Form Pwh-Wa - Performer Or Performing Entity Withholding Allocation Form

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Form PWH-WA
Massachusetts
Performer or Performing Entity
Department of
Withholding Allocation Form
Revenue
Withholding agent: Fill in your name and name of performer or performing entity. Provide this form to each performer and performing entity you have
a contract with. Keep a copy for your records.
Performing entity: Fill in your name and name of each member or participant. Provide this form to each member or participant. Keep a copy for your
records.
Member or participant: Enclose this form with your completed Form 1 or Form 1-NR/PY.
Do not enclose this form with, or claim the payment being submitted with it, on your corporate excise tax return.
Name of designated withholding agent
Massachusetts Tax Registration number
Address
City/Town
State
Zip
Name of performer and/or performing entity
Social Security and/or Federal Identification number
Address
City/Town
State
Zip
Name of member or participant
Social Security or Federal Identification number
Address
City/Town
State
Zip
Name of venue
Date(s) of performance
1 Income subject to withholding . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
2 Total Massachusetts tax withheld . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2

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