Form Tc-41w - Part 1 - Utah Withholding Tax Schedule - 2014 Page 2
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1
2Mineral Production and Pass-through Withholding
TC-41W
Pg. 2
41413
2014
EIN or SSN
Estate/trust name
USTC ORIGINAL FORM
Part 2 -Utah Mineral Production Withholding Tax - TC-675R
Do not send TC-675R or Utah Schedules K-1 with return. Enter TC-675R or Schedule K-1 information below. Use additional TC-41Ws if needed.
Line Explanations
1
Producer’s EIN number from box “2” of TC-675R
4
Pass-through entity EIN if credit from partnership or S corporation
2
Producer’s name from box “1” of TC-675R
(enter EIN from Utah Schedule K-1)
3
Producer’s Utah withholding number from box “3” of TC-675R
5
Utah mineral production withholding tax from box”6” of TC-675R or
(14 characters, ending in WMP, no hyphens)
from Utah Schedule K-1.
First TC-675R or Utah Schedule K-1
Second TC-675R or Utah Schedule K-1
1
1
2
2
3
(14 characters, no hyphens)
3
(14 characters, no hyphens)
4
4
.00
.00
5
5
Third TC-675R or Utah Schedule K-1
Fourth TC-675R or Utah Schedule K-1
1
1
2
2
3
(14 characters, no hyphens)
3
(14 characters, no hyphens)
4
4
.00
.00
5
5
.00
Enter total mineral production withholding tax from all lines 5 here and on TC-41A, Part 5, using code 46.
Part 3 -Utah Pass-through Entity Taxpayer Withholding - Utah Schedule K-1
Do not send Utah Schedule(s) K-1 with return. Enter information below. Use additional TC-41Ws if needed.
Line Explanations
1
Pass-through entity EIN from Utah Schedule K-1 box “A”
2
Name of pass-through entity from Utah Schedule K-1 box “B”
3
Utah withholding tax paid by pass-through entity
First Utah Schedule K-1
Second Utah Schedule K-1
1
1
2
2
.00
.00
3
3
Third Utah Schedule K-1
Fourth Utah Schedule K-1
1
1
2
2
.00
.00
3
3
.00
Enter total pass-through withholding tax from all lines 3 here and on TC-41A, Part 5, using code 43:
Submit page ONLY if data entered.
Attach completed schedule to your Utah Fiduciary Tax Return.
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