Form Withholding 2011

Or suite no. 6 Person subject to withholding is City province or state postal code and country not U.S. Form 8288-A Rev. 6-2011 Cat. No. 62261L 7 Country code An individual Other specify Mailing address of person subject to withholding if different Attach Copies A and B to Form 8288 Copy A For Internal Revenue Service Center For Privacy Act and Paperwork Reduction Act Notice see the Instructions for Form 8288. Withholding agent s name street address city state and ZIP code 1 Date of transfer Statement of Withholding on Dispositions by Foreign Persons of U*S* Real Property Interests 2 Federal income tax withheld OMB No* 1545-0902 identification number subject to withholding see instructions 3 Amount realized 4 Gain recognized by foreign corporation Name of person subject to withholding 5 Description of property transferred Foreign address number street and apt. Department of the Treasury - Internal Revenue Service Form 8288-A Rev* 6-2011 Copy B Send to For Use by Person Subject to This information is being furnished to the Internal Revenue Service. Generally if you are a foreign person that disposes of real property located in the United States as seller or transferor the buyer or other transferee must withhold 10 of the amount realized* Certain foreign interest holders that are beneficiaries or shareholders are subject to You must file a U*S* tax return Form 1040NR 1041 1065 1065-B or 1120-F to report the sale or other disposition as effectively connected with the conduct of a trade or business in the United States. To receive credit for any federal income tax withheld shown in box 2 attach Form 8288-A to your tax return unless you make a request for early refund. Foreign partnerships other than publicly traded partnerships should report the withholding on Form 8804 Annual Return for Partnership Withholding Tax Section 1446 and attach Form 8288-A. Publicly traded partnerships and nominees of such partnerships should use Forms 1042 and 1042-S to report the withholding. See Pub. 515 519 U*S* Tax Guide for Aliens for more information* If the amount shown in box 2 is greater than your maximum tax liability you may apply for an early refund. However you must still file your tax return when due. To apply for an early refund you must first get a withholding certificate. No particular form is required for an application for early refund but it must include the following information in separate paragraphs numbered as shown below 1. Your name address and U*S* taxpayer identification number 2. The amount required to be withheld as stated in the withholding certificate issued by the IRS 3. The amount withheld shown in box 2 attach a copy of this Form 8288-A and 4. The amount to be refunded* Send your application for a withholding certificate and/or application 84409. See Pub. 515 and Form 8288-B Application for Withholding Certificate for Dispositions by Foreign Persons of U*S* Real Property Interests for information about withholding certificates. Keep for your records Copy C Agent Prepare Form 8288-A for each foreign person subject to withholding.