RI-1120
Schedule SN
RHODE ISLAND NONRESIDENT INCOME TAX AGREEMENT
For Nonresident Shareholder of Subchapter S Corporations
and Limited Liability Companies
Nonresident’s Taxable Year
Beginning
Ending
Nonresident’s First Name and Initial, Last Name
Social Security #
Home Address (Number and Street or Rural Route)
Spouse’s Social Security #
City or Town, State and Zip Code
Name of Organization
Federal I.D. Number
Street or Other Mailing Address
City, State, Zip Code
Taxable Year of Organization
Beginning
Ending
I declare that I am a nonresident of Rhode Island, and hereby agree that I will timely file a Rhode Island Nonresident
Individual Income Tax Return; pay any income tax due; and that I will include in Rhode Island adjusted gross income
that portion of the above-named organization’s Rhode Island income attributable to my interest in said organization for
the indicated taxable year. This agreement shall be binding upon my heirs, representatives assigns, successors,
executors and administrators.
SIGNATURE
DATE
GENERAL INSTRUCTIONS
WHO SHOULD FILE: Any individual who has Rhode Island source income derived from a subchapter S corporation/LLC
and was a nonresident of Rhode Island during any part of the organization’s tax year must complete a Rhode Island
Nonresident Income Tax Agreement, Form RI-1120-Schedule SN. If this form is missing for any nonresident shareholder
or if the nonresident shareholder subsequently fails to file his/her Rhode Island personal income tax return, the corpora-
tion will be required to remit nine percent (9%) of the nonresident’s share of the corporation’s income attributable to
Rhode Island sources. Remittance by the corporation does not relieve the nonresident from filling his/her Rhode Island
personal income tax return. Corporations making payments on behalf of individual, nonresident shareholders must do so
using a separate RI1040ES form and check for each taxpayer for whom payment is being made. When the nonresident
does file his/her return, the remittance submitted by the organization will be allowed as a credit against his/her Rhode
Island income tax liability.
ATTACH THIS AGREEMENT TO THE ORGANIZATION’S RHODE ISLAND BUSINESS
CORPORATION TAX RETURN