Form Pte-12 - Idaho Schedule For Pass-Through Owners - 2016

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F
PTE-12
Idaho Schedule For Pass-Through Owners
O
R
(Required with Forms 41S, 65, or 66)
EFO00241
M
07-22-2016
Pass-through entity (PTE) name
PTE EIN
PTE tax year ending
Date of payment
Contact name
Contact email
Contact telephone
Other
Withholding
Composite
(a)
(b)
(c)
(d)
(e)
(f)
EIN or
Idaho
Idaho
Income Tax
Idaho
Income
Owner’s Name
Social Security
Owner’s Address
Distributable
Filing
Distributable
Withheld By
Distributable
Tax Paid
City, State, and ZIP Code
(one owner per line)
Number
Income
Income
Entity
Income
By Entity
Code
Total Columns (b), (c), (d), (e), and (f)
If you have more than one schedule, enter the total amounts on last page only.
Page _______ of ________

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