Fillable Form 13930 - Application For Central Withholding Agreement (Page 2 of 6) in pdf

Page 2

How do I apply?

3. An itinerary of dates and locations of all performances or

events to be covered by the CWA. Include any anticipated

performances that may be in negotiation or planning. Tours

You must submit a written application and appropriate

crossing calendar years may require additional information

attachments.

and will require a separate CWA for each year.

The only standard portion of an application for a CWA is the

4. A spreadsheet containing the proposed budget showing

application form itself appearing at the end of these instructions.

itemized estimates of all gross income (including but not

The remainder of the application will consist of a computer-

limited to income attributable to items listed in 1 and 2

generated letter from you explaining the facts requested below,

above) and US expenses for the tour or event. If the tour

along with the appropriate attachments.

encompasses events outside of the US, separately state the

US income and expenses.

Each individual requesting a CWA must submit a timely

5. A list of any previous CWA(s) for the calendar year in which

application. This includes all members of the group, regardless

the CWA is requested. If there is any US source income

as to whether or not they share in the profit of the tour or event.

previously earned in the calendar year not claimed on a

This also includes any back-up singer or musician who is

CWA, provide the income, the source and verification of

requesting a CWA. When requesting a CWA for multiple

amounts withheld and deposited. If no prior income, state

individuals list each individual and provide the complete

not applicable.

information for each.

6. For each NRA, state whether the NRA has been in the US

providing personal services during the current or six prior

You may need to provide additional information that affects the

years. Provide the US taxpayer SSN or ITIN of the NRA for

computation or completion of the CWA that is requested by the

whom the income and deductions were reported.

IRS. This information must be provided by the deadline

provided by the IRS when requested. Delays in response may

For an Athlete, attach the following:

jeopardize the approval of the CWA.

Each CWA application must include the following

statement and must either be signed by the NRA or by an

1. Copies of all agreements presented to the athletic

authorized representative of the NRA

association (e.g. bout agreements).

“I wish to obtain a Central Withholding Agreement between the

2. Copies of any other agreements regarding residual income,

nonresident alien athlete/entertainer, the withholding agent, and

such as Pay Per View or exclusive television rights to

the Internal Revenue Service covering the services to be

athlete's home country.

3. Copies of documents related to any other income such as

provided as shown."

endorsement income or sponsorship contracts.

4. Date and location of this event as well as the promoter

Initial Application must include:

name.

1. Name of NRA(s) to be covered by CWA

5. State whether the NRA has been in the US providing

2. SSN or ITIN of NRA if known

personal services during the current or six prior years.

3. Tour dates or event to be covered

Provide the US taxpayer SSN or ITIN of the NRA for whom

4. POA for NRA as appropriate

the income and deductions were reported.

5. Preliminary Budget

6. A spreadsheet of all expenses for the event such as

manager, trainer, cut man, sanction fee, sparring partner,

Supporting Documents Required to

training facility expense, and travel to and from home

Evaluate Your Application

country. List all persons in the travel party and their function.

7. List any previous CWA(s) for the calendar year in which the

1. Complete all boxes on the application form at the end of

CWA is requested. If there is any US source income

these instructions with information regarding the NRA, the

previously earned in the calendar year not claimed on a

withholding agent and an alternate contact representative, if

CWA, list the income, the source and verification of

desired. For CWAs involving multiple entertainers, complete

amounts withheld and deposited. If no prior income, state

the continuation sheet.

'not applicable'.

For an Entertainer(s), attach the following:

NOTE: These lists are not all inclusive. If other information

supports positions taken on the budget, include it.

1. Copies of all documentation related to income of the

covered NRA(s) regarding the time period and

performances or events to be covered by the CWA.

Documentation should include (but not be limited to)

contracts, letters of understanding, offer letters,

engagement letters, agreements with employers, agents,

representatives, promoters, venues such as exhibition halls

and the like.

2. All documentation related to merchandising, endorsements,

sponsorship income, production or tour support, and

reimbursement in any way associated with this activity or

event.

13930

Catalog Number 50991Q

Form

(Rev. 12-2012)

Form 13930 - Application For Central Withholding Agreement Page 2

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