Form Pwa - Passthrough Entity Withholding Adjustment For Nonresident Individual Partner, Shareholder, Or Beneficiary - 2012
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1Form
North Dakota Office of State Tax Commissioner
PWA
Passthrough Entity Withholding Adjustment
2012
for nonresident individual partner, shareholder, or beneficiary
Name (First, MI, Last)
Social security number
Mailing address
City
State
Zip Code
1.
Estimated North Dakota distributive share of income from the partnership, S corporation, or trust OR
1
estimated total North Dakota taxable income for the tax year, whichever is less
2
2.
Multiply line 1 by 3.99 percent (.0399)
3.
3
Estimated North Dakota individual income tax that you paid for the tax year
4
4.
Additional North Dakota income tax withheld from wage income
5
5.
Withholding adjustment amount. Add lines 3 and 4
6
6.
Amount to withhold. Subtract line 5 from line 2 (If less than zero, enter 0)
To be completed by partnership, S corporation, or trust -
To be completed by partner, shareholder, or beneficiary - Sign and
date this form. Then give it to the partnership, S corporation, or trust.
Name of entity
I declare that this form is correct and complete to the best of my
knowledge and belief.
Entity's federal EIN
Entity's tax year
Calendar year
to which this
Signature
Date
Fiscal year:
Ending
,
form applies:
Purpose
distributive share of income from the
This form is effective only for the entity’s
entity; or
tax year to which it applies, as indicated by
A partnership, S corporation, and trust is
the entity on the form. A new form must
required to withhold North Dakota income
• Will have a North Dakota taxable
be completed for each tax year you need to
tax for a full-year nonresident individual
income that is less than the North
request an adjustment.
partner, shareholder, or benefi ciary who:
Dakota distributive share of income
from the entity due to offsetting North
Instructions for owner or
• Has a North Dakota distributive share of
Dakota losses or adjustments.
benefi ciary
income of $1,000 or more and
Complete the form as instructed, sign and
Who may use this form
• Is not included in a composite return
date the form, and give it to the partnership,
filed by the partnership, S corporation,
If you are a full-year nonresident of North
S corporation, or trust on or before the last
or trust.
Dakota who is a partner in a partnership,
day of its tax year. The entity needs this
a shareholder in an S corporation, or a
Note: For this purpose, a trust means one
information before it fi les its North Dakota
benefi ciary of a trust, you may use this form
that files Form 38. This form also applies
tax return.
if you:
to the owner of a limited liability company
Note: The entity is not obligated to accept
that files either Form 58 or Form 60.
• Expect your year-end North Dakota
this form after the end of its tax year;
distributive share of income from the
The entity is required to withhold 3.99
however, subject to the entity’s discretion,
entity to be $1,000 or more for the year;
percent of the owner’s or beneficiary’s
it may accept and take it into account in
and
North Dakota distributive share of income.
preparing its return.
However, the entity may withhold a smaller
• You want the entity to reduce the
Do not fi le this form with your North
amount if the owner or beneficiary requests
amount of North Dakota income tax
Dakota individual income tax return or send
a withholding adjustment by completing
that it withholds from your distributive
it to the Offi ce of State Tax Commissioner.
and giving this form to the entity. An
share because you have already paid
owner or beneficiary may request a
the tax through estimated payments or
Instructions for entity
withholding adjustment if he or she:
withholding, or you expect your North
Enter your name, federal employer
Dakota taxable income to be less than
• Already paid estimated North Dakota
identifi cation number, and tax year on the
$1,000.
income tax using Form ND-1ES; or
lines provided on the form. You do not
have to attach a copy of this form to your
Do not complete this form if you elected
• Had extra North Dakota income tax
Form 38, 58, or 60. However, you must
to include your North Dakota distributive
withheld from wage income to cover
retain the completed form in your records
share of income in a composite return filed
the tax owed on his or her North Dakota
in case it is requested by the Offi ce of State
by the entity. This form does not apply to
Tax Commissioner.
withholding from wages by an employer.
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