California Form 592 Draft - Resident And Nonresident Withholding Statement 2010 - Page 2
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2Resident and Nonresident Withholding Statement
Withholding Agent (Payer) name: ______________________________ Withholding Agent ID no.:__________________
Schedules of Payees
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Business name
m SSN or ITIN m FEIN m CA Corp no.
Payee’s first name
Initial Last name
DBA (if applicable)
Address (number and street, suite, APT, PO Box, or PMB no.)
City
State
Zip Code
Total Income
Amount of Tax Withheld
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.
00
00
,
,
,
,
Business name
m SSN or ITIN m FEIN m CA Corp no.
Payee’s first name
Initial Last name
DBA (if applicable)
Address (number and street, suite, APT, PO Box, or PMB no.)
City
State
Zip Code
Total Income
Amount of Tax Withheld
.
.
,
,
00
,
,
00
Business name
m SSN or ITIN m FEIN m CA Corp no.
Payee’s first name
Initial Last name
DBA (if applicable)
Address (number and street, suite, APT, PO Box, or PMB no.)
City
State
Zip Code
Total Income
Amount of Tax Withheld
.
.
,
,
00
,
,
00
Business name
m SSN or ITIN m FEIN m CA Corp no.
Payee’s first name
Initial Last name
DBA (if applicable)
Address (number and street, suite, APT, PO Box, or PMB no.)
City
State
Zip Code
Total Income
Amount of Tax Withheld
.
.
,
,
00
,
,
00
.
,
,
00
Total Tax Withheld this page . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Side 2 Form 592
2009
7082103
C3
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