File Form 1042 — Annual Withholding Tax Return for U.S. Source Income of Foreign Persons

The withholding agent's annual return for tax withheld on U.S. source FDAP income paid to foreign persons, under chapters 3 and 4.

$5 per filing — $4 each (filings 101–200), $3 each (filings 201–500), $2 each (filings 501–1000), $1 each (filings 1001+) once you file that many with us in a year (a person reviews and files every return). Currently in preview — data collection is live and e-file is in progress.

Withholding agent

This is an amended return

Name of withholding agent

EIN

In care of (optional)

Daytime phone

Ch. 3 status code (required)

Ch. 4 status code (required)

Number and street

Room or suite no.

City or town

State or province

Country

ZIP or foreign postal code

Final return — I don't expect to file this return in the future

Section 1 — Record of Federal Tax Liability

Enter the tax liability for each quarter-monthly period and the monthly total (whole dollars). Do not show federal tax deposits here.

January

Jan 7

Jan 15

Jan 22

Jan 31

Jan total

February

Feb 7

Feb 15

Feb 22

Feb last day

Feb total

March

Mar 7

Mar 15

Mar 22

Mar 31

Mar total

April

Apr 7

Apr 15

Apr 22

Apr 30

Apr total

May

May 7

May 15

May 22

May 31

May total

June

Jun 7

Jun 15

Jun 22

Jun 30

Jun total

July

Jul 7

Jul 15

Jul 22

Jul 31

Jul total

August

Aug 7

Aug 15

Aug 22

Aug 31

Aug total

September

Sep 7

Sep 15

Sep 22

Sep 30

Sep total

October

Oct 7

Oct 15

Oct 22

Oct 31

Oct total

November

Nov 7

Nov 15

Nov 22

Nov 30

Nov total

December

Dec 7

Dec 15

Dec 22

Dec 31

Dec total

Gross amounts reported (lines 61–62)

61a. No. of Forms 1042-S filed on paper

61b. No. of Forms 1042-S filed electronically

62a. Total U.S. source FDAP income (other than substitute payments)

62b(1). Total U.S. source substitute dividend payments

62b(2). Total U.S. source substitute payments other than substitute dividends

62c. Total gross amounts reported (add 62a–b)

62d. Gross amounts actually paid (if different from reported)

63. Total tax reported as withheld or paid

63a. Tax withheld by withholding agent

63b(1). Tax withheld by other agents — payments other than substitute dividends

63b(2). Tax withheld by other agents — substitute dividends

63c(1). Adjustments to overwithholding

63c(2). Adjustments to underwithholding

63d. Tax paid by withholding agent

63e. Total tax reported as withheld or paid (add 63a–d)

Computation of Tax Due or Overpayment (lines 64–71)

64a. Adjustments to total net tax liability

64b. Total net tax liability under chapter 3

64c. Total net tax liability under chapter 4

64d. Excise tax on specified federal procurement payments (× 2%)

64e. Total net tax liability (add 64a–d)

65a. Total paid by EFT during the calendar year

65b. Total paid by EFT during the subsequent year

66. Overpayment applied as credit from 2024 Form 1042

67a. Credit for amounts withheld by other agents — other than substitute dividends

67b. Credit for amounts withheld by other agents — substitute dividends

68. Total payments (add 65 through 67)

Enter either a balance due (69) or an overpayment (70a/70b) — the return reports one or the other.

69. Balance due (if 64e is larger than 68)

70a. Overpayment attributable to overwithholding on U.S. source income

70b. Overpayment attributable to excise tax on federal procurement payments

71a. Apply overpayment to

71b. Routing number

71c. Account type

71d. Account number

Section 2 — Reconciliation of Payments of U.S. Source FDAP Income

1. Total FDAP income required to be withheld upon under chapter 4

2. Reportable under chapter 4 but not required to be withheld upon because:

2a. Income paid to recipients whose chapter 4 status established no withholding required

2b. Excluded nonfinancial payments

2c. Income paid with respect to grandfathered obligations

2d. Income effectively connected with a U.S. trade or business

2e. Total not required to be withheld upon (add 2a–d)

3. Total FDAP income reportable under chapter 4 (add 1 and 2e)

4. Total FDAP income reported on all Forms 1042-S (62a, 62b(1), 62b(2))

5. Total variance (line 4 minus line 3)

6. Explanation (if variance is not zero)

Sections 3 & 4

Section 3 — Payments were made under a potential section 871(m) transactionSection 4 — Payments were made by a Qualified Derivatives Dealer (QDD)

Allow another person to discuss this return with the IRS

Signature

Your name

Capacity in which acting

Date

Daytime phone

Taxpayer PIN (5 digits, for PIN signing)

Email (optional)

A paid preparer completed this return