California Form 593-I - Real Estate Withholding Installment Sale Acknowledgement - 2013
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1
2
3Real Estate Withholding Installment
YEAR
CALIFORNIA FORM
2013
Sale Acknowledgement
593-I
(This form should only be completed by the buyer. This is not a remittance document.)
Part I – Buyer’s Information
First name
Initial Last name
SSN or ITIN
- -
Spouse‘s/RDP‘s first name (if jointly purchased)
Initial Last name
Spouse’s/RDP’s SSN or ITIN
- -
FEIN
CA Corp no. CA SOS file no.
Business name (if applicable)
Address (apt./suite, room, PO Box, or PMB no.)
City
State ZIP Code
Daytime telephone number
-
-
(
)
Property address (if no street address, provide parcel number and county)
Part II – Seller’s Information
First name
Initial Last name
SSN or ITIN
- -
Spouse‘s/RDP‘s first name (if jointly sold)
Initial Last name
Spouse’s/RDP’s SSN or ITIN
- -
FEIN
CA Corp no. CA SOS file no.
Business name (if applicable)
Address (apt./suite, room, PO Box, or PMB no.)
City
State
ZIP Code
Installment Withholding Percent
Apply this percent
-
to all installment
____ ____ . ____ ____%
payments.
I acknowledge that the buyer is required to withhold on the principal portion of each installment payment.
Part III –
Installment Acknowledgement See instructions.
Principal Amount of Promissory Note
Payment Amount
Interest Rate
Terms of Repayment
.
.
.
,
,
,
,
months
%
Part IV –
Buyer’s Acknowledgement to Withhold (Read the “Buyer” information below before you sign.)
I acknowledge that I am required to withhold on the principal portion of each installment payment to the seller for the above shown California real property
either at the rate of 3 1/3% (.0333) or the Optional Gain on Sale withholding percentage, as specified by the seller on Form 593, Real Estate Withholding Tax
Statement, of the principal portion of each installment payment. I will complete Form 593 for the principal portion of each installment payment and send one
copy of each to the Franchise Tax Board along with Form 593-V, Payment Voucher for Real Estate Withholding, the withholding payment, and give one copy of
Form 593 to the seller. I will send each withholding payment to the Franchise Tax Board by the 20th day of the month following the month of the installment
payment. If the terms of the installment sale, promissory note, or payment schedule change, I will promptly inform the Franchise Tax Board. I understand that
the Franchise Tax Board may review relevant escrow documents to ensure withholding compliance. I also understand that I am subject to withholding penalties
if I do not withhold on the principal portion of each installment payment and do not send the withholding along with Form 593 to the Franchise Tax Board by the
due date, or if I do not send one copy of Form 593 to the seller by the due date.
Print name and title _____________________________________________________________________________________________________________
Buyer’s signature
________________________________________________________________________________ Date: _______________________
Buyer’s spouse’s/RDP’s name (if on title) _____________________________________________________________________________
It is unlawful to forge
Buyer’s spouse’s/RDP’s signature (if applicable) ___________________________________________ Date:
a spouse’s/RDP’s
_________________________
signature.
Buyer:
Make sure you copy all pages so you will have the instructions for withholding on subsequent payments. Provide the original Form 593-
I
,
along with copies of the promissory note and seller’s certified Form 593, to your real estate escrow person, who will mail the forms and remit
the payment to the Franchise Tax Board. Your real estate escrow person will withhold on the principal portion of the first installment payment.
You must withhold on the principal portion of all subsequent installment payments (including payoff or balloon payments). Complete
Form 593 and Form 593-V, and mail the documents and payment to the Franchise Tax Board for the principal portion of each installment
payment.
Seller:
Make a copy of this form for your records.
Real Estate
I
Make a copy of this form for your records. Mail Form 593-V, the original Form 593-
, a copy of the promissory note, and seller’s certified
Escrow Person:
Form 593 to the Franchise Tax Board with the required amount of the first installment payment.
Form 593-
2012
7141133
I
C2
For Privacy Notice, get form FTB 1131.
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