F
N-2
STATE OF HAWAII — DEPARTMENT OF TAXATION
O
R
INDIVIDUAL HOUSING ACCOUNT
(REV. 2004)
M
Type or machine print Payer's name
1. TOTAL AMOUNT WITHDRAWN FOR PURCHASE OF FIRST PRINCI-
PAL RESIDENCE AND HELD FOR LESS THAN 365 DAYS IN THE
IHA.
Street Address
2. TOTAL AMOUNT WITHDRAWN FOR OTHER THAN PURCHASE OF
__
FIRST PRINCIPAL RESIDENCE AND HELD FOR LESS THAN 365
20
DAYS IN THE IHA.
City, State and ZIP Code
3. TOTAL AMOUNT WITHDRAWN FOR OTHER THAN PURCHASE OF
FIRST PRINCIPAL RESIDENCE AND HELD FOR 365 DAYS OR
Federal Employer I.D. No.
This information is
MORE IN THE IHA.
being furnished to the
STATE OF HAWAII
Type or machine print Recipient's name (First, Middle, Last)
4. WITHHOLDING. (10% OF LINES 2 & 3 ABOVE)
DEPARTMENT OF
TAXATION
Street Address
Please see note on
5. TOTAL PAYMENT.
back of this copy
City, State and ZIP Code
Copy C
Social Security Number
For Recipient
Attach to Return
Form N-2
F
N-2
STATE OF HAWAII — DEPARTMENT OF TAXATION
O
R
INDIVIDUAL HOUSING ACCOUNT
(REV. 2004)
M
Type or machine print Payer's name
1. TOTAL AMOUNT WITHDRAWN FOR PURCHASE OF FIRST PRINCI-
PAL RESIDENCE AND HELD FOR LESS THAN 365 DAYS IN THE
IHA.
Street Address
2. TOTAL AMOUNT WITHDRAWN FOR OTHER THAN PURCHASE OF
__
FIRST PRINCIPAL RESIDENCE AND HELD FOR LESS THAN 365
20
DAYS IN THE IHA.
City, State and ZIP Code
3. TOTAL AMOUNT WITHDRAWN FOR OTHER THAN PURCHASE OF
FIRST PRINCIPAL RESIDENCE AND HELD FOR 365 DAYS OR
Federal Employer I.D. No.
This information is
MORE IN THE IHA.
being furnished to the
STATE OF HAWAII
Type or machine print Recipient's name (First, Middle, Last)
4. WITHHOLDING. (10% OF LINES 2 & 3 ABOVE)
DEPARTMENT OF
TAXATION
Street Address
Please see note on
5. TOTAL PAYMENT.
back of this copy
City, State and ZIP Code
Copy C
Social Security Number
For Recipient
Attach to Return
Form N-2
F
N-2
STATE OF HAWAII — DEPARTMENT OF TAXATION
O
R
INDIVIDUAL HOUSING ACCOUNT
(REV. 2004)
M
Type or machine print Payer's name
1. TOTAL AMOUNT WITHDRAWN FOR PURCHASE OF FIRST PRINCI-
PAL RESIDENCE AND HELD FOR LESS THAN 365 DAYS IN THE
IHA.
Street Address
2. TOTAL AMOUNT WITHDRAWN FOR OTHER THAN PURCHASE OF
__
FIRST PRINCIPAL RESIDENCE AND HELD FOR LESS THAN 365
20
DAYS IN THE IHA.
City, State and ZIP Code
3. TOTAL AMOUNT WITHDRAWN FOR OTHER THAN PURCHASE OF
FIRST PRINCIPAL RESIDENCE AND HELD FOR 365 DAYS OR
Federal Employer I.D. No.
This information is
MORE IN THE IHA.
being furnished to the
STATE OF HAWAII
Type or machine print Recipient's name (First, Middle, Last)
4. WITHHOLDING. (10% OF LINES 2 & 3 ABOVE)
DEPARTMENT OF
TAXATION
Street Address
Please see note on
5. TOTAL PAYMENT.
back of this copy
City, State and ZIP Code
Copy C
Social Security Number
For Recipient
Attach to Return
Form N-2