Guide to Global Payroll Management - 2020 - D-58

Guide to Global Payroll Management

1042

Annual Withholding Tax Return for U.S. Source
Income of Foreign Persons

Form
Department of the Treasury
Internal Revenue Service

▶

Go to www.irs.gov/Form1042 for instructions and the latest information.

If this is an amended return, check here .

.

.

.

.

.

.

.

.

.

Ch. 3 Status Code

Ch. 4 Status Code

Number, street, and room or suite no. (if a P.O. box, see instructions)
City or town, state or province, country, and ZIP or foreign postal code

If you do not expect to file this return in the future, check here
Line
No.

Period
ending

.

.

.

.

.

.

.

.

.

.

Employer identification number

Name of withholding agent

Section 1

OMB No. 1545-0096

▶

.

.

.

.

.

.

2019
.

.

.

For IRS Use Only

CC
RD
CAF
CR
EDC
Enter date final income paid

FD
FF
FP
I
SIC
▶

Record of Federal Tax Liability (Do not show federal tax deposits here)
Tax liability for period
(including any taxes assumed
on Form(s) 1000)

Line
No.

Period
ending

Tax liability for period
(including any taxes assumed
on Form(s) 1000)

Line
No.

Tax liability for period
(including any taxes assumed
on Form(s) 1000)

Period
ending

1
7
21
7
41
7
2
15
22
15
42
15
Jan.
May
Sept.
3
22
23
22
43
22
4
31
24
31
44
30
5 Jan. total
25 May total
45 Sept. total
6
7
26
7
46
7
7
15
27
15
47
15
Feb.
June
Oct.
8
22
28
22
48
22
9
28
29
30
49
31
10 Feb. total
30 June total
50 Oct. total
11
7
31
7
51
7
15
12
15
32
15
52
Mar.
July
Nov.
13
22
33
22
53
22
14
31
34
31
54
30
15 Mar. total
35 July total
55 Nov. total
16
7
36
7
56
7
17
15
37
15
57
15
Apr.
Aug.
Dec.
18
22
38
22
58
22
19
30
39
31
59
31
20 Apr. total
40 Aug. total
60 Dec. total
61
No. of Forms 1042-S filed: a On paper
b Electronically
62
Total gross amounts reported on all Forms 1042-S and 1000:
a Total U.S. source FDAP income (other than U.S. source substitute payments) reported . . . . .
62a
b Total U.S. source substitute payments reported:
(1) Total U.S. source substitute dividend payments reported . . . . . . . . . . . . . . 62b(1)
(2) Total U.S. source substitute payments reported other than substitute dividend payments . . . 62b(2)
c Total gross amounts reported (Add lines 62a-b) . . . . . . . . . . . . . . . . .
62c
d Enter gross amounts actually paid if different from gross amounts reported . . . . . . . . .
62d
Do you want to allow another person to discuss this return with the IRS (see instructions)?
Yes. Complete the following.
Third Party
Designee's
Phone
Personal identification
Designee

Paid
Preparer
Use Only

Your
signature

Date

Print/Type preparer's name

Firm's name

Preparer's signature

Capacity in which acting ▶
Daytime phone number
Date

▶

Check
if
self-employed

PTIN

Firm's EIN ▶

▶

Firm's address ▶

For Privacy Act and Paperwork Reduction Act Notice, see instructions.

D-58

No

▶
▶
name
no. ▶
number (PIN)
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my
knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than withholding agent) is based on all information of which preparer
has any knowledge.

▲

Sign
Here

▶

Phone no.
Cat. No. 11384V

Form 1042 (2019)
http://www.irs.gov/Form1042
Guide to Global Payroll Management - 2020

Table of Contents for the Digital Edition of Guide to Global Payroll Management - 2020
