2008 Form 1042-S

8/14/2019 2008 Form 1042-S

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OMB No. 1545-0096Foreign Persons U.S. Source IncomeSubject to Withholding

Form 1042-SCopy A for

Internal Revenue Service

Department of the TreasuryInternal Revenue Service

For Privacy Act and Paperwork Reduction Act Notice, see page 16 of the separate instructions.

Federal tax withheld

Exemptioncode

Net income

Withholdingallowances

Taxrate

Incomecode

WITHHOLDING AGENTS name

Recipients U.S. TIN, if any

RECIPIENTS name

Withholding agents EIN

NQIs/FLOW-THROUGH ENTITYS name

11

16

State income tax withheld

Recipients foreign tax identifying number, if any

19a

Payers state tax no.

1

13b

2

Form 1042-S (2008

Cat. No. 11386R

20

Name of state

21

AMENDEDGross income

3

4

5

6

7

25

12a

23

13a

Country code

24

NQIs/Entitys address (number and street)

14

Country code

15

18

PAYERS name and TIN (if different from withholding agents)

EIN

QI-EIN

SSN or ITIN

EIN

QI-EIN

Amount repaid to recipient

10

PRO-RATA BASIS REPORTING

17

NQIs/Entitys 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


13c


13d

19b


19c



13e

2008Withholding by other agents

8

Total withholding credit

9

22

Recipient account number (optional)

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Form 1042-SCopy B

for Recipient




Exemptioncode

Net income


Taxrate

Incomecode



RECIPIENTS name



11

16



19a


1

13b

2

Form 1042-S (2008

Cat. No. 11386R

20

Name of state

21

AMENDEDGross income

3

4

5

6

7

25

12a

23

13a

Country code

24


14

Country code

15

18


EIN

QI-EIN

SSN or ITIN

EIN

QI-EIN


10


17


Recipient code


12b


12c


12d


13c


13d

19b


19c



13e


8


9

22


8/14/2019 2008 Form 1042-S

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U.S. Income Tax Filing RequirementsGenerally, every nonresident alien individual, nonresident alienfiduciary, and foreign corporation with United States income,including income that is effectively connected with the conduct of atrade or business in the United States, must file a United Statesincome tax return. However, no return is required to be filed by anonresident alien individual, nonresident alien fiduciary, or a foreigncorporation if such person was not engaged in a trade or business inthe United States at any time during the tax year and if the taxliability of such person was fully satisfied by the withholding ofUnited States tax at the source. (Corporations file Form 1120-F; allothers file Form 1040NR (or Form 1040NR-EZ if eligible).) You mayget the return forms and instructions at any United States Embassyor consulate or by writing to: National Distribution Center, P.O. Box8903, Bloomington, IL 61702-8903, U.S.A.

En rgle gnrale, tout tranger non-rsident, tout organismefidicommissaire tranger non-rsident et toute socit trangrepercevant un revenu aux Etats-Unis, y compris tout revenu driv,en fait, du fonctionnement dun commerce ou dune affaire auxEtats-Unis, doit soumettre aux Etats-Unis, une dclaration dimptsur le revenu. Cependant aucune dclaration dimpt sur le revenunest exige dun tranger non-rsident, dun organismefidicommissaire trange non-rsident, ou dune socit trangresils nont pris part aucun commerce ou affaire aux Etats-Unis aucun moment pendant lanne fiscale et si les impts dont ils sontredevables, ont t entirement acquitts par une retenue lasource, de leur montant. (Les socits doivent faire leur dclarationdimpt en remplissant le formulaire 1120-F; tous les autresredevables doivent remplir le formulaire 1040NR (ou 1040NR-EZ si

ligible).) On peut se procurer formulaires de dclarations dimpts etinstructions dans toutes les Ambassades et tous les Consulats desEtats-Unis. Lon peut galement sadresser pour tousrenseignements a: National Distribution Center, P.O. Box 8903,Bloomington, IL 61702-8903, U.S.A.

Por regla general, todo extranjero no residente, todo organismofideicomisario extranjero no residente y toda sociedad annimaextranjera que reciba ingresos en los Estados Unidos, incluyendoingresos relacionados con la conduccin de un negocio o comerciodentro de los Estados Unidos, deber presentar una declaracinestadounidense de impuestos sobre ingreso. Sin embargo, no serequiere declaracin alguna a un individuo extranjero, una sociedadannima extranjera u organismo fideicomisario extranjero noresidente, si tal persona no ha efectuado comercio o negocio en losEstados Unidos durante el ao fiscal y si la responsabilidad con losimpuestos de tal persona ha sido satisfecha plenamente medianteretencion del impuesto de los Estados Unidos en la fuente. (Lassociedades annimas envian la Forma 1120-F; todos los demscontribuyentes envian la Forma 1040NR (o la Forma 1040NR-EZ si lecorresponde).) Se podrn obtener formas e instrucciones encualquier Embajada o Consulado de los Estados Unidos oescribiendo directamente a: National Distribution Center,P.O. Box 8903, Bloomington, IL 61702-8903, U.S.A.

Im allgemeinen muss jede auslndische Einzelperson, jederauslndische Bevollmchtigte und jede auslndische Gesellschaft mitEinkommen in den Vereinigten Staaten, einschliesslich desEinkommens, welches direkt mit der Ausbung von Handel oderGewerbe innerhalb der Staaten verbunden ist, eineEinkommensteuererklrung der Vereinigten Staaten abgeben. EineErklrung, muss jedoch nicht von Auslndern, auslndischenBevollmchtigten oder auslndischen Gesellschaften in den

Vereinigten Staaten eingereicht werden, falls eine solche Personwhrend des Steuerjahres kein Gewerbe oder Handel in den

Vereinigten Staaten ausgebt hat und die Steuerschuld durchEinbehaltung der Steuern der Vereinigten Staaten durch die

Einkommensquelle abgegolten ist. (Gesellschaften reichen denVordruck 1120-F ein; alle anderen reichen das Formblatt 1040NRoder wenn passend das Formblatt 1040NR-EZ ein.)Einkommensteuererklrungen und Instruktionen knnen bei denBotschaften und Konsulaten der Vereiningten Staaten eingeholtwerden. Um weitere Informationen wende man sich bitte an: NationalDistribution Center, P.O. Box 8903, Bloomington, IL 61702-8903,U.S.A.

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Copy C for RecipientAttach to any Federal tax return you file


Form 1042-SDepartment of the TreasuryInternal Revenue Service



Exemptioncode

Net income


Taxrate

Incomecode



RECIPIENTS name



11

16



19a


1

13b

2

Form 1042-S (2008

Cat. No. 11386R

20

Name of state

21

AMENDEDGross income

3

4

5

6

7

25

12a

23

13a

Country code

24


14

Country code

15

18


EIN

QI-EIN

SSN or ITIN

EIN

QI-EIN


10


17


Recipient code


12b


12c


12d


13c


13d

19b


19c



13e


8


9

22


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Explanation of CodesBox 6. Exemption code (applies if the tax rate entered in box 5 is 00.00).

Box 1. Income code.

Interest

Code

Authority for Exemption

Code01

Interest paid by U.S. obligorsgeneral

Income effectively connected with a U.S. trade or business

0102

Interest paid on real property mortgages03

Interest paid to controlling foreign corporations04

Interest paid by foreign corporations

Exempt under an Internal Revenue Code section (income other thanportfolio interest)

02

05

Income is not from U.S. sources4

03

Dividends paid by U.S. corporationsgeneralDividends qualifying for direct dividend rate

Exempt under tax treaty

04

Dividends paid by foreign corporations

06

Capital gains

Box 12. Recipient code.

07

Industrial royalties

08

Motion picture or television copyright royalties

Type of Recipient

Code09

Other royalties (for example, copyright, recording, publishing)

Individual2

0110

Real property income and natural resources royalties

Artist or athlete2

09

11

Pensions, annuities, alimony, and/or insurance premiums

0312

Scholarship or fellowship grants

Trust

0413

Compensation for independent personal services1

14

Compensation for dependent personal services1

Estate

05

15

Compensation for teaching1

Corporation2

10

16

Compensation during studying and training1

Government or international organization

02

17

Earnings as an artist or athlete2

Tax-exempt organization (IRC section 501(a))

06

18

Real estate investment trust (REIT) distributions of capital gains

Private foundation

07

19

Trust distributions subject to IRC section 1445Unsevered growing crops and timber distributions by a trust subjectto IRC section 1445

20

U.S. branch treated as U.S. person

08

Qualified intermediary

11

27

Publicly traded partnership distributions subject to IRC section 144628

Gambling winnings

Substitute paymentother36

If compensation that otherwise would be covered under Income Codes 1619 is directly attributable to the recipients occupation as an artist or athlete, use Income Code 20 instead.

Use appropriate Interest Income Code for embedded interest in a notional principal contract.

Portfolio interest exempt under an Internal Revenue Code section

05

1213

If Income Code 20 is used, Recipient Code 09 (artist or athlete) should be used instead of Recipient Code 01 (individual), 02 (corporation), or 03 (partnership other than withholding foreignpartnership).

Notional principal contract income

242526

32

06

Qualified intermediary that assumes primary withholding responsibilityWithholding foreign partnership or withholding foreign trustU.S. branch treated as a U.S. person

0708

Partnership other than withholding foreign partnership2

Withholding foreign partnership or withholding foreign trust

Private arrangement intermediary withholding rate poolgeneral5

Private arrangement intermediary withholding rate poolexempt organizations

5

Public pension fund

14

18

Interest on tax-free covenant bonds

Qualified intermediary represents income is exempt

09

293031

Deposit interestOriginal issue discount (OID)Short-term OID

Qualified intermediary withholding rate poolexempt organizations5

16

Div

idend

Other

May be used only by a qualified intermediary.

Non-U.S. source income received by a nonresident alien is not subject to U.S. tax. Use Exemption Code 03 when entering an amount for information reporting purposes only.

15

Qualified intermediary withholding rate poolgeneral5

Authorized foreign agent

17

Types of Income

Substitute paymentinterest

33

Substitute paymentdividends

34

Capital gains distributions

Other income

35

50

Unknown recipient

20

Subject to 30% withholding rate unless the recipient is from one of the treaty countries listed under Gambling winnings (Income Code 28) in Pub. 515.

1

2

3

4

5

6

3

6

37

Return of capital

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Copy D for RecipientAttach to any state tax return you file


Form 1042-SDepartment of the TreasuryInternal Revenue Service



Exemptioncode

Net income


Taxrate

Incomecode



RECIPIENTS name



11

16



19a


1

13b

2

Form 1042-S (2008

Cat. No. 11386R

20

Name of state

21

AMENDEDGross income

3

4

5

6

7

25

12a

23

13a

Country code

24


14

Country code

15

18


EIN

QI-EIN

SSN or ITIN

EIN

QI-EIN


10


17


Recipient code


12b


12c


12d


13c


13d

19b


19c



13e


8


9

22


8/14/2019 2008 Form 1042-S

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Form 1042-SCopy E

for Withholding Agent




Exemptioncode

Net income


Taxrate

Incomecode



RECIPIENTS name



11

16



19a


1

13b

2

Form 1042-S (2008

Cat. No. 11386R

20

Name of state

21

AMENDEDGross income

3

4

5

6

7

25

12a

23

13a

Country code

24


14

Country code

15

18


EIN

QI-EIN

SSN or ITIN

EIN

QI-EIN


10


17


Recipient code


12b


12c


12d


13c


13d

19b


19c



13e


8


9

22


Documents

2008 Form 1042-S