This form contains 146 fields organized into 35 sections. Below is a complete list of every field, its type, and what information is expected.

Field Name Type Description
Business/Nongrantor Trust Entity Information
Business/Nongrantor Trust Name Text
Enter the full legal name of the business or nongrantor trust that is the buyer/transferee (if applicable). Fill only if 'Part IV, box 11' is 'Yes'.
Depends on: Installment sale
FEIN Checkbox
Check this box if the Business/Nongrantor Trust identifier you are providing is a Federal Employer Identification Number (FEIN). Fill only if 'Part IV, box 11' is 'Yes'.
Depends on: Installment sale
CA Corp no. Checkbox
Check this box if the Business/Nongrantor Trust identifier you are providing is a California Corporation Number. Fill only if 'Part IV, box 11' is 'Yes'.
Depends on: Installment sale
CA SOS file no. Checkbox
Check this box if the Business/Nongrantor Trust identifier you are providing is a California Secretary of State (CA SOS) file number. Fill only if 'Part IV, box 11' is 'Yes'.
Depends on: Installment sale
Entity Identification Number Text
Enter the entity’s identification number that corresponds to the selected type (FEIN, California corporation number, or California Secretary of State file number). Fill only if 'FEIN', 'CA Corp no.', 'CA SOS file no.' is 'Yes' (any).
Depends on: FEIN, CA Corp no., CA SOS file no.
Buyer/Transferee Address and Contact
Street Address Text
Enter the buyer/transferee street address, including apartment/suite/room number, PO box, or PMB number if applicable. Fill only if 'Part IV, box 11' is 'Yes'.
Depends on: Installment sale
City Text
Enter the city for the buyer/transferee mailing address. Fill only if 'Part IV, box 11' is 'Yes'.
Depends on: Installment sale
State Text
Enter the state for the buyer/transferee mailing address. Fill only if 'Part IV, box 11' is 'Yes'.
Max length: 2 characters
Depends on: Installment sale
ZIP Code Text
Enter the ZIP code for the buyer/transferee mailing address. Fill only if 'Part IV, box 11' is 'Yes'.
Max length: 10 characters
Depends on: Installment sale
Telephone Number Text
Enter the buyer/transferee telephone number. Fill only if 'Part IV, box 11' is 'Yes'.
Depends on: Installment sale
Buyer/Transferee Name and SSN/ITIN
Buyer/Transferee First Name Text
Enter the buyer/transferee (grantor) first name. Fill only if 'Part IV, box 11' is 'Yes'.
Depends on: Installment sale
Buyer/Transferee Middle Initial Text
Enter the buyer/transferee (grantor) middle initial, if any. Fill only if 'Part IV, box 11' is 'Yes'.
Max length: 1 characters
Depends on: Installment sale
Buyer/Transferee Last Name Text
Enter the buyer/transferee (grantor) last name. Fill only if 'Part IV, box 11' is 'Yes'.
Depends on: Installment sale
Buyer/Transferee SSN or ITIN Text
Enter the buyer/transferee Social Security Number (SSN) or Individual Taxpayer Identification Number (ITIN). Fill only if 'Part IV, box 11' is 'Yes'.
Max length: 11 characters
Depends on: Installment sale
Computation (Adjusted Basis and Estimated Gain/Loss)
Adjusted basis (Line 25) Number
Enter the adjusted basis of the property (line 21 plus line 24). Fill only if 'Part III, box 3' is 'Yes'.
Max length: 12 characters
Depends on: Loss or zero gain for California income tax purposes
Suspended passive activity losses (Line 26) Number
Enter any suspended passive activity losses related to this property. Fill only if 'Part III, box 3' is 'Yes'.
Max length: 12 characters
Depends on: Loss or zero gain for California income tax purposes
Total of adjusted basis and suspended losses (Line 27) Number
Enter the total of line 25 and line 26. Fill only if 'Part III, box 3' is 'Yes'.
Max length: 12 characters
Depends on: Loss or zero gain for California income tax purposes
Estimated gain or loss on sale (Line 28) Number
Enter the estimated gain or loss on the sale by subtracting line 27 from line 15. Fill only if 'Part III, box 3' is 'Yes'.
Max length: 12 characters
Depends on: Loss or zero gain for California income tax purposes
Computation (Increases to Basis)
Cost of Additions and Improvements Number
Enter the total cost of any additions and improvements made to the property that increase its basis. Fill only if 'Part III, box 3' is 'Yes'.
Max length: 12 characters
Depends on: Loss or zero gain for California income tax purposes
Other Increases to Basis Number
Enter the total of any other amounts that increase the property's basis, excluding additions and improvements. Fill only if 'Part III, box 3' is 'Yes'.
Max length: 12 characters
Depends on: Loss or zero gain for California income tax purposes
Total Increases to Basis Number
Enter the total increases to basis by adding the amounts from the additions and improvements line and the other increases line. Fill only if 'Part III, box 3' is 'Yes'.
Max length: 12 characters
Depends on: Loss or zero gain for California income tax purposes
Computation (Purchase Price and Decreases to Basis)
Purchase price paid (Line 16) Number
Enter the amount you paid to purchase the property. Fill only if 'Part III, box 3' is 'Yes'.
Max length: 12 characters
Depends on: Loss or zero gain for California income tax purposes
Seller-paid points (Line 17) Number
Enter the amount of points paid by the seller/transferor that decrease your basis. Fill only if 'Part III, box 3' is 'Yes'.
Max length: 12 characters
Depends on: Loss or zero gain for California income tax purposes
Depreciation (Line 18) Number
Enter the total depreciation taken on the property that decreases your basis. Fill only if 'Part III, box 3' is 'Yes'.
Max length: 12 characters
Depends on: Loss or zero gain for California income tax purposes
Other decreases to basis (Line 19) Number
Enter any other amounts that decrease your basis in the property. Fill only if 'Part III, box 3' is 'Yes'.
Max length: 12 characters
Depends on: Loss or zero gain for California income tax purposes
Total decreases to basis (Line 20) Number
Enter the total decreases to basis by adding the amounts from lines 17 through 19. Fill only if 'Part III, box 3' is 'Yes'.
Max length: 12 characters
Depends on: Loss or zero gain for California income tax purposes
Purchase price minus total decreases (Line 21) Number
Enter the result of subtracting line 20 from line 16. Fill only if 'Part III, box 3' is 'Yes'.
Max length: 12 characters
Depends on: Loss or zero gain for California income tax purposes
Computation (Selling Price, Expenses, Amount Realized)
Selling Price Number
Enter the total selling price of the property. Fill only if 'Part III, box 3' is 'Yes'.
Max length: 12 characters
Depends on: Loss or zero gain for California income tax purposes
Selling Expenses Number
Enter the total selling expenses paid in connection with the sale. Fill only if 'Part III, box 3' is 'Yes'.
Max length: 12 characters
Depends on: Loss or zero gain for California income tax purposes
Amount Realized Number
Enter the amount realized from the sale, which is the selling price minus the selling expenses. Fill only if 'Part III, box 3' is 'Yes'.
Max length: 12 characters
Depends on: Loss or zero gain for California income tax purposes
Filing Information
Amended Checkbox
Check this box if you are filing an amended (corrected) Real Estate Withholding Statement for the taxable year shown.
1000A Text
Enter the form number 1000A.
Escrow or Exchange Number Text
Enter the escrow or exchange number associated with this real estate withholding filing.
General Information
1000A Text
Enter the specific information required for field 1000A.
Escrow or Exchange Number Text
Enter the escrow or exchange number associated with this real estate transaction.
Installment Promissory Note Terms
Principal Amount (Dollars) Number
Enter the dollar portion of the principal amount of the promissory note. Fill only if 'Part IV, box 11' is 'Yes'.
Max length: 10 characters
Depends on: Installment sale
Principal Amount (Cents) Text
Enter the cents portion of the principal amount of the promissory note. Fill only if 'Part IV, box 11' is 'Yes'.
Max length: 2 characters
Depends on: Installment sale
Installment Amount (Dollars) Number
Enter the dollar portion of the regular installment payment amount. Fill only if 'Part IV, box 11' is 'Yes'.
Max length: 12 characters
Depends on: Installment sale
Installment Amount (Cents) Text
Enter the cents portion of the regular installment payment amount. Fill only if 'Part IV, box 11' is 'Yes'.
Max length: 2 characters
Depends on: Installment sale
Interest Rate (Whole Percent) Text
Enter the whole-number portion of the interest rate for the promissory note. Fill only if 'Part IV, box 11' is 'Yes'.
Max length: 2 characters
Depends on: Installment sale
Interest Rate (Decimal) Text
Enter the decimal portion of the interest rate for the promissory note. Fill only if 'Part IV, box 11' is 'Yes'.
Max length: 2 characters
Depends on: Installment sale
Repayment Period (Months) Text
Enter the number of months over which the promissory note will be repaid. Fill only if 'Part IV, box 11' is 'Yes'.
Max length: 5 characters
Depends on: Installment sale
Line 29 Alternative Withholding Filing Type and Amount
Individual (12.3%) Checkbox
Check this box if the filing type for the alternative withholding calculation amount is Individual (tax rate 12.3%). Fill only if 'Line 28 Estimated gain or loss on sale' is a gain (greater than zero).
Depends on: Estimated gain or loss on sale (Line 28)
Corporation (8.84%) Checkbox
Check this box if the filing type for the alternative withholding calculation amount is Corporation (tax rate 8.84%). Fill only if 'Line 28 Estimated gain or loss on sale' is a gain (greater than zero).
Depends on: Estimated gain or loss on sale (Line 28)
Bank and Financial Corporation (10.84%) Checkbox
Check this box if the filing type for the alternative withholding calculation amount is Bank and Financial Corporation (tax rate 10.84%). Fill only if 'Line 28 Estimated gain or loss on sale' is a gain (greater than zero).
Depends on: Estimated gain or loss on sale (Line 28)
Trust (12.3%) Checkbox
Check this box if the filing type for the alternative withholding calculation amount is Trust (tax rate 12.3%). Fill only if 'Line 28 Estimated gain or loss on sale' is a gain (greater than zero).
Depends on: Estimated gain or loss on sale (Line 28)
Non-California Partnership (12.3%) Checkbox
Check this box if the filing type for the alternative withholding calculation amount is Non-California Partnership (tax rate 12.3%). Fill only if 'Line 28 Estimated gain or loss on sale' is a gain (greater than zero).
Depends on: Estimated gain or loss on sale (Line 28)
S Corporation (13.8%) Checkbox
Check this box if the filing type for the alternative withholding calculation amount is S Corporation (tax rate 13.8%). Fill only if 'Line 28 Estimated gain or loss on sale' is a gain (greater than zero).
Depends on: Estimated gain or loss on sale (Line 28)
Financial S Corporation (15.8%) Checkbox
Check this box if the filing type for the alternative withholding calculation amount is Financial S Corporation (tax rate 15.8%). Fill only if 'Line 28 Estimated gain or loss on sale' is a gain (greater than zero).
Depends on: Estimated gain or loss on sale (Line 28)
Line 29 Alternative Withholding Calculation Amount Number
Enter the alternative withholding calculation amount for line 29 based on the selected filing type and tax rate. Fill only if 'B — Individual (12.3% × gain on sale)', 'C — Non-California Partnership (12.3% × gain on sale)', 'D — Corporation (8.84% × gain on sale)', 'E — Bank and Financial Corporation (10.84% × gain on sale)', 'F — S Corporation (13.8% × gain on sale)', 'G — Financial S Corporation (15.8% × gain on sale)', 'H — Trust (12.3% × gain on sale)' is 'Yes' (any).
Max length: 12 characters
Depends on: B — Individual (12.3% × gain on sale), C — Non-California Partnership (12.3% × gain on sale), D — Corporation (8.84% × gain on sale), E — Bank and Financial Corporation (10.84% × gain on sale), F — S Corporation (13.8% × gain on sale), G — Financial S Corporation (15.8% × gain on sale), H — Trust (12.3% × gain on sale)
Line 30 Sales Price Withholding Amount
Sales Price Withholding Amount Number
Enter the calculated withholding amount based on the sales price (line 13) for line 30. Fill only if 'A — Sales Price Method (3 1/3% × sales price/boot/installment sale payment)' is 'Yes'.
Max length: 12 characters
Depends on: A — Sales Price Method (3 1/3% × sales price/boot/installment sale payment)
Line 32 Date of Transfer/Exchange Completion/Payment
Date of Transfer/Exchange Completion/Payment Date
Enter the date the property transfer occurred, the exchange was completed or failed, or an installment payment was made.
Max length: 10 characters
Line 33 Sales Price/Boot Amount and Ownership Percentage Calculation
Sales Price / Boot Amount Number
Enter the total sales price, failed exchange amount, or boot amount to be multiplied by the ownership percentage.
Max length: 12 characters
Ownership Percentage (Whole Number) Text
Enter the whole-number portion of the ownership percentage.
Max length: 3 characters
Ownership Percentage (Decimal) Text
Enter the decimal portion of the ownership percentage (digits after the decimal point).
Max length: 2 characters
Line 33 Ownership-Adjusted Amount Number
Enter the result of multiplying the sales price/boot amount by the ownership percentage.
Max length: 10 characters
Line 34 Cash Poor Transaction Amount That Should Have Been Withheld
Cash Poor Transaction Withholding Amount (Dollars) Number
Enter the dollar amount that should have been withheld for the cash poor transaction on line 34. Fill only if 'Cash Poor' is 'Yes'.
Max length: 10 characters
Depends on: Cash Poor
Cash Poor Transaction Withholding Amount (Cents) Text
Enter the cents portion of the amount that should have been withheld for the cash poor transaction on line 34. Fill only if 'Cash Poor' is 'Yes'.
Max length: 2 characters
Depends on: Cash Poor
Line 35 Type of Transaction (Check One Only)
Conventional Sale/Transfer Checkbox
Check this box if the transaction is a standard property sale or transfer (not an installment payment, boot, failed exchange, or cash poor transaction).
Installment Sale Payment Checkbox
Check this box if this transaction involves an installment sale payment (a payment received over time under an installment sale).
Boot Checkbox
Check this box if the exchange includes boot (cash or other non-like-kind property received as part of the exchange).
Failed Exchange Checkbox
Check this box if the intended exchange failed (the exchange was not completed as an eligible exchange).
Cash Poor Checkbox
Check this box if this is a cash poor transaction where insufficient cash was available to withhold the required amount at closing.
Line 36 Withholding Calculation Method (Check One Only)
A — Sales Price Method (3 1/3% × sales price/boot/installment sale payment) Checkbox
Check this box if you are using the Sales Price Method to calculate withholding at 3 1/3% (.0333) of the sales price, boot amount, or installment sale payment. Fill only if 'Line 28 Estimated gain or loss on sale' is a gain (greater than zero).
Depends on: Estimated gain or loss on sale (Line 28)
B — Individual (12.3% × gain on sale) Checkbox
Check this box if you elect the Alternative Withholding Calculation and the seller/transferor is an Individual, so withholding is 12.3% of gain on sale. Fill only if 'Line 28 Estimated gain or loss on sale' is a gain (greater than zero).
Depends on: Estimated gain or loss on sale (Line 28)
C — Non-California Partnership (12.3% × gain on sale) Checkbox
Check this box if you elect the Alternative Withholding Calculation and the seller/transferor is a Non-California Partnership, so withholding is 12.3% of gain on sale. Fill only if 'Line 28 Estimated gain or loss on sale' is a gain (greater than zero).
Depends on: Estimated gain or loss on sale (Line 28)
D — Corporation (8.84% × gain on sale) Checkbox
Check this box if you elect the Alternative Withholding Calculation and the seller/transferor is a Corporation, so withholding is 8.84% of gain on sale. Fill only if 'Line 28 Estimated gain or loss on sale' is a gain (greater than zero).
Depends on: Estimated gain or loss on sale (Line 28)
E — Bank and Financial Corporation (10.84% × gain on sale) Checkbox
Check this box if you elect the Alternative Withholding Calculation and the seller/transferor is a Bank and Financial Corporation, so withholding is 10.84% of gain on sale. Fill only if 'Line 28 Estimated gain or loss on sale' is a gain (greater than zero).
Depends on: Estimated gain or loss on sale (Line 28)
F — S Corporation (13.8% × gain on sale) Checkbox
Check this box if you elect the Alternative Withholding Calculation and the seller/transferor is an S Corporation, so withholding is 13.8% of gain on sale. Fill only if 'Line 28 Estimated gain or loss on sale' is a gain (greater than zero).
Depends on: Estimated gain or loss on sale (Line 28)
G — Financial S Corporation (15.8% × gain on sale) Checkbox
Check this box if you elect the Alternative Withholding Calculation and the seller/transferor is a Financial S Corporation, so withholding is 15.8% of gain on sale. Fill only if 'Line 28 Estimated gain or loss on sale' is a gain (greater than zero).
Depends on: Estimated gain or loss on sale (Line 28)
H — Trust (12.3% × gain on sale) Checkbox
Check this box if you elect the Alternative Withholding Calculation and the seller/transferor is a Trust, so withholding is 12.3% of gain on sale. Fill only if 'Line 28 Estimated gain or loss on sale' is a gain (greater than zero).
Depends on: Estimated gain or loss on sale (Line 28)
Line 37 Amount Withheld From Seller/Transferor
Amount Withheld (Dollars) Number
Enter the total amount withheld from the seller/transferor for line 37 in dollars (whole-dollar portion). Fill only if 'A — Sales Price Method (3 1/3% × sales price/boot/installment sale payment)', 'B — Individual (12.3% × gain on sale)', 'C — Non-California Partnership (12.3% × gain on sale)', 'D — Corporation (8.84% × gain on sale)', 'E — Bank and Financial Corporation (10.84% × gain on sale)', 'F — S Corporation (13.8% × gain on sale)', 'G — Financial S Corporation (15.8% × gain on sale)', 'H — Trust (12.3% × gain on sale)' is 'Yes' (any).
Max length: 12 characters
Depends on: A — Sales Price Method (3 1/3% × sales price/boot/installment sale payment), B — Individual (12.3% × gain on sale), C — Non-California Partnership (12.3% × gain on sale), D — Corporation (8.84% × gain on sale), E — Bank and Financial Corporation (10.84% × gain on sale), F — S Corporation (13.8% × gain on sale), G — Financial S Corporation (15.8% × gain on sale), H — Trust (12.3% × gain on sale)
Amount Withheld (Cents) Number
Enter the cents portion of the total amount withheld from the seller/transferor for line 37. Fill only if 'A — Sales Price Method (3 1/3% × sales price/boot/installment sale payment)', 'B — Individual (12.3% × gain on sale)', 'C — Non-California Partnership (12.3% × gain on sale)', 'D — Corporation (8.84% × gain on sale)', 'E — Bank and Financial Corporation (10.84% × gain on sale)', 'F — S Corporation (13.8% × gain on sale)', 'G — Financial S Corporation (15.8% × gain on sale)', 'H — Trust (12.3% × gain on sale)' is 'Yes' (any).
Max length: 2 characters
Depends on: A — Sales Price Method (3 1/3% × sales price/boot/installment sale payment), B — Individual (12.3% × gain on sale), C — Non-California Partnership (12.3% × gain on sale), D — Corporation (8.84% × gain on sale), E — Bank and Financial Corporation (10.84% × gain on sale), F — S Corporation (13.8% × gain on sale), G — Financial S Corporation (15.8% × gain on sale), H — Trust (12.3% × gain on sale)
Part III Full Withholding Exemption Certifications
Principal residence exemption (IRC Section 121) Checkbox
Check this box if the property qualifies as the seller’s (or decedent’s, if sold by the decedent’s estate or trust) principal residence under IRC Section 121.
Decedent principal residence—no two-year time limit (IRC Section 121) Checkbox
Check this box if the seller (or decedent, if sold by the decedent’s estate or trust) last used the property as the principal residence under IRC Section 121 without regard to the two-year time period.
Loss or zero gain for California income tax purposes Checkbox
Check this box if the seller will have a loss or zero gain for California income tax purposes on this sale.
Involuntary conversion—intends to replace property (IRC Section 1033) Checkbox
Check this box if the property was compulsorily or involuntarily converted and the seller intends to acquire replacement property that qualifies for nonrecognition of gain under IRC Section 1033.
Nonrecognition transfer (IRC Section 351 or 721) Checkbox
Check this box if the transfer qualifies for nonrecognition treatment under IRC Section 351 (transfer to a controlled corporation) or IRC Section 721 (contribution to a partnership for a partnership interest).
Seller is qualified corporation/LLC taxed as corporation in California Checkbox
Check this box if the seller is a corporation (or an LLC classified as a corporation) that is qualified through the California Secretary of State or has a permanent place of business in California.
Seller is California partnership/LLC taxed as partnership Checkbox
Check this box if the seller is a California partnership or qualified to do business in California (or an LLC classified as a partnership and not a disregarded single-member LLC).
Seller is a tax-exempt entity Checkbox
Check this box if the seller is a tax-exempt entity under California or federal law.
Seller is insurance company/IRA/qualified plan/charitable remainder trust Checkbox
Check this box if the seller is an insurance company, an individual retirement account, a qualified pension/profit sharing plan, or a charitable remainder trust.
Part IV Partial/Other Exemption or No Exemption Certifications
Like-kind exchange (IRC Section 1031) Checkbox
Check this box if the transfer qualifies as a simultaneous or deferred like-kind exchange under IRC Section 1031. Fill only if 'Principal residence exemption (IRC Section 121)', 'Decedent principal residence—no two-year time limit (IRC Section 121)', 'Loss or zero gain for California income tax purposes', 'Involuntary conversion—intends to replace property (IRC Section 1033)', 'Nonrecognition transfer (IRC Section 351 or 721)', 'Seller is qualified corporation/LLC taxed as corporation in California', 'Seller is California partnership/LLC taxed as partnership', 'Seller is a tax-exempt entity', 'Seller is insurance company/IRA/qualified plan/charitable remainder trust' are all 'No'.
Depends on: Principal residence exemption (IRC Section 121), Decedent principal residence—no two-year time limit (IRC Section 121), Loss or zero gain for California income tax purposes, Involuntary conversion—intends to replace property (IRC Section 1033), Nonrecognition transfer (IRC Section 351 or 721), Seller is qualified corporation/LLC taxed as corporation in California, Seller is California partnership/LLC taxed as partnership, Seller is a tax-exempt entity, Seller is insurance company/IRA/qualified plan/charitable remainder trust
Installment sale Checkbox
Check this box if the transfer is an installment sale where the buyer must withhold on the principal portion of each installment payment. Fill only if 'Principal residence exemption (IRC Section 121)', 'Decedent principal residence—no two-year time limit (IRC Section 121)', 'Loss or zero gain for California income tax purposes', 'Involuntary conversion—intends to replace property (IRC Section 1033)', 'Nonrecognition transfer (IRC Section 351 or 721)', 'Seller is qualified corporation/LLC taxed as corporation in California', 'Seller is California partnership/LLC taxed as partnership', 'Seller is a tax-exempt entity', 'Seller is insurance company/IRA/qualified plan/charitable remainder trust' are all 'No'.
Depends on: Principal residence exemption (IRC Section 121), Decedent principal residence—no two-year time limit (IRC Section 121), Loss or zero gain for California income tax purposes, Involuntary conversion—intends to replace property (IRC Section 1033), Nonrecognition transfer (IRC Section 351 or 721), Seller is qualified corporation/LLC taxed as corporation in California, Seller is California partnership/LLC taxed as partnership, Seller is a tax-exempt entity, Seller is insurance company/IRA/qualified plan/charitable remainder trust
No exemptions apply Checkbox
Check this box if none of the exemptions in Part III or Part IV (lines 10 and 11) apply and withholding is required. Fill only if 'Principal residence exemption (IRC Section 121)', 'Decedent principal residence—no two-year time limit (IRC Section 121)', 'Loss or zero gain for California income tax purposes', 'Involuntary conversion—intends to replace property (IRC Section 1033)', 'Nonrecognition transfer (IRC Section 351 or 721)', 'Seller is qualified corporation/LLC taxed as corporation in California', 'Seller is California partnership/LLC taxed as partnership', 'Seller is a tax-exempt entity', 'Seller is insurance company/IRA/qualified plan/charitable remainder trust', 'Like-kind exchange (IRC Section 1031)', 'Installment sale' are all 'No'.
Depends on: Principal residence exemption (IRC Section 121), Decedent principal residence—no two-year time limit (IRC Section 121), Loss or zero gain for California income tax purposes, Involuntary conversion—intends to replace property (IRC Section 1033), Nonrecognition transfer (IRC Section 351 or 721), Seller is qualified corporation/LLC taxed as corporation in California, Seller is California partnership/LLC taxed as partnership, Seller is a tax-exempt entity, Seller is insurance company/IRA/qualified plan/charitable remainder trust, Like-kind exchange (IRC Section 1031), Installment sale
Perjury Statement Checkboxes
Sale fully exempt from withholding (Part III) Checkbox
Check this box if the sale is fully exempt from withholding as indicated by check mark(s) in Part III. Fill only if 'Part III Certifications (lines 1–9)' has one or more boxes checked.
Depends on: Principal residence exemption (IRC Section 121), Decedent principal residence—no two-year time limit (IRC Section 121), Loss or zero gain for California income tax purposes, Involuntary conversion—intends to replace property (IRC Section 1033), Nonrecognition transfer (IRC Section 351 or 721), Seller is qualified corporation/LLC taxed as corporation in California, Seller is California partnership/LLC taxed as partnership, Seller is a tax-exempt entity, Seller is insurance company/IRA/qualified plan/charitable remainder trust
Sale fully or partially exempt from withholding (Part IV, box 10 or 11) Checkbox
Check this box if the sale is fully or partially exempt from withholding as indicated by a check mark in Part IV, box 10 or 11. Fill only if 'Part IV (box 10 or 11)' is 'Yes'.
Depends on: Like-kind exchange (IRC Section 1031), Installment sale
Seller elected Alternative Withholding Calculation (Part VII, line 36 B–H) Checkbox
Check this box if the seller has elected the Alternative Withholding Calculation as indicated by a check mark in Part VII, line 36 (boxes B–H).
Buyer/transferee accepts withholding requirements (installment sale only) Checkbox
Check this box if the buyer/transferee understands and accepts the withholding requirements and the transaction is an installment sale. Fill only if 'Installment Sale Payment' is 'Yes'.
Depends on: Installment Sale Payment
Remitter acknowledges cash poor transaction (Part VII, line 35, box E) Checkbox
Check this box if the remitter (qualified intermediary) acknowledges this is a cash poor transaction as indicated by a check mark in Part VII, line 35, box E. Fill only if 'Cash Poor' is 'Yes'.
Depends on: Cash Poor
Property Address and Ownership Percentage
Property address Text
Enter the property’s street address along with any additional identifying details requested on the form, such as parcel number and county.
Ownership percentage (whole number) Text
Enter the whole-number portion of the seller/transferor’s ownership percentage in the property.
Max length: 3 characters
Ownership percentage (decimal) Text
Enter the digits after the decimal point for the seller/transferor’s ownership percentage in the property.
Max length: 2 characters
Remitter Address and Phone
Street Address Text
Enter the remitter’s mailing street address, including apartment/suite/room number, PO box, or PMB number if applicable.
City Text
Enter the city for the remitter’s mailing address.
State Text
Enter the state for the remitter’s mailing address.
Max length: 2 characters
ZIP Code Text
Enter the ZIP code for the remitter’s mailing address.
Max length: 10 characters
Telephone Number Text
Enter the remitter’s telephone number.
Remitter Business Name and Entity ID
Remitter Business Name Text
Enter the legal name of the remitter business.
FEIN Checkbox
Check this box if the remitter is identified by a Federal Employer Identification Number (FEIN).
CA Corp no. Checkbox
Check this box if the remitter is identified by a California Corporation Number.
CA SOS file no. Checkbox
Check this box if the remitter is identified by a California Secretary of State (SOS) file number.
Remitter Entity ID Number Text
Enter the remitter’s entity identification number (such as FEIN, California corporation number, or California SOS file number). Fill only if 'FEIN', 'CA Corp no.', 'CA SOS file no.' is 'Yes' (any).
Depends on: FEIN, CA Corp no., CA SOS file no.
Remitter Contact Information
Remitter Name and Title / Escrow Business Name Text
Enter the remitter's name and title, or the escrow business name, as it should appear on the form.
Remitter Telephone Number Text
Enter the telephone number where the remitter can be reached.
Remitter Identification
Remitter Name Text
Enter the full name of the remitter sending the payment.
Remitter Identification Number Text
Enter the remitter’s identifying number (SSN, ITIN, FEIN, CA corporation number, or CA Secretary of State file number).
Remitter Name Text
Enter the full name of the remitter (person or entity) submitting the payment.
Remitter Tax ID or CA Entity/File Number Text
Enter the remitter’s identifying number, such as SSN, ITIN, FEIN, California corporation number, or California Secretary of State file number.
Remitter Individual Name and SSN/ITIN
Remitter First Name Text
Enter the remitter individual’s first name.
Middle Initial Text
Enter the remitter individual’s middle initial, if applicable.
Max length: 1 characters
Remitter Last Name Text
Enter the remitter individual’s last name.
Remitter SSN or ITIN Text
Enter the remitter individual’s Social Security Number (SSN) or Individual Taxpayer Identification Number (ITIN).
Max length: 11 characters
Remitter Type (Check One / Other Specify)
REEP Checkbox
Check this box if the remitter is a Real Estate Escrow Person (REEP) submitting the withholding payment.
Qualified Intermediary Checkbox
Check this box if the remitter is a qualified intermediary (such as for a like-kind exchange) submitting the withholding payment.
Buyer/Transferee Checkbox
Check this box if the remitter is the buyer/transferee making the withholding payment.
Other (specify) Checkbox
Check this box if the remitter is another type not listed above, and enter the remitter type on the line provided.
Other Remitter Type (Specify) Text
Enter the remitter type if you selected "Other" as the remitter type. Fill only if 'Other (specify)' is 'Yes'.
Depends on: Other (specify)
Seller Address and Phone
Seller mailing address Text
Enter the seller/transferror’s mailing street address, including apartment/suite/room number, PO box, or PMB if applicable.
Seller city Text
Enter the city for the seller/transferror’s mailing address.
Seller state Text
Enter the state for the seller/transferror’s mailing address.
Max length: 2 characters
Seller ZIP code Text
Enter the ZIP code for the seller/transferror’s mailing address.
Max length: 10 characters
Seller telephone number Text
Enter the seller/transferror’s telephone number.
Seller Business/Nongrantor Trust Name and Entity ID
Seller Business/Nongrantor Trust Name Text
Enter the seller/transferor’s business name or nongrantor trust name, if applicable. Fill only if 'Nongrantor Trust' is 'Yes'.
Depends on: Nongrantor Trust
FEIN Checkbox
Check this box if the entity ID you are providing for the seller’s Business/Nongrantor Trust is a Federal Employer Identification Number (FEIN).
CA Corp no. Checkbox
Check this box if the entity ID you are providing for the seller’s Business/Nongrantor Trust is a California Corporation number.
CA SOS file no. Checkbox
Check this box if the entity ID you are providing for the seller’s Business/Nongrantor Trust is a California Secretary of State (SOS) file number.
Seller Entity ID Number Text
Enter the seller/transferor’s entity identification number (FEIN, CA Corporation number, or CA SOS file number, as applicable). Fill only if 'FEIN', 'CA Corp no.', 'CA SOS file no.' is 'Yes' (any).
Depends on: FEIN, CA Corp no., CA SOS file no.
Seller/Grantor Name and SSN/ITIN
Seller/Grantor First Name Text
Enter the seller’s or grantor’s first name.
Seller/Grantor Middle Initial Text
Enter the seller’s or grantor’s middle initial, if any.
Max length: 1 characters
Seller/Grantor Last Name Text
Enter the seller’s or grantor’s last name.
Seller/Grantor SSN or ITIN Text
Enter the seller’s or grantor’s Social Security Number (SSN) or Individual Taxpayer Identification Number (ITIN).
Max length: 11 characters
Seller/Transferor Trust Type (Grantor vs Nongrantor)
Grantor Checkbox
Check this box if the seller/transferor is a grantor trust.
Nongrantor Trust Checkbox
Check this box if the seller/transferor is a nongrantor trust.
Signature Dates
Seller/Transferor Signature Date Date
Enter the date the seller/transferor signed the form.
Max length: 10 characters
Seller/Transferor Spouse/RDP Signature Date Date
Enter the date the seller/transferor's spouse or registered domestic partner (RDP) signed the form.
Max length: 10 characters
Buyer/Transferee Signature Date Date
Enter the date the buyer/transferee signed the form.
Max length: 10 characters
Buyer/Transferee Spouse/RDP Signature Date Date
Enter the date the buyer/transferee's spouse or registered domestic partner (RDP) signed the form.
Max length: 10 characters
Spouse/RDP Name and SSN/ITIN (If Jointly Owned)
Spouse/RDP First Name Text
Enter the first name of the spouse or registered domestic partner if the property is jointly owned.
Spouse/RDP Middle Initial Text
Enter the middle initial of the spouse or registered domestic partner if the property is jointly owned.
Max length: 1 characters
Spouse/RDP Last Name Text
Enter the last name of the spouse or registered domestic partner if the property is jointly owned.
Spouse/RDP SSN or ITIN Text
Enter the spouse's or registered domestic partner's Social Security Number or Individual Taxpayer Identification Number if the property is jointly owned.
Max length: 11 characters
Spouse/RDP Name and SSN/ITIN (if jointly purchased)
Spouse/RDP First Name Text
Enter the spouse’s or registered domestic partner’s first name if the property is jointly purchased. Fill only if 'Part IV, box 11' is 'Yes'.
Depends on: Installment sale
Spouse/RDP Middle Initial Text
Enter the spouse’s or registered domestic partner’s middle initial if applicable. Fill only if 'Part IV, box 11' is 'Yes'.
Max length: 1 characters
Depends on: Installment sale
Spouse/RDP Last Name Text
Enter the spouse’s or registered domestic partner’s last name if the property is jointly purchased. Fill only if 'Part IV, box 11' is 'Yes'.
Depends on: Installment sale
Spouse/RDP SSN or ITIN Text
Enter the spouse’s or registered domestic partner’s Social Security number or ITIN. Fill only if 'Part IV, box 11' is 'Yes'.
Max length: 11 characters
Depends on: Installment sale