Form Tc-40w - Part 1 - Utah Withholding Tax Schedule Page 2

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TC-40W
Mineral Production and Pass-through Withholding Tax
40310
Rev. 12/13
Your last name
Your social security number
Part 2 - Utah Mineral Production Withholding Tax - TC-675R
Do not send TC-675Rs or Utah Schedules K-1 with return. Enter TC-675R or Schedule K-1 information below. Use additional TC-40Ws if needed.
Line explanations:
4 Pass-through entity EIN, if credit from partnership or S corporation
(enter EIN from Utah Schedule K-1)
1 Producer’s EIN from box “2” of TC-675R
5 Utah mineral production withholding tax from box “6” of TC-675R or
2 Producer’s name from box “1” of TC-675R
from Utah Schedule K-1
3 Producer’s Utah withholding ID # from box “3” of TC-675R
* See illustration instructions *
(14-characters, ending in WMP, no hyphens)
First TC-675R or Utah Schedule K-1
Second TC-675R or Utah Schedule K-1
1
1
2
2
<14 characters, no hyphens
<14 characters, no hyphens
3
3
4
4
5
.00
5
.00
Fourth TC-675R or Utah Schedule K-1
Third TC-675R or Utah Schedule K-1
1
1
2
2
<14 characters, no hyphens
<14 characters, no hyphens
3
3
4
4
.00
5
5
.00
Enter total mineral production withholding tax from all lines 5. Enter this total on form TC-40, page 2, line 36.
.00
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-40Ws if needed.
2 Name of pass-through entity from Utah Schedule K-1 box “B”
Line explanations:
3 Utah withholding tax paid by pass-through entity
1 Pass-through entity EIN from Utah Schedule K-1 box “A”
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
Enter total pass-through withholding tax from all lines 3. Enter on TC-40, page 2, line 35.
.00
Do not send TC-675Rs or Utah Schedules K-1.
Use additional forms TC-40W, Part 2 or Part 3 if needed.
Submit this page ONLY if data entered.
Attach completed schedule to your 2013 Utah income tax return.

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