DO NOT STAPLE

Form

1 042-T

Annual Summary and Transmittal of
Forms 1042-S

OMB No. 1545-0096	

Department of the Treasury Internal Revenue Service

Name of withholding agent

Employer identification number

1 a Type of paper Forms 1042-S attached (check only one box):

Original

Amended

Also check here if pro-rata (see instructions)

b Number of paper Forms 1042-S attached

2a Total gross income on all paper Forms 1042-S (box 2) attached

	

$

b Total U.S. federal tax withheld on all paper Forms 1042-S (box 7) attached

	

$

Caution: If you have already filed a Form 1042 and an attached Form 1042-S causes the gross income or tax withheld information shown on your previously filed Form 1042 to change, you must file an amended Form 1042. See the instructions below.

If this is your FINAL return, enter an “X” here

Please return this entire page to the Internal Revenue Service.

Under penalties of perjury, I declare that I have examined this return and accompanying documents, and to the best of my knowledge

Sign Your signature

and belief they are true, correct, and complete.

Here

T itle

Date

Daytime phone number

Instructions

Center, P.O. Box 409101, Ogden, UT 84409, by March 15, 2007. Send the forms in a flat mailing (not folded).

Purpose of form. Use this form to transmit paper Forms 1042-S, Foreign Person’s U.S. Source Income Subject to Withholding, to the Internal Revenue Service. Use a separate Form 1042-T to transmit each type of Form 1042-S (see the instructions for line 1a).

Identifying information at top of form. The name, address, and EIN of the withholding agent or intermediary on this form must be the same as those you enter on Forms 1042 and 1042-S. See Form 1042 for definitions of withholding agent and intermediary.

If you file 250 or more Forms 1042-S, you are required to submit them electronically or using magnetic media. You can also use these methods to submit less than 250 Forms 1042-S. If you submit

Line 1a. You must file a separate Form 1042-T for each type of paper Form 1042-S you are transmitting. Check only the Original or Amended box. If you are filing pro-rata Forms 1042-S, also check the pro-rata box. As a result, there are four possible types

CAUTION

of Form 1042-S that may be transmitted:

Forms 1042-S using either of these methods, do not

• Original

• Original pro-rata • Amended pro-rata

use Form 1042-T. If you file electronically or using magnetic media, use Form 4804, Transmittal of Information Returns

• Amended

Reported Magnetically.

Each type would be transmitted with a separate Form 1 042-T. For example, you would transmit only original Forms 1042-S with one Form 1042-T and only amended Forms 1042-S with another Form 1 042-T.

Use of this form to transmit paper Forms 1042-S does not affect your obligation to file Form 1042, Annual Withholding Tax Return for U.S. Source Income of Foreign Persons.

If you have not yet filed a Form 1042 for 2006, you may send in more than one Form 1 042-T to submit paper Forms 1042-S prior to filing your Form 1042. You may submit amended Forms 1042-S even though changes reflect differences in gross income and tax withheld information of Forms 1042-S previously submitted with a Form 1 042-T.

Line 2a. Enter the total of the gross income amounts shown on the Forms 1042-S (box 2) being transmitted with this Form 1042-T.

Line 2b. Enter the total of the U.S. federal tax withheld amounts shown on the Forms 1042-S (box 7) being transmitted with this Form 1 042-T.

If you have already filed a Form 1042 for 2006 and an attached Form 1042-S caused the gross income or tax withheld information previously reported on line 62a or 62b of your Form 1042 to change, you must file an amended Form 1042.

Final return. If you will not be required to file Forms 1042-S in the future (on paper, electronically, or on magnetic media), enter an “X” in the “FINAL return” box.

Where and when to file. File Form 1 042-T (and Copy A of the

paper Forms 1042-S being transmitted) with the Ogden Service

For more information and the Privacy Act and Paperwork Reduction Act Notice, see Form 1042.

Cat. No. 28848W

Form 1042-T (2006)

Number, street, and room or suite no.

City or town, province or state, and country (including postal code)

	
	
If you are an intermediary (see Form 1042 instructions), check if you are a:	□	QI/Withholding foreign partnership or trust	
	□		
		NQI/Flow-through entity	

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2006