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Form 1096-B

Annual Information Return

Form 1096-B is the annual return of payments of interest on bonds and other similar obligations of domestic and foreign corporations and foreign countries, and dividends on stocks of foreign corporations.

This return must be filed with the Commissioner of Internal Revenue (Sorting Division), Washington, D. C., by the debtor corporation, paying agent, or bank which is the source of information, on or before March 15 of the year following that for which the return is made, and must show, by months in which the income was paid and reported on monthly returns (Form 1096-A, page 51), the total number of exemption certificates filed with such returns, and the total income paid without deduction of tax as shown by such certificates and returns. The return must be executed under oath.

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Claim is hereby made for benefit of the personal exemption and the credit for dependents (if any) provided under section 216 of the Revenue Act of 1918 by (or for)—

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6. If married, has your wife or husband derived income during the taxable year to date from sources in the United States separate from your own t

7. If so, is such income included in the income stated below? .

8. Have you filed a return of net income for all or any of the past four years!... for which years and the Internal Revenue Districts in which filed..

9. If so, state

INCOME OF CLAIMANT, DURING TAXABLE YEAR TO DATE, FROM SOURCES WITHIN THE UNITED STATES.

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Total income of claimant, during taxable year to date, from sources within the United States (X) $.
STATEMENT OF CREDITS CLAIMED.

Credit for dependents, 3

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Total (Y) §.

Amount of credits claimed: Personal exemption, $.
Total income of claimant, during taxable year to date, from sources within the United States (item X from above)..........

Balance of credit (item Y minus item X)...................... ‡.

I swear (or affirm) that the above is, to the best of my knowledge and belief, a true and complete statement of facts in connection with the claim for credits above made.

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Form 1115

Claim by Nonresident Alien Employee for
Exemption from Withholding

Form 1115 may be filed by nonresident alien employees with their employers to claim credit for personal exemption, and credit for dependents, or both, in the collection of salary, wages, or other fixed or determinable annual or periodical compensation. A nonresident alien individual is permitted to claim such credit only if the country of which he is a citizen or subject allows a similar credit for personal exemption or credit for dependents, as the case may be, and allows it without discrimination to citizens of the United States not residing in such country. To satisfy the requirements of a "similar credit" it is not necessary that the personal exemption or credit for dependents should be the same as that allowed by the United States statute. For list of foreign countries, citizens or subjects of which are entitled to exemptions, see pages 7 and 8.

Every employer who receives Form 1115, duly filled out and executed under oath, should examine it, and if it appears that the claim is in due form, that it contains no statement which to the knowledge of the employer is untrue, that such employee on the face of the claim is entitled to credit, and that such credit has not been exhausted, the employer need not, until such credit is in fact exhausted, withhold any tax from payments of salary or wages made to such employee.

All affidavits on Form 1115 should be preserved by the employer until the following calendar year and should then be filed with his annual withholding return on Form 1042 with the collector on or before March 1. In case, however, the employer has no withholding to return, all such affidavits of claim so filed with him by employees should be filed directly with the Commissioner of Internal Revenue (Sorting Division), Washington, D.C. with a letter of transmittal on or before March 15.

In all other cases benefit of the credits allowed against net income for the purpose of the normal tax may not be received by a nonresident alien by filing a claim with the withholding agent, but only by claiming them upon filing a return of income in prescribed form.

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