Form Ftb 4827 - Withholding Voluntary Compliance Program Application

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STATE OF CALIFORNIA
WVCP APPLICATION
FRANCHISE TAX BOARD
PO BOX 942867
SACRAMENTO CA 94267-88
88
Withholding Voluntary Compliance Program Application
Franchise Tax Board (FTB) offers a Withholding Voluntary Compliance Program (WVCP) to withholding agents who are
not in compliance with California’s nonwage withholding requirements. If we approve the WVCP Application, withholding
agents receive the following benefits, and we agree to:
Waive information return penalties for the required look-back period.
Eliminate withholding audits prior to the look-back period.
Limit the unpaid withholding liability to the look-back period, plus interest.
To take advantage of and apply for this program, complete Pages 1 and 2 of FTB 4827, Withholding Voluntary Compliance
Program Application.
Before you complete the Application, we suggest you review the:
Instructions on Pages 3 and 4.
Withholding requirement information in FTB Pub. 1016, Real Estate Withholding Guidelines, and FTB Pub. 1017,
Resident and Nonresident Withholding Guidelines.
General withholding requirements on our website. Go to ftb.ca.gov and search for withholding.
Part 1 – Withholding Agent (Applicant) Information
  FEIN
  CA SOS file No.
Withholding Agent
SSN or ITIN
CA Corp No.
Address (include suite, room, PO Box, or PMB No.)
Telephone No.
Fax No.
(
)
-
(
)
-
City
State
ZIP Code
SIC Code (from Tax Return)
Part 2 – Representative Information
Representative(s)
Title
Address (include suite, room, PO Box, or PMB No.)
Telephone No.
Fax No.
(
)
-
(
)
-
City
State
ZIP Code
Part 3 – Calendar Years Covered by the Application (Look-Back Period)
Year 1
Year 2
Current Year
Part 4 – Eligibility Questions (Please mark the appropriate boxes below.)
1. Did the withholding agent participate in the 2008 Nonresident Withholding Incentive Program?. . . . . . . . . . . . . . . . . . .  Yes  No
2. Has the withholding agent ever been audited by FTB for nonwage withholding? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  Yes  No
3. Has the withholding agent ever been assessed a withholding liability or information return penalty
for nonwage withholding? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  Yes  No
If you answered “No” to all three questions in Part 4, then go to Part 5.
A “Yes” answer to any of the questions in Part 4 indicates the withholding agent does not qualify for the WVCP and no
further action is necessary.
FTB 4827 (NEW 06-2013) C2 PAGE 1

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