Form Ri-1099pt - Rhode Island Pass-Through Withholding - 2012

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2. Payer’s entity type
3.
2012
Rhode Island
Check if amended
Sub S corporation
RI-1099PT
Pass-Through
LLC
1. Payer’s federal employer identification number
Partnership
Fiscal year payers, enter fiscal dates
Withholding
, 2012 to
, 2013
Trust
6. Recipient’s identification number
4. Payer’s name and address
5. Recipient’s name and address
7. Recipient
Individual
type
Pass-through
Other ____________
8. Recipient’s percent of ownership
9. Recipient’s Rhode Island withholding
Copy A - PAYER copy (attach to Form RI-1096PT)
2. Payer’s entity type
3.
2012
Rhode Island
Check if amended
Sub S corporation
RI-1099PT
Pass-Through
LLC
1. Payer’s federal employer identification number
Fiscal year payers, enter fiscal dates
Partnership
Withholding
, 2012 to
, 2013
Trust
6. Recipient’s identification number
4. Payer’s name and address
5. Recipient’s name and address
7. Recipient
Individual
Type
Pass-through
Other ____________
8. Recipient’s percent of ownership
9. Recipient’s Rhode Island withholding
Copy B - PAYER copy (retain for your records)
3.
2. Payer’s entity type
2012
Rhode Island
Check if amended
Sub S corporation
RI-1099PT
Pass-Through
LLC
1. Payer’s federal employer identification number
Partnership
Fiscal year payers, enter fiscal dates
Withholding
, 2012 to
, 2013
Trust
6. Recipient’s identification number
4. Payer’s name and address
5. Recipient’s name and address
7. Recipient
Individual
Type
Pass-through
Other ____________
8. Recipient’s percent of ownership
9. Recipient’s Rhode Island withholding
Copy C - RECIPIENT copy (attach to your Rhode Island income tax return)

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