California Resident and Nonresident Withholding Statement

Resident and Nonresident Withholding Statement
2023 Form 592 Resident and Nonresident Withholding Statement
Resident and Nonresident
Withholding Statement

TAXABLE YEAR

2023
Amended:•
Due Date:

□

Prior Year Distribution •

•

□

April 18, 2023

Part I Withholding Agent Information

□
□

June 15, 2023

CALIFORNIA FORM

592
□

□

September 15, 2023

January 16, 2024

□ SSN or ITIN □ FEIN □ CA Corp no. □ CA SOS file no.

Business name
First name

Initial Last name

Telephone

Address (apt./ste., room, PO box, or PMB no.)
City (If you have a foreign address, see instructions.)

State

ZIP code

Total Number of Payees

Part II

Type of Income

Check all that apply .

•

A □ Payments to Independent Contractors

D □ Distributions to Domestic Nonresident

B □ Trust Distributions
C □ Rents or Royalties
Part III

Partners/Members/Beneficiaries/
S Corporation Shareholders

E □ Estate Distributions

F □ Elective Withholding
G □ Elective Withholding by Indian Tribe
I

□

Other______________________

Tax Withheld

1 Total tax withheld from Schedule of Payees, excluding backup withholding
(Side 2 and any additional pages)  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .

◾1

.

2 Total backup withholding (Side 2 and any additional pages)  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .

◾2

.

3 Add line 1 and line 2. This is the total amount of tax withheld  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .

◾3

.

4 Amount of prior payments not previously distributed  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .

◾4

.

5 Amount withheld by another entity and being distributed  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .

◾5

.

6 Add line 4 and line 5. This is the total amount of payments  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .

◾6

.

7 Total Withholding Amount Due. Subtract line 6 from line 3 . Remit the withholding payment with
Form 592-V, along with Form 592 .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .

◾7

.

Our privacy notice can be found in annual tax booklets or online . Go to ftb.ca.gov/privacy to learn about our privacy policy statement, or go to ftb.ca.gov/
forms and search for 1131 to locate FTB 1131 EN-SP, Franchise Tax Board Privacy Notice on Collection . To request this notice by mail, call 800 .338 .0505 and
enter form code 948 when instructed .
Under penalties of perjury, I declare that I have examined this form, 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
Preparer’s
Use Only

Print or type withholding agent's name

Telephone

Withholding agent's signature

Date

▶

Print or type preparer’s name

Preparer's PTIN

Preparer's signature

Date

▶

Preparer’s address

Telephone

7081233

Form 592 2022

Side 1

Withholding Agent Name: ______________________________________ Withholding Agent TIN:__________________

Schedule of Payees (Enter business or individual name, not both .)
Business name

PRINT CLEARLY
□ FEIN □ CA Corp no . □ CA SOS file no .

First name

Initial

Last name

SSN or ITIN

Address (apt ./ste ., room, PO box, or PMB no .)
City (If you have a foreign address, see instructions .)
Total income

□

.

State

ZIP code

Amount of tax withheld
If backup withholding, check the box .

Business name

.
□ FEIN □ CA Corp no . □ CA SOS file no .

First name

Initial

Last name

SSN or ITIN

Address (apt ./ste ., room, PO box, or PMB no .)
City (If you have a foreign address, see instructions .)
Total income

□

.

State

ZIP code

Amount of tax withheld
If backup withholding, check the box .

Business name

.
□ FEIN □ CA Corp no . □ CA SOS file no .

First name

Initial

Last name

SSN or ITIN

Address (apt ./ste ., room, PO box, or PMB no .)
City (If you have a foreign address, see instructions .)
Total income

□

.

State

ZIP code

Amount of tax withheld
If backup withholding, check the box .

Business name

.
□ FEIN □ CA Corp no . □ CA SOS file no .

First name

Initial

Last name

SSN or ITIN

Address (apt ./ste ., room, PO box, or PMB no .)
City (If you have a foreign address, see instructions .)
Total income

.

Side 2

Form 592 2022

□

State

ZIP code

Amount of tax withheld
If backup withholding, check the box .

7082233

.