Part III

Annual Return for Partnership Withholding Tax (Section 1446) OMB No. 1545-1119

Form 8804  See separate Instructions for Forms 8804, 8805, and 8813.

 Attach Form(s) 8805. Department of the Treasury

Internal Revenue Service For calendar year 2004 or tax year beginning , 2004, and ending , 20

Check this box if the partnership keeps its records and books of account outside the United States and Puerto Rico 

Partnership

1a b U.S. employer identification number

For IRS Use Only

CC FD

RD FF

CAF FP

CR I

EDC

Withholding Agent

Withholding agent’s U.S.

employer identification number

2a Name of withholding agent. If partnership is also the withholding agent, enter “SAME” and do not complete lines 2b–d. b

c Number, street, and room or suite no. If a P.O. box, see page 5 of the instructions.

d City, state, and ZIP code

Section 1446 Tax Liability and Payments

3 Enter number of foreign partners 

4 Total effectively connected taxable income allocable to foreign partners 4

5

Payments of section 1446 tax made by the partnership identified

on line 1a during its tax year (or with a request for an extension

of time to file) and amount credited from 2003 Form 8804

6a

6a

Section 1446 tax paid or withheld by another partnership in which

the partnership identified on line 1a was a partner during the tax

year (attach Form(s) 1042-S or 8805)

b

6b

Section 1445(a) or 1445(e)(1) tax withheld from the partnership

identified on line 1a during the tax year for a disposition of a U.S.

real property interest. Attach Form(s) 1042-S or 8288-A. See page

6 of the instructions

c

6c

7 Total payments. Add lines 6a through 6c 7

8

9 Overpayment. If line 7 is more than line 5, subtract line 5 from line 7 9

10 10

Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge

and belief, it is true, correct, and complete. Declaration of preparer (other than general partner, limited liability company member, or withholding agent)

is based on all information of which preparer has any knowledge. Sign

Here

Signature of general partner, limited liability company Title Date

member, or withholding agent

Date Preparer’s SSN or PTIN Preparer’s

signature

Check if

self-employed Paid

Preparer’s

Use Only Firm’s name (or yours

if self-employed),

address, and ZIP code

EIN 

Phone no.

For Paperwork Reduction Act Notice, see separate Instructions for Forms 8804, 8805, and 8813. Form 8804 (2004)

Part I

Part II







Cat. No. 10077T

11

Amount of line 9 you want refunded to you 

Amount of line 9 you want credited to next year’s Form 8804

Balance due. If line 5 is more than line 7, subtract line 7 from line 5. Attach a check or money

order for the full amount payable to the “United States Treasury.” Write the partnership’s U.S.

employer identification number, tax year, and Form 8804 on it

8

11

Name of partnership

Number, street, and room or suite no. If a P.O. box, see page 5 of the instructions.

City, state, and ZIP code. If a foreign address, see page 5 of the instructions.

c

d

Total section 1446 tax owed. Multiply line 4 by 35% (.35) 5

( )

2004