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 1995 or tax year beginning , 1995, and ending , 19

Check this box if the partnership consisted entirely of nonresident alien partners during the tax year ©

Partnership

1a b Employer identification number

For IRS Use Only

CC FD

RD FF

CAF FP

CR I

EDC

Withholding Agent

Withholding agent’s U.S.

identifying 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 4 of the instructions.

d City, state, and ZIP code

Section 1446 Tax Liability and Payments

3a Enter number of noncorporate foreign partners ©

b Enter number of corporate foreign partners ©

Total effectively connected taxable income allocable to

noncorporate foreign partners

4a

4a

b Multiply line 4a by 39.6% (.396) 4b

5b

Total effectively connected taxable income allocable to corporate

foreign partners

5a

Payments of section 1446 tax made by the partnership identified

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

of time to file) and amount credited from 1994 Form 8804

7a

7a

Section 1446 tax paid or withheld by another partnership in which

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

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

b

7b

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

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

real property interest by that partnership. Attach Form(s) 1042-S

or 8288-A. See page 5 of the instructions

c

7c

8 Total payments. Add lines 7a through 7c 8

9

10 Overpayment. If line 8 is more than line 6, subtract line 6 from line 8 10

11 11

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. Please

Sign

Here

Signature of general partner, limited liability company Title Date

member, or withholding agent

Date Preparer’s social security no. Preparer’s

signature

Check if

self-employed Paid

Preparer’s

Use Only Firm’s name (or yours

if self-employed) and

address

EIN

ZIP code

For Paperwork Reduction Act Notice, see separate Instructions for Forms 8804, 8805, and 8813. Form 8804 (1995)

Part I

Part II

©

©

©

Cat. No. 10077T

12

Amount of line 10 you want refunded to you ©

Amount of line 10 you want credited to next year’s Form 8804

Balance due. If line 6 is more than line 8, subtract line 8 from line 6. Attach a check or money

order for the full amount payable to the Internal Revenue Service. Write the partnership’s

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

9

12

Name of partnership

Number, street, and room or suite no. If a P.O. box, see page 4 of the instructions.

City, state, and ZIP code. If a foreign address, enter city, province or state, postal code and country.

c

d

b Multiply line 5a by 35% (.35)

5a

6 Total section 1446 tax owed. Add lines 4b and 5b 6

Printed on recycled paper