Form Pwh-Wa - Performer Or Performing Entity Withholding Allocation Form - Massachusetts Department Of Revenue - Massachusetts

Form PWH-WA

Massachusetts

Performer or Performing Entity

Department of

Withholding Allocation Form

Revenue

Withholding agent: Fill in your name and name of performer or performing entity. Provide this form to each performer and performing entity you have

a contract with. Keep a copy for your records.

Performing entity: Fill in your name and name of each member or participant. Provide this form to each member or participant. Keep a copy for your

records.

Member or participant: Enclose this form with your completed Form 1 or Form 1-NR/PY.

Do not enclose this form with, or claim the payment being submitted with it, on your corporate excise tax return.

Name of designated withholding agent

Massachusetts Tax Registration number

Address

City/Town

State

Zip

Name of performer or performing entity

Social Security or Federal Identification number

Address

City/Town

State

Zip

Name of member or participant

Social Security or Federal Identification number

Address

City/Town

State

Zip

Name of venue

Date(s) of performance

1 Income subject to withholding . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

2 Total Massachusetts tax withheld . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2