Statement of Withholding Under Section 1446(f)(4) for Withholding on Dispositions by Foreign Persons of Partnership Interests

UniqueFormIdentifier
Name of Withholding Agent (Partnership)

FCheckifSubsequentDistribution

DistributionNumber

U.S. Employer Identification Number (EIN) 1 Date of transfer

Street address, city, state, and ZIP code

Statement of Withholding
Under Section 1446(f)(4) for
Withholding on Dispositions
by Foreign Persons of
Partnership Interests

2 Amount realized

Name of Partner subject to withholding (Transferee)

U.S. identifying number

3 Federal income tax withholding
OMBNo.NNNNͲNNNN

Street address, city, state, and ZIP code

U.S. identifying number

Street address, city, state, and ZIP code

(Rev. M-YYYY)

Country code

Attach Copy A to Form 8288

Cat.No.XXXXXX

UniqueFormIdentifier

FCheckifSubsequentDistribution

or
O

2 Amount realized

Name of Partner subject to withholding (Transferee)

U.S. identifying number

Street address, city, state, and ZIP code

Street address, city, state, and ZIP code

ot
f
-N

Country code

UniqueFormIdentifier

FCheckifSubsequentDistribution

DistributionNumber

t

Dr
af

Name of Seller (Transferor)

U.S. identifying number

3 Federal income tax withholding
OMBNo.NNNNͲNNNN

4 Date of this distribution

U.S. identifying number

Cat.No.XXXXXX

Copy C
For Withholding Agent
(Partnership)

5 Amount of this distribution

Country code

Street address, city, state, and ZIP code

Statement of Withholding
Under Section 1446(f)(4) for
Withholding on Dispositions
by Foreign Persons of
Partnership Interests

2 Amount realized

Street address, city, state, and ZIP code

(Rev. M-YYYY)

6 Total distributions

U.S. Employer Identification Number (EIN) 1 Date of transfer

Name of Partner subject to withholding (Transferee)

8288-C

Keep for your records.

Department of the Treasury - Internal Revenue Service

Street address, city, state, and ZIP code

Form

Copy B
For Partner (Transferee)
Subject to Withholding

5 Amount of this distribution

Cat.No.XXXXXX

Name of Withholding Agent (Partnership)

OMBNo.NNNNͲNNNN

4 Date of this distribution

U.S. identifying number

(Rev. M-YYYY)

Statement of Withholding
Under Section 1446(f)(4) for
Withholding on Dispositions
by Foreign Persons of
Partnership Interests

3 Federal income tax withholding

Name of Seller (Transferor)

8288-C

DistributionNumber

U.S. Employer Identification Number (EIN) 1 Date of transfer

Street address, city, state, and ZIP code

Form

Department of the Treasury - Internal Revenue Service

ffi

Name of Withholding Agent (Partnership)

6 Total distributions

For Privacy Act and Paperwork
Reduction Act Notice, see the
Instructions for Form 8288.

cia

8288-C

5 Amount of this distribution

lU
se

Name of Seller (Transferor)

Form

Copy A
For Internal Revenue Service
Center

4 Date of this distribution

6 Total distributions

Keep for your records

VERSION 7

Department of the Treasury - Internal Revenue Service