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

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

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1545-0096 can be found here:

Documents and Forms

Document Name Document Type
Form 1042-S Foreign Person's U.S. Source Income Subject to Withholding Form
Instr 1042-S--2015.pdf Instruction
1042-S Foreign Person's U.S. Source Income Subject to Withholdi Form 1042-S--2015.pdf Form
Burden Computation Form 1042-S rev2015 .pdf Burden Computation Form 1042-S IC Document

Information Collection (IC) Details

IC Title:	Foreign Person's U.S. Source Income Subject to Withholding	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	1042-S	Foreign Person's U.S. Source Income Subject to Withholding	Form 1042-S--2015.pdf		Yes	Yes	Fillable Fileable
Instruction			Instr 1042-S--2015.pdf		Yes	No	Printable Only

Line of Business: General Government

Subfunction: Taxation Management

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 22,000	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 90 %

	Approved	Previously Approved
Annual Number of Responses for this IC	3,525,300	3,525,300
Annual IC Time Burden (Hours)	2,044,674	2,044,674
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Burden Computation Form 1042-S	Burden Computation Form 1042-S rev2015 .pdf	08/19/2015

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.