Form 1042

Form 1042Department of the TreasuryInternal Revenue Service
Annual Withholding Tax Return for U.S. Source Income of Foreign PersonsGo to www.irs.gov/Form1042 for instructions and the latest information.
OMB No. 1545-00962025
1
Name of withholding agent
First NameLast Name
Employer identification number
Ch. 3 Status Code
Ch. 4 Status Code
Address
Street Address
Street Address Line 2
CityState / Province
Postal / Zip CodeCountry
For IRS Use Only
CC
FD
RD
FF
CAF
FP
CR
I
EDC
SIC
2
Enter date final income paid

Section 1 Record of Federal Tax Liability (do not show federal tax deposits here)

Rows	Tax liability for period (including any taxes assumed on Form(s) 1000)
1- Jan 7
2- Jan 15
3- Jan 22
4- Jan 31
5- Jan Total
6- Feb 7
7- Feb 15
8- Feb 22
9- Feb 28
10- Feb total
11- Mar 7
12- Mar 15
13- Mar 22
14- Mar 31
15- Mar total
16- Apr 7
17- Apr 15
18- Apr 22
19- Apr 30
20- Apr total

Section 1 Record of Federal Tax Liability (do not show federal tax deposits here)

Rows	Tax liability for period (including any taxes assumed on Form(s) 1000)
21- May 7
22- May 15
23- May 22
24- May 31
25- May Total
26- June 7
27- June 15
28- June 22
29- June 30
30- June total
31- July 7
32- July 15
33- July 22
34- July 31
35- July total
36- Aug 7
37- Aug 15
38- Aug 22
39- Aug 31
40- Aug total

Section 1 Record of Federal Tax Liability (do not show federal tax deposits here)

Rows	Tax liability for period (including any taxes assumed on Form(s) 1000)
41- Sept 7
42- Sept 15
43- Sept 22
44- Sept 31
45- Sept Total
46- Oct 7
47- Oct 15
48- Oct 22
49- Oct 31
50- Oct total
51- Nov 7
52- Nov 15
53- Nov 22
54- Nov 30
55- Nov total
56- Dec 7
57- Dec 15
58- Dec 22
59- Dec 31
60- Dec total

Note: The totals from the above table are to be entered on lines 64b through 64d (as indicated in the instructions for those lines).
61 No. of Forms 1042-S filed: a On paper
61 b Electronically
62 Total gross amounts reported on all Forms 1042-S and 1000:a Total U.S. source FDAP income (other than U.S. source substitute payments) reported
62 b Total U.S. source substitute payments reported:(1) Total U.S. source substitute dividend payments reported
62 b (2) Total U.S. source substitute payments reported other than substitute dividend payments
62 c Total gross amounts reported (add lines 62a-b)
62 d Enter gross amounts actually paid if different from gross amounts reported
Do you want to allow another person to discuss this return with the IRS? See instructions.
Yes. Complete the following.
Third Party Designee
Designee's name
First NameLast Name
Phone no.
Format: (000) 000-0000.
Personal identification number (PIN)
Sign Here
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than withholding agent) is based on all information of which preparer has any knowledge.
Your signature
Clear
Date
MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Capacity in which acting
Daytime phone number
Format: (000) 000-0000.
Paid Preparer Use Only
Preparer's name
First NameLast Name
Preparer's signature
Clear
Date
MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
3
PTIN
Firm's name
Firm's EIN
Firm's address
Street Address
Street Address Line 2
CityState / Province
Postal / Zip Code
Phone no.
Format: (000) 000-0000.
For Privacy Act and Paperwork Reduction Act Notice, see instructions.
Cat. No. 11384V
Form 1042 (2025) Created 8/25/25

Form 1042 (2025)
Page 2
63 Total tax reported as withheld or paid by withholding agent on all Forms 1042-S and 1000:a Tax withheld by withholding agent
b Tax withheld by other withholding agents:(1) For payments other than substitute dividends
(2) For substitute dividends
c Adjustments to withholding:(1) Adjustments to overwithholding
(2) Adjustments to underwithholding
d Tax paid by withholding agent
e Total tax reported as withheld or paid (add lines 63a-d)
Computation of Tax Due or Overpayment
64 Total net tax liabilitya Adjustments to total net tax liability
b Total net tax liability under chapter 3
c Total net tax liability under chapter 4
d Excise tax on specified federal procurement payments (total payments made x 2% (0.02))
e Total net tax liability (add lines 64a-d)
65 Total paid by electronic funds transfer (or with a request for extension of time to file):a Total paid during calendar year
b Total paid during subsequent year
66 Enter overpayment applied as credit from 2024 Form 1042
67 Credit for amounts withheld by other withholding agents:a For payments other than substitute dividend payments
b For substitute dividend payments
68 Total payments. Add lines 65 through 67
69 If line 64e is larger than line 68, enter balance due here
70a Enter overpayment attributable to overwithholding on U.S. source income of foreign persons
b Enter overpayment attributable to excise tax on specified federal procurement payments
71a Apply overpayment (sum of lines 70a and 70b) to (check one):
Complete lines 71b, 71c, and 71d.b Routing number
c Type:
d Account number
Section 2 Reconciliation of Payments of U.S. Source FDAP Income
1 Total U.S. source FDAP income required to be withheld upon under chapter 4
2 Total U.S. source FDAP income required to be reported under chapter 4 but not required to be withheld upon under chapter 4 because:
a Amount of income paid to recipients whose chapter 4 status established no withholding is required
b Amount of excluded nonfinancial payments
c Amount of income paid with respect to grandfathered obligations
d Amount of income effectively connected with the conduct of a trade or business in the United States
e Total U.S. source FDAP income required to be reported under chapter 4 but not required to be withheld upon under chapter 4 (add lines 2a-d)
3 Total U.S. source FDAP income reportable under chapter 4 (add lines 1 and 2e)
4 Total U.S. source FDAP income reported on all Forms 1042-S (from lines 62a, 62b(1), and 62b(2))
5 Total variance, subtract line 3 from line 4; if amount other than zero, provide explanation on line 6
6 Explanation of variance
Section 3 Potential Section 871(m) Transactions
4
Section 4 Payments by a Qualified Derivatives Dealer (QDD)
5
If the box is checked, you must do the following.
(1) Attach Schedule(s) Q (Form 1042). See instructions.
(2) Enter your EIN (other than your QI-EIN)
(2) Enter your EIN (other than your QI-EIN)
Should be Empty:

Select theme:

Form 1042Department of the TreasuryInternal Revenue Service

Annual Withholding Tax Return for U.S. Source Income of Foreign PersonsGo to www.irs.gov/Form1042 for instructions and the latest information.

OMB No. 1545-00962025

For IRS Use Only

Third Party Designee

Sign Here

Paid Preparer Use Only

Computation of Tax Due or Overpayment

Section 2 Reconciliation of Payments of U.S. Source FDAP Income

Section 3 Potential Section 871(m) Transactions

Section 4 Payments by a Qualified Derivatives Dealer (QDD)