California Real Estate Withholding Installment Sale Acknowledgement

Real Estate Withholding Installment Sale Acknowledgement
2019 Form 593-I Real Estate Withholding Installment Sale Acknowledgement
TAXABLE YEAR

2019

Real Estate Withholding Installment
Sale Acknowledgement

CALIFORNIA FORM

593-I

This form should only be completed by the buyer/transferee.
Part I – Buyer/Transferee Information
First name

Initial Last name

SSN or ITIN

Spouse’s/RDP’s first name (if jointly purchased)

Initial Last name

Spouse’s/RDP’s SSN or ITIN

-

-

 FEIN    CA Corp no.   CA SOS file no.

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

State

ZIP code

Part II – Seller/Transferor Information

Daytime telephone number

-

(

     )

-

First name

Initial Last name

SSN or ITIN

Spouse’s/RDP’s first name (if jointly sold)

Initial Last name

Spouse’s/RDP’s SSN or ITIN

-

-

 FEIN    CA Corp no.   CA SOS file no.

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

State

ZIP code

Property address (if no street address, provide parcel number and county)

Installment Withholding Percent Apply this percent

-

to all installment
payments.

____ ____ . ____ ____%	

Part III – Installment Agreement Terms (See instructions.)
Principal Amount of Promissory Note

,

,

Installment Amount

.

,

Interest Rate

,

.

.

Repayment Period

%

Number of months

Part IV – Buyer’s/Transferee’s Acknowledgement to Withhold (Read the “Buyer/Transferee” information below before you sign.)
To learn about your privacy rights, how we may use your information, and the consequences for not providing the requested information, go to ftb.ca.gov/forms
and search for 1131. To request this notice by mail, call 800.852.5711.
I acknowledge that I am required to withhold on the principal portion of each installment payment to the seller/transferor for the above shown California real
property either at the rate of 31/3% (.0333) of the total sales price or the Optional Gain on Sale withholding percentage, as specified by the seller/transferor on
Form 593, Real Estate Withholding Tax Statement, of the principal portion of each installment payment. I will complete Form 593 for the principal portion of
each installment payment and send one copy of each to the Franchise Tax Board along with Form 593-V, Payment Voucher for Real Estate Withholding, the
withholding payment, and give one copy of Form 593 to the seller/transferor. I will send each withholding payment to the Franchise Tax Board by the 20th day
of the month following the month of the installment payment. If the terms of the installment sale, promissory note, or payment schedule change, I will promptly
inform the Franchise Tax Board. I understand that the Franchise Tax Board may review relevant escrow documents to ensure withholding compliance. I also
understand that I am subject to withholding penalties if I do not withhold on the principal portion of each installment payment and do not send the withholding
along with Form 593 to the ­Franchise Tax Board by the due date, or if I do not send one copy of Form 593 to the seller/transferor by the due date.
Print name and title______________________________________________________________________________________________________________
Buyer’s/Transferee’s signature__________________________________________________________________________ Date ________________________
It is unlawful to forge
a spouse’s/RDP’s
signature.

Buyer’s/Transferee’s spouse’s/RDP’s name (if on title) ____________________________________________________________________
Buyer’s/Transferee’s spouse’s/RDP’s signature (if applicable) __________________________________ Date __________________________

	
Buyer/
Transferee:

Make sure you copy all pages so you will have the instructions for withholding on subsequent payments. Provide the original Form 593-I,
along with copies of the promissory note and seller’s/transferor’s Form 593, to your real estate escrow person (REEP), who will mail the
forms and remit the payment to the Franchise Tax Board. Your REEP will withhold on the down payment. You must withhold on the principal
portion of all subsequent installment payments (including payoff or balloon payments). Complete Form 593 and Form 593-V, and mail the
documents and payment to the Franchise Tax Board for the principal portion of each installment payment.

	
Seller/
Transferor:

Make a copy of this form for your records.

REEP:
	

Make a copy of this form for your records. Mail Form 593-V, the original Form 593-I, a copy of the promissory note, and seller’s/transferor’s
Form 593 to the Franchise Tax Board with the required amount of the down payment.

7141193

Form 593-I 2018