Form R-5p - Nonresident Real Property Owner Shareholder/partner Schedule
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1
2Form R-5P
Commonwealth of Virginia
Department of Taxation
Nonresident Real Property Owner Shareholder/Partner Schedule
Use this form to register partners, shareholders or beneficiaries.
Corporations must record Federal Employer Identification Number or Virginia Account Number.
□
(check one and enter number)
□
(check one and enter number)
1. Social Security Number
1. Social Security Number
□
□
2. Federal Employer Identification
2. Federal Employer Identification
Number or
Number or
□
□
3. Virginia Business Account Number
3. Virginia Business Account Number
Name
Name
If Trust, Name and Title of Fiduciary
If Trust, Name and Title of Fiduciary
Address (of Fiduciary if Trust) Number and Street or Rural Route and Box
Address (of Fiduciary if Trust) Number and Street or Rural Route and Box
Number
Number
City or Town, State and ZIP Code
City or Town, State and ZIP Code
Partners, shareholders or beneficiaries
Partners, shareholders or beneficiaries
average gross monthly rental income
average gross monthly rental income
$
$
.
.
or gross proceeds from sale
or gross proceeds from sale
□
□
(check one and enter number)
(check one and enter number)
1. Social Security Number
1. Social Security Number
□
□
2. Federal Employer Identification
2. Federal Employer Identification
Number or
Number or
□
□
3. Virginia Business Account Number
3. Virginia Business Account Number
Name
Name
If Trust, Name and Title of Fiduciary
If Trust, Name and Title of Fiduciary
Address (of Fiduciary if Trust) Number and Street or Rural Route and Box
Address (of Fiduciary if Trust) Number and Street or Rural Route and Box
Number
Number
City or Town, State and ZIP Code
City or Town, State and ZIP Code
Partners, shareholders or beneficiaries
Partners, shareholders or beneficiaries
average gross monthly rental income
average gross monthly rental income
$
$
.
.
or gross proceeds from sale
or gross proceeds from sale
□
(check one and enter number)
□
(check one and enter number)
1. Social Security Number
1. Social Security Number
□
□
2. Federal Employer Identification
2. Federal Employer Identification
Number or
Number or
□
□
3. Virginia Business Account Number
3. Virginia Business Account Number
Name
Name
If Trust, Name and Title of Fiduciary
If Trust, Name and Title of Fiduciary
Address (of Fiduciary if Trust) Number and Street or Rural Route and Box
Address (of Fiduciary if Trust) Number and Street or Rural Route and Box
Number
Number
City or Town, State and ZIP Code
City or Town, State and ZIP Code
Partners, shareholders or beneficiaries
Partners, shareholders or beneficiaries
average gross monthly rental income
average gross monthly rental income
$
$
.
.
or gross proceeds from sale
or gross proceeds from sale
PAGE __________ of __________
1501240 Rev. 1/12
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