California Form 592-A - Payment Voucher For Foreign Partner Or Member Withholding - 2013 Page 2
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DETACH HERE
IF NO PAYMENT IS DUE, DO NOT MAIL THIS FORM
DETACH HERE
Payment Voucher for Foreign Partner or
TAXABLE YEAR
CALIFORNIA FORM
Member Withholding
592-A
2013
To be filed by the Withholding Agent.
Taxable year: Beginning month __________ day __________ year __________, and ending month __________ day ___________ year __________.
Installment 4
Due by the 15th day of 12th month of taxable year; for weekend or holiday, see instructions.
FEIN
CA Corp no.
CA SOS file no.
Business name
SSN or ITIN
First name
Initial Last name
Contact telephone no.
(
)
Address (including suite, room, PO Box, or PMB no.)
City
State
ZIP Code
-
Make check or money order payable to: “Franchise Tax Board.” Write the tax ID no. and “2013 Form 592-A” on the check or
Amount of payment
money order. Mail Form 592-A and check or money order to FRANCHISE TAX BOARD, PO BOX 942867, SACRAMENTO CA
94267-0651.
.
,
,
Form 592-A 2012
7091133
For Privacy Notice, get form FTB 1131.
DETACH HERE
IF NO PAYMENT IS DUE, DO NOT MAIL THIS FORM
DETACH HERE
Payment Voucher for Foreign Partner or
TAXABLE YEAR
CALIFORNIA FORM
2013
Member Withholding
592-A
Check the box to indicate how Form 592-F was submitted (check one box only) Electronic Paper
Taxable year: Beginning month __________ day __________ year __________, and ending month __________ day ___________ year __________.
Supplemental
Use this voucher only if you have a final withholding payment to remit with Form 592-F. The due date of the Supplemental
Payment Voucher is the same as your original due date for Form 592-F, regardless of extension.
Payment Voucher
FEIN
CA Corp no.
CA SOS file no.
Business name
SSN or ITIN
First name
Initial Last name
Contact telephone no.
(
)
Address (including suite, room, PO Box, or PMB no.)
City
State
ZIP Code
-
Make check or money order payable to: “Franchise Tax Board.” Write the tax ID no. and “2013 Form 592-A” on the check or
Amount of payment
money order. Mail Form 592-A and check or money order to FRANCHISE TAX BOARD, PO BOX 942867, SACRAMENTO CA
.
94267-0651.
,
,
Form 592-A 2012
7091133
For Privacy Notice, get form FTB 1131.
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