W-011
2019
WT-11
Nonresident
Entertainer
Withholding Report
Form
Name Employer’s FEIN or SSN
Address Telephone number
City State ZIP code
Part 1: Employer Information
Part 2: Performance Information
If this is an amended return, check here.
Purpose of this form: Nonresident entertainers performing in Wisconsin are subject to 6% withholding. Use this form for any
withholding tax, cash deposit, or bond due. Complete Parts 1, 2, and 3.
Venue name
Address
City State ZIP code
Performance Location Check here if the performance location is the same as the employer’s information above.
Performance begins and ends .
M Y Y Y Y D D M
M Y
Y
Y
Y D D M
Personal Identication Number (PIN)Phone Number
I declare, under penalties of law, that this report is true, correct, and complete to the best of my knowledge and belief.
Third
Party
Designee
Print
Designee’s
Name
Do you want to allow another person to discuss this return with the department? Yes Complete the following. No
3 Amended return only - amount previously paid .................................. 3
4 Add lines 2 and 3 ......................................................... 4
5 Amended return only - amount previously refunded ............................... 5
6 Subtract line 5 from line 4 ................................................... 6
7 Amount due. If line 1 is greater than line 6, subtract line 6 from line 1 ................ 7
8 Overpayment to be refunded. If line 6 is greater than line 1, subtract line 1 from line 6 ... 8
Mail completed form with payment to:
Wisconsin Department of Revenue
PO Box 8991
Madison, WI 53708-8991
Authorized signature Date
A Total contract price (from Part 3, line 11c) ....................................... A
B Total number of entertainers for this return ...................................... B
1 Total nonresident entertainer withholding tax computed (from Part 3, line 11d) .......... 1
2 Total nonresident entertainer payment(s) submitted with this return ($) ................ 2
Complete lines 3 through 8 if this is an amended return or refund request.
Important -- to ensure this form works properly,
save it to your computer before completing the form.
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W-011
Part 3: Nonresident Entertainer Information
Page 2 of 2
A
Entertainer Information
B
Withholding
%
C
Total Contract Price *
D
Withholding
a
Stage name FEIN SSN
%
$ $
Legal name Withholding required? Reason code Entity type
Address Dates of performance
b
Stage name FEIN SSN
%
$ $
Legal name Withholding required? Reason code Entity type
Address Dates of performance
c
Stage name FEIN SSN
%
$ $
Legal name Withholding required? Reason code Entity type
Address Dates of performance
d
Stage name FEIN SSN
%
$ $
Legal name Withholding required? Reason code Entity type
Address Dates of performance
e
Stage name FEIN SSN
%
$ $
Legal name Withholding required? Reason code Entity type
Address Dates of performance
f
Stage name FEIN SSN
%
$ $
Legal name Withholding required? Reason code Entity type
Address Dates of performance
9 Column totals this page ........................................................................
9c 9d
10 Number of additional pages included . Column total from all additional pages ..................
10c 10d
11 Total contract price and withholding tax computed. Add lines 9 and 10 in columns C and D. Enter totals in Part 2 ...
11c 11d
Yes No
/ / / /
From To
Yes No
/ / / /
From To
Yes No
/ / / /
From To
Yes No
/ / / /
From To
Yes No
/ / / /
From To
Yes No
/ / / /
From To
* Include amounts previously earned in this state by the entertainer during the same calendar year for which no bond or cash deposit has been led or for which no Wisconsin income tax has been withheld to determine the total contract price.