Form Ri-1041 - Rhode Island Fiduciary Income Tax Return - 2012 Page 3

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RI SCHEDULE W
2012
RHODE ISLAND W2 AND 1099 INFORMATION
Name of estate or trust shown on Form RI-1041
Federal employer identification number
Complete the Schedule below listing all of your and your spouse’s (if applicable) W2s and 1099s showing Rhode Island Income
Tax withheld. W2s or 1099s showing Rhode Island Income Tax withheld must still be attached to the front of your return. Failure
ATTACH THIS SCHEDULE W TO YOUR RETURN
to do so may delay the processing of your return.
Column A
Column B
Column D
Column C
Rhode Island Income Tax
Enter 1099
Employer’s Federal ID # from box
Employer’s Name from Box C of your W2 or
Withheld (SEE BELOW FOR
letter code
b of your W2 or Payer’s Federal
Payer’s Name from your Form 1099
BOX REFERENCES)
from chart
ID # from Form 1099
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
18.
19.
20.
21.
Total RI Income Tax Withheld. Add lines 1 through 20, Column D. Enter total here and on page 1, Line 15A.......
22.
Total number of W2s and 1099s showing Rhode Island Income Tax Withheld ........................................................
INSTRUCTIONS FOR COMPLETING SCHEDULE W
Lines 1 - 20:
Column D, lines 1 through 20. Enter the total here and on RI-1041, line
Please complete columns A, B, C and D for each W2 and 1099 showing
15A.
Schedule W Reference Chart
Rhode Island withholding.
Line 22: Enter the number
Letter Code
Withholding
Form Type
Column A: For each W2 or 1099 being entered, leave blank if the infor-
of W2s and 1099s entered
for Column A
Box
mation being entered is from a W2. For all 1099s being entered, enter
on lines 1-20 showing
-
W2
17
the letter code from the chart to the right.
Rhode Island income tax
-
W-2G
14
withheld.
Column B: For each W2 or 1099 being entered, enter the name of the
1099-B
B
15
Schedule W plus all W2s
employer or payer.
and 1099s with Rhode
1099-DIV
D
14
Island withholding must
Column C: For each W2, enter the employer identification number from
1099-G
G
11
be attached to your Rhode
box b of the W2. For each 1099, enter the payer’s federal identification
1099-INT
I
13
Island return in order to
number.
receive credit for your Rhode
1099-MISC
M
16
Island withholding tax amount.
Column D: For each W2 or 1099, enter the amount of Rhode Island with-
1099-OID
O
10
holding as shown on each form. See chart to the right for box reference.
ATTACH THIS FORM TO
1099-R
R
12
YOUR RHODE ISLAND
Line 21: Total Rhode Island Income Tax Withheld. Add the amounts from
RI-1099PT
P
9
RETURN.
Page 3

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