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PASSTHROUGH ENTITY WITHHOLDING -
NONRESIDENT MEMBER ADJUSTMENT
OFFICE OF STATE TAX COMMISSIONER Form PWA
SFN 28728 (8-2021)
2021
Part 1 - To be completed by nonresident member
Nonresident Member Name Social Security Number (or FEIN)
1. Estimated North Dakota distributive share of income or estimated total North Dakota taxable
income, whichever is smaller 1
2. Multiply line 1 by 2.90% (.029) 2
3. a. Estimated North Dakota income tax paid 3a
b. Additional North Dakota income tax withheld from wage income 3b
4. Withholding adjustment amount. Add lines 3a and 3b 4
5. Amount to withhold. Subtract line 4 from line 2 5
I declare, under penalty of perjury, that this form is correct and complete to the best of my knowledge and belief.
Nonresident Member's Signature Date
Part 2 - To be completed by passthrough entity
Passthrough Entity Name Federal Employer Identification Number
Tax year for which this adjustment applies. If the passthrough entity and the nonresident member have different tax years, specify
the tax year of the passthrough entity to which the adjustment applies.
Calendar year 2021 OR Fiscal year beginning 2021, and ending ,
A “nonresident member” means an
Purpose of form individual who is not domiciled in North Specific instructions for
Under North Dakota Century Code Dakota, a trust that is not organized in passthrough entity
(N.D.C.C.) § 57-38-31.1, a passthrough North Dakota, or a passthrough entity that
entity is required to withhold North Dakota does not have a commercial domicile in If you receive Form PWA from a
income tax at the rate of 2.90% from North Dakota. nonresident member, do the following:
a nonresident member’s North Dakota A “passthrough entity” means a 1. Complete Part 2.
distributive share of income if (1) it is partnership (all types), S corporation,
$1,000 or more and (2) it is not included trust, limited liability company not taxed as 2. Only withhold the amount shown in
in a composite return. If eligible, a a C corporation, or other entity not taxed Part 1, line 5, from the nonresident
nonresident member may request that an at the entity level for North Dakota income member’s North Dakota distributive
amount less than the statutory amount tax purposes. share of income for the specified tax
year.
be withheld by completing and submitting Exemption for certain members. If
Form PWA to the passthrough entity. the nonresident member is a passthrough 3. Fill in the circle under “Form PWA or
entity, the member may be eligible to elect Form PWE” for the nonresident member
General instructions to exempt its North Dakota distributive on your North Dakota income tax
share of income from North Dakota income return as follows—
A nonresident member is eligible to use tax withholding. See Form PWE for more If filing Form 38 (fiduciary return),
Form PWA if any of the following apply: information. see Schedule BI, Column 6.
The member already paid estimated If filing Form 58 (partnership return),
North Dakota income tax on the North see Schedule KP, Column 7.
Dakota distributive share of income. Specific instructions for If filing Form 60 (S corporation
nonresident member return), see Schedule KS, Column 7.
The member had additional North Dakota Complete Part 1 of Form PWA. On line 3, 4. Attach a copy of Form PWA to your
income tax withheld from wage income the North Dakota income tax paid or North Dakota income tax return.
to cover the tax expected to be owed on withheld must be for the same tax year Keep the original signed copy for your
the North Dakota distributive share of that your North Dakota distributive share records.
income. of income is reportable on your North
The member will have a North Dakota Dakota income tax return. Submit the Privacy Act Notification. In compliance
taxable income less than the North completed Form PWA to the passthrough with the Privacy Act of 1974, disclosure of a
Dakota distributive share of income entity before the last day of the social security number or Federal Employer
because of an offsetting North Dakota passthrough entity’s tax year to which the Identification Number (FEIN) on this form is
required under N.D.C.C. §§ 57-01-15 and
loss or adjustment to income on the adjustment it is to apply. 57-38-31.1, and will be used for tax reporting,
member’s North Dakota income tax identification, and administration of North Dakota
return. tax laws. Disclosure is mandatory. Failure to
provide the social security number or FEIN may
delay or prevent the processing of this form.
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