Burden Computation Form 1042-S

Burden Computation Form 1042-S rev2015 .pdf

Dividend Equivalents from Sources within the United States (REG-120282-10 & 127895-14) & Forms 1042, 1042-S and 1042-T

Burden Computation Form 1042-S

OMB: 1545-0096

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Burden Computation - Special Business Forms
Page 1 of 1

August 19, 2015

Product:
Description:
Variables
Responses.......
Line Items......
Forms Prepared..

1042S/
Foreign Person's U.S. Source Income Subject to Withholding
2014

Changes (+ -)

2015

3,525,300
______________
37
______________
0.85
______________

_____________________________
_____________________________
_____________________________

3,525,300
______________
37
______________
0.85
______________

Computation of Changes
3,525,300 x _____________
0.58
Old Computation (Prog. Change) ______________
3,525,300 x _____________
0.58
New Computation.............. ______________
Balance...

=
=

2,044,674
_______________
2,044,674
_______________
0
_______________

Old Computation (Adjustment)
New Computation..............
Balance...

3,525,300 x _____________
0.58
______________
______________
3,525,300 x _____________
0.58

=
=

2,044,674
_______________
_______________
2,044,674
0
_______________

Old Computation..............
New Computation..............
Balance...

______________ x _____________
______________ x _____________

=
=

_______________
_______________
_______________

Summary
Old Burden...................................................
Program Change...............................................
Adjustment...................................................
New Burden...................................................

2,044,674
_______________
0
_______________
0
_______________
2,044,674
_______________

Paperwork Reduction Act Notice
Time Per Response
0.58
Record Keeping............
Learning..................
Preparing.................
Sending...................

Notes:

Average Hours
Per Response
______________
______________
______________
0.58
______________

Average Time
Per Response
___________________
___________________
___________________
0 hrs. , 34 min.
___________________


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