STATE OF HAWAII—DEPARTMENT OF TAXATION
FORM
THIS SPACE FOR DATE RECEIVED STAMP
STATEMENT OF WITHHOLDING ON
N-288A
DISPOSITIONS BY NONRESIDENT PERSONS
(Rev. 2014)
OF HAWAII REAL PROPERTY INTERESTS
2015
Copy B
Send to Transferor/Seller. This information is
being furnished to the State of Hawaii, Department
of Taxation. See Instructions on back of this copy.
NFF141
1. Description and location of property transferred (Include tax map key number)
6. Transferor/Seller is:
An individual or revocable living trust
A partnership
A corporation
An S corporation
2. Date of transfer or installment
3. Amount realized (Your share
A trust or estate
payment date
of sales or contract price)
7. If the transferor/seller is reporting
8. Hawaii income tax withheld
the gain under the installment
(Your share of tax withheld)
method, check box
4. Transferee/Buyer’s I.D. no. (SSN or FEIN)
9. Transferor/Seller’s I.D. no. (SSN
10. Spouse’s SSN
or FEIN) (Enter only one I.D. no.)
5. Transferee/Buyer’s name
11.Name of transferor/seller (Enter
12. Spouse’s Name
only one name. See Instructions.)
Street address
Transferor/Seller’s street address
City, state, and postal/ZIP code
City, province or state, postal/ZIP code, and country
THIS FORM IS TO BE USED FOR TRANSFERS OR PAYMENTS MADE IN 2015 ONLY.
FORM N-288A
STATE OF HAWAII—DEPARTMENT OF TAXATION
FORM
THIS SPACE FOR DATE RECEIVED STAMP
STATEMENT OF WITHHOLDING ON
N-288A
DISPOSITIONS BY NONRESIDENT PERSONS
(Rev. 2014)
OF HAWAII REAL PROPERTY INTERESTS
2015
Copy B
Send to Transferor/Seller. This information is
being furnished to the State of Hawaii, Department
NFF141
of Taxation. See Instructions on back of this copy.
1. Description and location of property transferred (Include tax map key number)
6. Transferor/Seller is:
An individual or revocable living trust
A partnership
A corporation
An S corporation
2. Date of transfer or installment
3. Amount realized (Your share
A trust or estate
payment date
of sales or contract price)
7. If the transferor/seller is reporting
8. Hawaii income tax withheld
the gain under the installment
(Your share of tax withheld)
method, check box
4. Transferee/Buyer’s I.D. no. (SSN or FEIN)
9. Transferor/Seller’s I.D. no. (SSN
10. Spouse’s SSN
or FEIN) (Enter only one I.D. no.)
5. Transferee/Buyer’s name
11.Name of transferor/seller (Enter
12. Spouse’s Name
only one name. See Instructions.)
Street address
Transferor/Seller’s street address
City, state, and postal/ZIP code
City, province or state, postal/ZIP code, and country
THIS FORM IS TO BE USED FOR TRANSFERS OR PAYMENTS MADE IN 2015 ONLY.
FORM N-288A