FTB 4089 (REV 07-2006)
STATE OF CALIFORNIA
FRANCHISE TAX BOARD
PO BOX 942867
SACRAMENTO, CA 94267-0651
Telephone: (888) 792-4900 U.S. Toll-Free Notification of Performance Withholding for Nonresident Entertainers
Withholding Agent FEIN
City, State, Zip Code
Venue (Name and City)
Please see Withholding Agent Instructions below for filling out this form.
2. Performing Entity’s Name
3. Performer’s Corporation or
4. Performer’s SSN,
CA Corp, or FEIN
(Note: Tax ID# used for year
end tax reporting purposes.)
5. Payment Amount
6. Number of
people in the
Withholding Agent Instructions: Please complete this form to request a reduced withholding rate if the statutory seven percent rate will result in over-withholding of tax.
Processing could be delayed if the form is not completed accurately. All submitted requests must be received by fax to the FTB fax number noted above at least 10 days prior to the
performance date. If you do not receive a Form 594, Notice to Withhold Tax at Source, with a revised withholding rate, prior to the performance date, you must withhold at the
statutory rate. Please refer to the FTB Pub. 1024, Nonresident Withholding Entertainment Guidelines, located on our Website at www.ftb.ca.gov for more information.
Enter the performance date(s) (Col 1).
Enter the performer’s name (Col 2). Do not enter the agent, promoter, For Services Of (FSO), or For Benefit Of (FBO) name.
3-6. Please provide information for the performing entity only and not the performer’s agent or promoter.
If the performing entity is being paid as a group, provide the tax reporting entity’s name (Col 3), tax identification numb