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    Foreign Person's U.S. Source Income Subject To Withholding: Copy B

    Uploaded by

    shamla
    The 1042-S form reports income and tax withholding for a non-US recipient for 2020. It shows the recipient's name, address, income codes, gross income, and federal tax withheld. Amazon is providing the form but cannot provide tax advice or submit the form to the IRS.

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    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd

    Foreign Person's U.S. Source Income Subject To Withholding: Copy B

    Uploaded by

    shamla
    64 views2 pages
    The 1042-S form reports income and tax withholding for a non-US recipient for 2020. It shows the recipient's name, address, income codes, gross income, and federal tax withheld. Amazon is providing the form but cannot provide tax advice or submit the form to the IRS.

    Original Title

    2020-1042S

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    The 1042-S form reports income and tax withholding for a non-US recipient for 2020. It shows the recipient's name, address, income codes, gross income, and federal tax withheld. Amazon is providing the form but cannot provide tax advice or submit the form to the IRS.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    64 views2 pages

    Foreign Person's U.S. Source Income Subject To Withholding: Copy B

    Uploaded by

    shamla
    The 1042-S form reports income and tax withholding for a non-US recipient for 2020. It shows the recipient's name, address, income codes, gross income, and federal tax withheld. Amazon is providing the form but cannot provide tax advice or submit the form to the IRS.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 2

    Form Reference ID

    US_2020_1042S_1008164703_0

    AMAZON.COM, INC.
    PO BOX 80683
    SEATTLE, WA 98108-0683
    1-425-697-9440

    SAAJU
    90, ANBU ROAD, AKKARAIPATTU 12
    AMPARA, EASTERN 32400
    SRI LANKA

    Form 1042-S Foreign Person’s U.S. Source Income Subject to Withholding


    Go to www.irs.gov/Form1042S for instructions and the latest information.
    2020 OMB No. 1545-0096

    Copy B
    Department of the Treasury
    Internal Revenue Service 1 0 0 8 1 6 4 7 0 3 UNIQUE FORM IDENTIFIER AMENDED AMENDMENT NO. for Recipient
    1 Income 2 Gross income 3 Chapter indicator. Enter “3” or “4” 3 13e Recipient’s U.S. TIN, if any 13f Ch. 3 status code 16
    code
    3a Exemption code 00 4a Exemption code 16 13g Ch. 4 status code
    12 116 3b Tax rate 10.00 4b Tax rate 00.00 13h Recipient’s GIIN 13i Recipient’s foreign tax identification 13j LOB code
    number, if any
    5 Withholding allowance
    6 Net income XXXXXX582V
    7a Federal tax withheld 12 13k Recipient’s account number

    7b Check if federal tax withheld was not deposited with the IRS because
    escrow procedures were applied (see instructions) . . . . . . 13l Recipient’s date of birth (YYYYMMDD)
    7c Check if withholding occurred in subsequent year with respect to a
    partnership interest . . . . . . . . . . . . . .

    8 Tax withheld by other agents 14a Primary Withholding Agent’s Name (if applicable)
    9 Overwithheld tax repaid to recipient pursuant to adjustment procedures (see instructions)
    (0 ) 14b Primary Withholding Agent’s EIN
    15 Check if pro-rata basis reporting
    10 Total withholding credit (combine boxes 7a, 8, and 9)
    12 15a Intermediary or flow-through entity’s EIN, if any 15b Ch. 3 status code 15c Ch. 4 status code
    11 Tax paid by withholding agent (amounts not withheld) (see instructions)
    0 15d Intermediary or flow-through entity’s name
    12a Withholding agent’s EIN 12b Ch. 3 status code 12c Ch. 4 status code
    91-1646860 15 02 15e Intermediary or flow-through entity’s GIIN
    12d Withholding agent’s name 15f Country code 15g Foreign tax identification number, if any
    AMAZON.COM, INC.
    12e Withholding agent’s Global Intermediary Identification Number (GIIN) 15h Address (number and street)

    12f Country code 12g Foreign tax identification number, if any 15i City or town, state or province, country, ZIP or foreign postal code

    12h Address (number and street) 16a Payer’s name 16b Payer’s TIN
    PO BOX 80683
    12i City or town, state or province, country, ZIP or foreign postal code 16c Payer’s GIIN 16d Ch. 3 status code 16e Ch. 4 status code
    SEATTLE, WA 98108-0683
    13a Recipient’s name 13b Recipient’s country code 17a State income tax withheld 17b Payer’s state tax no. 17c Name of state
    SAAJU CE
    13c Address (number and street)
    90, ANBU ROAD, AKKARAIPATTU 12
    13d City or town, state or province, country, ZIP or foreign postal code
    AMPARA, EASTERN SRI LANKA 32400
    (keep for your records) Form 1042-S (2020)

    Printed on Mar 01, 2021


    The 1042-S form is an informational tax statement the U.S. Internal Revenue Service (IRS) requires Amazon to
    provide. Amazon will not be able to advise you on how to use the statement.

    What is Form 1042-S?

    The U.S. Internal Revenue Service (IRS) requires Amazon to provide the Form 1042-S every year. Amazon provides the Form
    1042-S to all non-U.S. persons who receive U.S. sourced payments. The form reports gross income and U.S. tax withholding, if
    any, for royalties, services, rent, and other withholdable payments during the calendar year 2020.

    The box 7a shows the withholding tax that Amazon paid to the IRS on your behalf. You may be able to claim a tax credit in
    your country of tax residence or claim a refund for any excess tax that you paid by filing a U.S. non-resident tax return directly
    with the IRS.

    Note: Amazon cannot provide tax advice. If you have questions, consult with your tax advisor or go to www.irs.gov.

    What's represented in the table on the Form 1042-S?

    Your form summarizes the payments you received from Amazon in 2020. This table is only for your information, Amazon will
    not submit it to the IRS.

    Note: If multiple Amazon businesses have paid you, we have consolidated these payments on one form.

    Company Name Box 1 Box 2 Box 7a


    (Income Code & Income Code Description) (Gross Income) (Federal Tax Withheld)

    Amazon.com Services, Inc. 12 Other royalties (for example, copyright, software, broadcasting, endorsement payments) 115.61 11.58

    Total - Pre-rounding 115.61 11.58


    Total - Rounded per Form 1042-S specifications* 116 12
    *All values in the table above are USD($). Values have been rounded and reported per IRS requirements.

    Have a 1042-S related question?


    - Visit the Help section on kdp.amazon.com and submit your question by clicking on 'Contact US'. Select Payments, Taxes, and
    Reports --> U.S. Tax Information
    - or Login to https://taxcentral.amazon.com and click 'Contact us' button.

    Printed on Mar 01, 2021

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