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YEAR Withholding Exemption Certificate and <br />CALIFORNIA FORM <br />Nonresident Waiver Request for Real Estate Sales 597-W <br />Der* 1 Cn/lnr'e Infnrrnlinn <br />Name <br />^ <br />Social Security Number/California Corporation NoJFEIN <br />Street Address <br />/20a <br />�� �o� <br />�•.e. s'�,xc 2�' <br />PMB no. <br />City, State, ZIP Code /+ <br />C.�o C. <br />Q /� <br />7 �{ ��t d <br />Phone Number <br />9Zs �, Z S'� Z. <br />Ownership <br />Percentage <br />Property Address (if n street address, provide parcel number and county) <br />H903 C-ATaL-, ti�2 rf� ,-� L N�) G <br />Buyer's Information <br />Name I Social Security Number/California Corporation NoJFEIN <br />C=r OF 1— N <br />Street Address PMB no. <br />City, State, ZIP Code Phone Number <br />If there is more than one seller, attach a separate sheet listing additional seller's information. <br />Read the following and check the boxes as they apply to the seller (see General Information C, Exemptions from <br />Withholding (Part 1) for definitions and details for each area): <br />YES <br />1. Is the total sales price of this property $100,000 or less?............................................................ <br />ElxX <br />xNOO <br />2. Are you a resident of California?................................................................................ <br />X <br />❑ <br />3. Does the property being sold qualify as your principal residence?..................................................... <br />❑ <br />X <br />4. Are you a corporation registered in California or that has a permanent place of business in California? ....................... <br />❑ <br />5d <br />5. Are you a partnership or a limited liability company with recorded title to the <br />property in the name of the partnership or limited liability company? .................................................. <br />❑ <br />6. Are you a tax-exempt entity?................................................................................... <br />❑ <br />X <br />7. Are you an irrevocable trust with at least one trustee who is a California resident? ........................................ <br />❑ <br />8. Are you an estate where the decedent was a California resident at the time of death? ...................................... <br />❑ <br />ary for a trust?........................................................... <br />9. Are you a bank or a bank ac;IRA, <br />❑ <br />�i <br />10. Are you an insurance compaalified pension/profit sharing plan?...........................................Under <br />penalties of perjury,I herethe i form n rovided above is, to the best of my knowledge, true and correct. If conditions <br />change, <br />I will <br />promptly inform the withholdingst th o eting this form does not exempt me from filing a California income tax return <br />to report <br />this sale. <br />Seller's Signature Date: <br />If you answered "YES" to any of the above questions, STOP HERE. You are exempt from the nonresident withholding requirements. Provide this form to <br />your escrow company or the buyer (withholding agent). <br />If you answered "NO" to all of the above questions, you are subject to the nonresident withholding requirements. The required withholding is 3 1/3% of the <br />total sales price. Do you believe that your estimated tax liability from the sale of this property will be less than the required withholding amount? <br />❑ Yes. Complete the Waiver Request Section on Side 2 and send this form to the Franchise Tax Board. <br />❑ No. STOP HERE. Your escrow person will withhold 3 1/3% of the total sales price and send it to the Franchise Tax Board on your <br />behalf. Obtain the seller's copy of Form 597, Nonresident Withholding Tax Statement for Real Estate Sales, to attach to your <br />California income tax return when you file and claim the withholding amount. <br />For Privacy Act Notice, get form FTB 1131 <br />-1 597W99109 F_ <br />Form 597-W (NEW 1999) Pagel <br />