Form 14n-2006 - Statement Of Nebraska Income Tax Withheld For Nonresident Individual Form

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STATEMENT OF NEBRASKA INCOME TAX WITHHELD
FORM 14N
FOR NONRESIDENT INDIVIDUAL
2006
nebraska
RESET FORM
department
• Read instructions on reverse side
of revenue
ORGANIZATION’S NAME AND MAILING ADDRESS
NONRESIDENT INDIVIDUAL’S NAME AND MAILING ADDRESS
Name
Name
Street or Other Mailing Address
Street or Other Mailing Address
City, Town, or Post Office
State
Zip Code
City, Town, or Post Office
State
Zip Code
Nebraska Identification Number
Federal Identification Number
Social Security Number
Spouse’s Social Security Number
1 Income subject to withholding for nonresident individual
Check One:
(from Schedule II, col. E, Form 1041N; Schedule III, col.
Estate or Trust
S Corporation
Partnership
Limited Liability Co.
E, Form 1065N; or Schedule III, col. E, Form 1120-SN .... $
Taxable Year of Organization
2 Amount of Nebraska income tax withheld and remitted
Beginning
, 20
and Ending
, 20
(6.84% of the amount on line 1) (See instructions) ........... $
TO BE FILED IN THE ABSENCE OF FORM 12N, NEBRASKA NONRESIDENT INCOME TAX AGREEMENT
Attach to Organization’s Nebraska Tax Return —White Copy
Nonresident Individual — Attach to Form 1040N — Canary Copy
MAKE A COPY FOR YOUR RECORDS.
8-282-2006
INSTRUCTIONS
WHO MUST FILE. Every estate, trust, S corporation, partnership
Income Tax Return, Form 1040N, with the Nebraska Department of
which is not a publicly traded partnership, or limited liability company
Revenue, P.O. Box 98911, Lincoln, Nebraska 68509-8911. The amount
must complete the Statement of Nebraska Income Tax Withheld for
entered on line 2, Form 14N, will be allowed as a credit against the
Nonresident Individual, Form 14N, for each nonresident individual
taxpayer’s Nebraska income tax liability and should be claimed as
beneficiary, partner, member, or shareholder who did not complete a
Nebraska income tax withheld on Form 1040N. Attach the pink copy
Nebraska Nonresident Income Tax Agreement, Form 12N. Do not file
of Form 14N to the Form 1040N in the space otherwise provided for
Form 14N for entities other than individuals.
attaching Wage and Tax Statement, Federal Form W-2.
WHEN AND WHERE TO FILE. The Form 14N and remittance must
Nonresidents are not required to file Form 1040N if:
accompany the organization’s Nebraska income tax return when filed
1.
Their only connection with Nebraska is conduct of the
with the Nebraska Department of Revenue, P.O. Box 98911, Lincoln,
business activities of the organization; and
Nebraska 68509-8911.
2.
The organization has withheld tax from all the Nebraska
Visit our Web site: , or call 1-800-742-7474 (toll
income attributable to the nonresident’s share of the
free in NE and IA) or 1-402-471-5729.
organization’s income.
AMOUNT OF WITHHOLDING. The amount withheld is 6.84% of
the amount subject to withholding. The total of line 2 entries from each
Instead, the full amount of the withholding may, at the taxpayer’s option,
be retained in lieu of the filing of Form 1040N.
Form 14N should equal the amount entered on the Nebraska Fiduciary
Income Tax Return, Form 1041N; the Nebraska Partnership Return of
A nonresident taxpayer who has a taxable year different from the
Income, Form 1065N; or the Nebraska S Corporation Income Tax Return,
taxable year shown on the Form 14N for the estate, trust, S corporation,
Form 1120-SN.
partnership, or limited liability company is to claim the income and
NONRESIDENT INDIVIDUAL. Except as noted below, the nonresident
withholding on Form 1040N by attaching the Form 14N with a taxable
taxpayer named on this Form 14N is required to file a Nebraska Individual
year ending during the individual’s taxable year.

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