Payment Voucher for Foreign Partner or
TAXABLE YEAR
CALIFORNIA FORM
2015
Member Withholding
592-A
To be filed by the Withholding Agent.
For calendar year 2015 or fiscal year beginning (mm/dd/yyyy)
, and ending (mm/dd/yyyy)
.
Installment 1
Due by the 15th day of 4th month of taxable year; for weekend or holiday, see instructions.
FEIN
CA Corp no.
Business name
SSN or ITIN
CA SOS file no.
First name
Initial Last name
Telephone
(
)
Address (apt./ste., room, PO Box, or PMB no.)
City (If you have a foreign address, see instructions.)
State
ZIP Code
Using black or blue ink, make check or money order payable to: “Franchise Tax Board.” Write the tax ID no. and “2015 Form 592‑A”
Amount of payment
on the check or 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 2014
7091153
For Privacy Notice, get FTB 1131 ENG/SP.
DETACH HERE
IF NO PAYMENT IS DUE, DO NOT MAIL THIS FORM
DETACH HERE
Payment Voucher for Foreign Partner or
TAXABLE YEAR
CALIFORNIA FORM
2015
Member Withholding
592-A
To be filed by the Withholding Agent.
For calendar year 2015 or fiscal year beginning (mm/dd/yyyy)
, and ending (mm/dd/yyyy)
.
Installment 2
Due by the 15th day of 6th month of taxable year; for weekend or holiday, see instructions.
FEIN
CA Corp no.
Business name
SSN or ITIN
CA SOS file no.
First name
Initial Last name
Telephone
(
)
Address (apt./ste., room, PO Box, or PMB no.)
City (If you have a foreign address, see instructions.)
State
ZIP Code
Using black or blue ink, make check or money order payable to: “Franchise Tax Board.” Write the tax ID no. and “2015 Form 592‑A”
Amount of payment
on the check or 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 2014
7091153
For Privacy Notice, get FTB 1131 ENG/SP.
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
2015
592-A
To be filed by the Withholding Agent.
For calendar year 2015 or fiscal year beginning (mm/dd/yyyy)
, and ending (mm/dd/yyyy)
.
Installment 3
Due by the 15th day of 9th month of taxable year; for weekend or holiday, see instructions.
FEIN
CA Corp no.
Business name
SSN or ITIN
CA SOS file no.
First name
Initial Last name
Telephone
(
)
Address (apt./ste., room, PO Box, or PMB no.)
City (If you have a foreign address, see instructions.)
State
ZIP Code
Using black or blue ink, make check or money order payable to: “Franchise Tax Board.” Write the tax ID no. and “2015 Form 592‑A”
Amount of payment
on the check or 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 2014
7091153
For Privacy Notice, get FTB 1131 ENG/SP.