1042SBCD-1 - Form 1042-S Department of the Treasury...

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OMB No. 1545-0096 Foreign Person’s U.S. Source Income Subject to Withholding Form 1042-S Copy B for Recipient Department of the Treasury Internal Revenue Service For Privacy Act and Paperwork Reduction Act Notice, see page 16 of the separate instructions. Federal tax withheld Net income Withholding allowances Income code WITHHOLDING AGENT’S name Recipient’s U.S. TIN, if any ' RECIPIENT’S name Withholding agent’s EIN ' NQI’s/FLOW-THROUGH ENTITY’S name 11 16 State income tax withheld Recipient’s foreign tax identifying number, if any 19a Payer’s state tax no. 1 13b 2 Form 1042-S (2009) Cat. No. 11386R 20 Name of state 21 AMENDED Gross income 3 4 7 25 12a 23 13a Country code 24 NQI’s/Entity’s address (number and street) 14 Country code 15 18 PAYER’S name and TIN (if different from withholding agent’s) EIN QI-EIN SSN or ITIN EIN QI-EIN Amount repaid to recipient 10 PRO-RATA BASIS REPORTING 17 NQI’s/Entity’s U.S. TIN, if any ' Recipient code Address (number and street) 12b Additional address line (room or suite no.) 12c City or town, province or state, country, ZIP or foreign postal code 12d Address (number and street) 13c Additional address line (room or suite no.) 13d 19b Additional address line (room or suite no.) 19c City or town, province or state, country, ZIP or foreign postal code City or town, province or state, country, ZIP or foreign postal code 13e Withholding by other agents 8 Total withholding credit 9 22 Recipient account number (optional) 20 09 Exemption code Tax rate 5 6 U.S. Income Tax Filing Requirements Generally, every nonresident alien individual, nonresident alien fiduciary, and foreign corporation with United States income, including income that is effectively connected with the conduct of a trade or business in the United States, must file a United States income tax return. However, no return is required to be filed by a nonresident alien individual, nonresident alien fiduciary, or a foreign corporation if such person was not engaged in a trade or business in the United States at any time during the tax year and if the tax liability of such person was fully satisfied by the withholding of United States tax at the source. (Corporations file Form 1120-F; all others file Form 1040NR (or Form 1040NR-EZ if eligible).) You may get the return forms and instructions at any United States Embassy or consulate or by writing to: Internal Revenue Service, 1201 N. Mitsubishi Motorway, Bloomington, IL 61705-6613 En règle générale, tout étranger non-résident, tout organisme fidéicommissaire étranger non-résident et toute société étrangère percevant un revenu aux Etats-Unis, y compris tout revenu dérivé, en fait, du fonctionnement d’un commerce ou d’une affaire aux Etats-Unis, doit soumettre aux Etats-Unis, une déclaration d’impôt sur le revenu. Cependant aucune déclaration d’impôt sur le revenu n’est exigée d’un étranger non-résident, d’un organisme fidéicommissaire étrange non-résident, ou d’une société étrangère
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This note was uploaded on 01/30/2011 for the course MAT 219 taught by Professor Ab during the Spring '10 term at Coast Guard Academy.

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1042SBCD-1 - Form 1042-S Department of the Treasury...

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