Withholding agent’s name, street address, city, state, and ZIP code Date of transfer 1

Statement of Withholding on

Dispositions by Foreign Persons

of U.S. Real Property Interests 2 Federal income tax withheld

OMB No. 1545-0902

Withholding agent’s Federal

identification number

Identification number of foreign person

subject to withholding (see instructions)

Gain recognized by foreign

corporation

3 Amount realized 4

Copy A

For Internal

Revenue

Service Center

Name of person subject to withholding 5 Description of property transferred

For Paperwork

Reduction Act

Notice, see the

instructions for

Form 8288.

Foreign address (number, street, and apt. or suite no.) 6 Person subject to withholding is: An individual

A corporation Other (specify) 

City, province or state, postal code, and country (not U.S.) Mailing address of person subject to withholding (if different)

Form 8288-A (Rev. 1-2004) Cat. No. 62261L Attach Copies A and B to Form 8288 Department of the Treasury - Internal Revenue Service
Withholding agent’s name, street address, city, state, and ZIP code Date of transfer 1

Statement of Withholding on

Dispositions by Foreign Persons

of U.S. Real Property Interests 2 Federal income tax withheld

OMB No. 1545-0902

Withholding agent’s Federal

identification number

Identification number of foreign person

subject to withholding (see instructions)

Gain recognized by foreign

corporation

3 Amount realized 4 Copy B

Send to

Internal

Revenue

Service Center

(For Use by

Person

Subject to

Withholding)

Name of person subject to withholding 5 Description of property transferred

This information is

being furnished to

the Internal

Revenue Service.

Foreign address (number, street, and apt. or suite no.) 6 Person subject to withholding is: An individual

A corporation Other (specify) 

City, province or state, postal code, and country (not U.S.) Mailing address of person subject to withholding (if different)

Form 8288-A (Rev. 1-2004) Department of the Treasury - Internal Revenue Service
If the amount shown in box 2 is greater than your maximum

tax liability, you may apply for an early refund. However, you

must still file your tax return when due. To apply for an early

Instructions for the Person Subject to

Withholding

Generally, if you are a foreign person that disposes of real

property located in the United States as seller or transferor, the

buyer or other transferee must withhold 10% of the amount

realized. Certain foreign interest holders that are beneficiaries or

shareholders are subject to Federal income tax withholding at a

rate of 35%.

1. Your name, address, and U.S. taxpayer identification

number,

2. The amount required to be withheld as stated in the

withholding certificate issued by the IRS,

3. The amount withheld shown in box 2 (attach a copy of this

Form 8288-A), and

4. The amount to be refunded.

See Regulations sections 1.1445-3 and 1.1445-6, Rev. Proc.

2000-35, and Form 8288-B, Application for Withholding

Certificate for Dispositions by Foreign Persons of U.S. Real

Property Interests, for information about withholding certificates.

Send your application for a withholding certificate and/or

application for early refund to the Director, Philadephia Service

Center, P.O. Box 21086, Drop Point N423, FIRPTA Unit,

Philadelphia, PA 19114-0586.

You must file a tax return (Form 1040NR, 1041, 1065, 1065-B,

or 1120-F) to report the sale or other disposition as effectively

connected with the conduct of a trade or business in the United

States. To receive credit for any Federal income tax withheld

shown in box 2, attach Form 8288-A to your tax return, unless

you make a request for early refund. Foreign partnerships should

report the withholding on Form 8804, Annual Return for

Partnership Withholding Tax (Section 1446), and attach Form

8288-A. See Pub. 515, Withholding of Tax on Nonresident Aliens

and Foreign Entities, and Pub. 519, U.S. Tax Guide for Aliens,

for more information.

refund, you must first get a withholding certificate. No particular

form is required for an application for early refund, but it must

include the following information in separate paragraphs

numbered as shown below:
Withholding agent’s name, street address, city, state, and ZIP code Date of transfer 1

Statement of Withholding on

Dispositions by Foreign Persons

of U.S. Real Property Interests 2 Federal income tax withheld

OMB No. 1545-0902

Withholding agent’s Federal

identification number

Identification number of foreign person

subject to withholding (see instructions)

Gain recognized by foreign

corporation

3 Amount realized 4

Copy C

For

Withholding

Agent

Name of person subject to withholding 5 Description of property transferred

For Paperwork

Reduction Act

Notice, see the

instructions for

Form 8288.

Foreign address (number, street, and apt. or suite no.) 6 Person subject to withholding is: An individual

A corporation Other (specify) 

City, province or state, postal code, and country (not U.S.) Mailing address of person subject to withholding (if different)

Form 8288-A (Rev. 1-2004) Keep for your records Department of the Treasury - Internal Revenue Service
Box 1. Enter the date of transfer. However, enter the date of

distribution if you withheld under section 1445(e)(2) or (e)(3) or if

you made the large trust election to withhold at the date of

distribution.

Instructions for the Withholding Agent

Prepare Form 8288-A for each foreign person subject to

withholding. Attach Copies A and B to Form 8288, U.S.

Withholding Tax Return for Dispositions by Foreign Persons of

U.S. Real Property Interests. Copy B will be stamped by the IRS

and sent to the person subject to withholding if the form is

complete, including the transferor’s identification number. Retain

Copy C for your records. You do not have to give a copy of this

form to the person subject to withholding. Box 2. Enter the Federal income tax you withheld for the foreign

person whose name appears on this form.

Box 3. Enter the amount realized by the foreign person whose

name appears on this form.

Box 4. Complete only if you are a foreign corporation required to

withhold under section 1445(e)(2).

Address. You must enter the foreign home address (for an

individual) or the foreign office address (for other than an

individual) of the person subject to withholding. You may enter a

separate mailing address in the space provided. If provided, the

IRS will use the separate mailing address to forward Copy B to

the person subject to withholding.

Box 6. Check the applicable box to indicate whether the foreign

person subject to withholding is an individual or a corporation. If

“other,” specify whether the person is a partnership, trust, or

estate.

See the instructions for Form 8288 for more information.

Note: The home or office address of the person subject to

withholding must be an address outside the United States. If the

person does not have an address outside the United States,

enter the country of residence of the foreign person in this

section and provide a complete mailing address.

Identification number. A U.S. taxpayer identification number

(TIN) is a social security number (SSN), employer identification

number (EIN), or IRS individual taxpayer identification number

(ITIN). For more information, see Forms 8288-A Must Be

Attached on page 2 of Form 8288 and Identifying number on

page 5 of Form 8288.