Form Pte-12 - Idaho Schedule For Pass-Through Owners

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F
PTE-12
Idaho Schedule For Pass-Through Owners
O
R
EFO00241
(Required with Forms 41S, 65 or 66)
M
07-24-14
Pass-through entity (PTE) name
PTE EIN
PTE tax year ending
Date of payment
Contact name
Contact email
Contact telephone
Composite
Other
Withholding
(a)
(b)
(d)
(c)
(e)
(f)
EIN or
Idaho
Idaho
Income Tax
Idaho
Income
Owner’s Name
Social Security
Owner’s Address
Filing
Distributable
Distributable
Withheld By
Distributable
Tax Paid
(one owner per line)
Number
City, State, ZIP Code
Code
Income
Income
Entity
Income
By Entity
Total Columns (b), (c), (d), (e), and (f)
If you have more than one schedule, enter the total amounts on last page only.
Page _______ of ________

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