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

Statement of Withholding on

Dispositions by Foreign Persons

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

OMB No. 1545-0902

Expires 2-29-96

Withholding agent’s Federal

identification number

Identification number of foreign person

subject to withholding (if any)

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. 3-93) Attach Copies A and B to Form 8288 Department of the Treasury - Internal Revenue Service

Cat. No. 62261L

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

Statement of Withholding on

Dispositions by Foreign Persons

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

OMB No. 1545-0902

Expires 2-29-96

Withholding agent’s Federal

identification number

Identification number of foreign person

subject to withholding (if any)

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. 3-93) 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

before filing your tax return. To do so, you must also apply

for a withholding certificate (if you do not already have one).

Send your application for early refund to the Director,

Philadelphia Service Center, P.O. Box 21086, Philadelphia, PA

19114. No particular form is required for the application, but

it must include the following information in separate

paragraphs numbered as shown below:

Instructions for the Person Subject to

Withholding

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

property located in the United States, 10% of the amount

realized must be withheld by the buyer or other transferee.

Generally, certain foreign interest holders that are

beneficiaries or shareholders are also subject to the

withholding, but at a rate of 34%. Even though tax may have

been withheld, you are required to file a Form 1040NR, 1041,

1065, or 1120F 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

Federal income tax return, or send it with any request for

refund. However, foreign partnerships should report the

withholding on and attach Form 8288-A to Form 8804,

Annual Return for Partnership Withholding Tax (Section

1446). See Pub. 519, U.S. Tax Guide for Aliens, for more

information about filing requirements.

1. Your name, address, and 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. 88-23, and Form 8288-B, Application for Withholding

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

Property Interests, for information about how to request a

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

Statement of Withholding on

Dispositions by Foreign Persons

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

OMB No. 1545-0902

Expires 2-29-96

Withholding agent’s Federal

identification number

Identification number of foreign person

subject to withholding (if any)

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. 3-93) Keep for your records Department of the Treasury - Internal Revenue Service
Box 1.—Enter the date of transfer. Enter the date of

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

(3) or you made the large trust election to withhold at

the date of distribution.

Instructions for the Withholding Agent

Prepare Form 8288-A for each 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 for that person’s future use.

Copy C is for your records. You need not give a copy

of this form to the foreign person subject to

withholding.

Box 2.—Enter the Federal income tax withheld by you

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) for the person subject to

withholding. However, 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 person subject to withholding is an individual or a

corporation. If other, please specify whether the person

is a partnership, trust, or estate.

For definitions and other rules, see the instructions

for Form 8288.

Note: The foreign address must be an address outside

the United States. If the person does not have a

foreign address, then enter the country of the foreign

person in this section and use the mailing address

section.