Form 500-B - Information Return Report Of Nonresident Member Income Tax Withheld - 2003

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Information Return
Tax Year 2003
Report of Nonresident Member Income Tax Withheld
500-B
Tax Year End Date of Partnership, S Corporation, LLC or Trust _________________
Part A: Pass-Through Entity Information
Part B: Nonresident Member Information
Name of Pass-Through Entity:
Name:
Type of Ownership:
Type of Taxpayer:
Partnership
S Corporation
LLC
Trust
Other (specify)
Individual
Partnership
S Corporation
LLC
Corporation
______________
Trust
Other (specify) ___________________________
Federal Identification Number:
Social Security Number or Federal Identification Number of Member:
Street Address:
Street Address:
City
State
Zip
City
State
Zip
Part C: 2003 Distribution and Withholding
Oklahoma Income Tax Withheld:
Total Amounts Distributed from Oklahoma Sources:
The nonresident member must enclose Form 500-B with their Oklahoma income tax return to substantiate the withholding.
Information Return
Tax Year 2003
Report of Nonresident Member Income Tax Withheld
500-B
Tax Year End Date of Partnership, S Corporation, LLC or Trust _________________
Part A: Pass-Through Entity Information
Part B: Nonresident Member Information
Name of Pass-Through Entity:
Name:
Type of Ownership:
Type of Taxpayer:
Partnership
S Corporation
LLC
Trust
Other (specify)
Individual
Partnership
S Corporation
LLC
Corporation
______________
Trust
Other (specify) ___________________________
Federal Identification Number:
Social Security Number or Federal Identification Number of Member:
Street Address:
Street Address:
City
State
Zip
City
State
Zip
Part C: 2003 Distribution and Withholding
Total Amounts Distributed from Oklahoma Sources:
Oklahoma Income Tax Withheld:
The nonresident member must enclose Form 500-B with their Oklahoma income tax return to substantiate the withholding.

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