This form is used to report amounts paid to foreign persons (including those presumed to be foreign) by a United States based institution or business.
Form 1042-S, Foreign Person’s U.S. Source Income Subject to Withholding, is a form used to report income and amounts withheld, the specified federal procurement payments paid to foreign individuals that are subject to withholding, and the distribution of connected income by a publicly traded partnership.
Form 1042-S has several copies. The following instructions below are applicable to all the copies:
To fill out Form 1042-S, one must provide the following information:
Item 1. Income Code
Enter the income code.
Item 2. Gross Income
Enter the gross income.
Item 3. Chapter Indicator
Enter the chapter indicator. The applicant may enter either “3” or “4.”
Item 3a. Exemption Code
Enter the exemption code for Chapter 3.
Item 3b. Tax Rate
Enter the tax rate for Chapter 3.
Item 4a. Exemption Code
Enter the exemption code for Chapter 4.
Item 4b. Tax Rate
Enter the tax rate for Chapter 4.
Item 5. Withholding Allowance
Enter the amount of withholding allowance.
Item 6. Net Income
Enter the amount of net income.
Item 7a. Federal Tax Withheld
Enter the amount of federal tax withheld.
Item 7b
Mark the box if the federal tax withheld was not deposited with the Internal Revenue Service (IRS) because escrow procedures were applied.
Item 7c
Mark the box if the withholding occurred in a subsequent year with respect to a partnership interest.
Item 8. Tax Withheld by Other Agents
Enter the amount of tax withheld by other agents.
Item 9. Overwithheld Tax Repaid to Recipient Pursuant to Adjustment Procedures
Enter the amount of overwithheld tax repaid to the recipient pursuant to any adjustment procedures.
Item 10. Total Withholding Credit
Enter the total amount of withholding credit by combining items 7a, 8, and 9.
Item 11. Tax Paid by Withholding Agent
Have the withholding agent enter the amount of tax paid by the withholding agent.
Item 12a. Withholding Agent’s Employer Identification Number (EIN)
Have the withholding agent enter his or her Employer Identification Number (EIN).
Item 12b. Chapter 3 Status Code
Have the withholding agent enter the status code of Chapter 3.
Item 12c. Chapter 4 Status Code
Have the withholding agent enter the status code of Chapter 4.
Item 12d. Withholding Agent’s Name
Have the withholding agent enter his or her full legal name.
Item 12e. Withholding Agent’s Global Intermediary Identification Number (GIN)
Have the withholding agent enter his or her Global Intermediary Identification Number (GIN).
Item 12f. Country Code
Have the withholding agent enter his or her country code.
Item 12g. Foreign Tax Identification Number (FTIN)
Have the withholding agent enter his or her Foreign Tax Identification Number (FTIN).
Item 12h. Address
Have the withholding agent enter his or her address.
Item 12i. City or Town, State or Province, Country, ZIP or Foreign Postal Code
Have the withholding agent enter his or her city or town, state or province, country, ZIP code or foreign postal code.
Item 13a. Recipient’s Name
Have the recipient enter his or her full legal name.
Item 13b. Recipient’s Country Code
Have the recipient enter his or her country code.
Item 13c. Address
Have the recipient enter his or her address.
Item 13d. City or Town, State or Province, Country, ZIP or Foreign Postal Code
Have the recipient enter his or her city or town, state or province, country, ZIP code or foreign postal code.
Item 13e. Recipient’s U.S. Tax Identification Number (TIN)
Have the recipient enter his or her U.S. tax identification number (TIN).
Item 13f. Chapter 3 Status Code
Have the recipient enter the status code of Chapter 3.
Item 13g. Chapter 4 Status Code
Have the recipient enter the status code of Chapter 4.
Item 13h. Recipient’s Global Intermediary Identification Number (GIIN)
Have the recipient enter his or her Global Intermediary Identification Number (GIIN).
Item 13i. Recipient’s Foreign Tax Identification Number (FTIN)
Have the recipient enter his or her Foreign Tax Identification Number (FTIN).
Item 13j. Limitation on Benefit (LOB) Code
Have the recipient enter his or her Limitation on Benefit (LOB) code.
Item 13k. Recipient’s Account Number
Have the recipient enter his or her account number.
Item 13l. Recipient’s Date of Birth
Have the recipient enter his or her date of birth using the format: Year-Month-Day.
Item 14a. Primary Withholding Agent’s Name
Have the primary withholding agent enter his or her full legal name.
Item 14b. Primary Withholding Agent’s Employer Identification Number (EIN)
Have the primary withholding agent enter his or her employee identification number (EIN).
Item 15
Mark the box if the primary withholding agent used pro-rata basis reporting.
Item 15a. Intermediary or Flow-Through Entity’s Employer Identification Number (EIN)
Have the intermediary or flow-through entity enter his or her employee identification number (EIN).
Item 15b. Chapter 3 Status Code
Have the intermediary or flow-through entity enter the status code of Chapter 3.
Item 15c. Chapter 4 Status Code
Have the intermediary or flow-through entity enter the status code of Chapter 4.
Item 15d. Intermediary or Flow-Through Entity’s Name
Have the intermediary or flow-through entity enter his or her full legal name.
Item 15e. Intermediary or Flow-Through Entity’s Global Intermediary Identification Number (GIIN)
Have the intermediary or flow-through entity enter his or her Global Intermediary Identification Number (GIIN).
Item 15f. Country Code
Have the intermediary or flow-through entity enter his or her country code.
Item 15g. Foreign Tax Identification Number (FTIN)
Have the intermediary or flow-through entity enter his or her Foreign Tax Identification Number (FTIN).
Item 15h. Address
Have the intermediary or flow-through entity enter his or her address.
Item 15i. City or Town, State or Province, Country, ZIP or Foreign Postal Code
Have the intermediary or flow-through entity enter his or her city or town, state or province, country, ZIP code or foreign postal code.
Item 16a. Payer’s Name
Have the payer enter his or her full legal name.
Item 16b. Payer’s Tax Identification Number (TIN)
Have the payer enter his or her tax identification number (TIN).
Item 16c. Payer’s Global Intermediary Identification Number (GIIN)
Have the payer enter his or her Global Intermediary Identification Number (GIIN).
Item 16d. Chapter 3 Status Code
Have the payer enter the status code of Chapter 3.
Item 16e. Chapter 4 Status Code
Have the payer enter the status code of Chapter 4.
Item 17a. State Income Tax Withheld
Have the payer enter his or her state income with the tax withheld.
Item 17b. Payer’s State Tax Number
Have the payer enter his or her state tax number.
Item 17c. Name of State
Have the payer enter the name of the state.
Box 1. Income Code
Boxes 3a and 4a. Exemption Code
Boxes 12b, 12c, 13f, 15b, 15c, 16d, and 16e. Withholding Agent, Recipient, Intermediary, and Payer Chapter 3 and Chapter 4 Status Codes
Box 13j. LOB Code