add line 5 and line 6 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

7 _________________

8 Balance due. Subtract line 7 from line 4 and enter the result here. If this amount is less than

zero, enter -0-. Attach a check or money order for the full amount payable to “Franchise Tax

. . . . .

Board.” Write the partnership’s or LLC’s FEIN and “Form 592” on the check or money order . . . . . 8

Mail Form 592 to the FRANCHISE TAX BOARD, PO BOX 942867, SACRAMENTO CA 94267-0001.

. . . . .

9 Overpayment. If line 7 is more than line 4, subtract line 4 from line 7 and enter the result here . .

. . . . .

10 Enter the amount of line 9 you want credited to next year’s Form 592 . . . . . . . . . . . . . . . .

. . . . .

11 Refund. Subtract line 10 from line 9 and enter the result here . . . . . . . . . . . . . . . . . . . . . . . . . .

Part III Tax Withheld by Another Entity on Above Partnership or LLC

12 Enter number of additional Forms 592-B attached, flowing through the credit. The credit must be allocated to all partners

or members, whether residents or nonresidents of California according to their interests in the above partnership or LLC . . . . . 12__________________

13 Enter amount withheld by another entity and being allocated to the partners or members. This credit must be documented

by a Form 592-B from the withholding entity. If any of the withholding credit is retained to offset tax at the partnership or

LLC level, show only the net flow through amount . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13__________________

Part IV 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, partner of partnership, or member of LLC

Signature of withholding agent (payer)

Date

___________________________________________________________

________________________________________________________________

Name and title of preparer other than withholding agent, partner, or member

Signature of preparer other than withholding agent (payer)

Date

___________________________________________________________