DO NOT STAPLE
Form 1042-T
Department of the Treasury
Internal Revenue Service
Annual Summary and Transmittal of
Forms 1042-S
OMB No. 1545-0096
2018
Go to www.irs.gov/Form1042T for the latest information.
Name of withholding agent
Ch. 4 Status Code
Ch. 3 Status Code
Employer identification number
Number, street, and room or suite no.
City or town, state or province, country, and ZIP or foreign postal code
1 Type of paper Forms 1042S attached:
a Choose only one:
Chapter 4 or Chapter 3 (enter 4 or 3)
b Check only one box:
Original Amended
c Check if pro-rata
d
Enter the number of paper Forms 1042S attached
2 Total gross income reported on all paper Forms 1042-S (box 2) attached . . . . . . . . .
$
3 Total federal tax withheld on all paper Forms 1042-S attached:
a Total federal tax withheld under Chapter 4 . . . . . . . . . . .
$
b Total federal tax withheld under Chapter 3 . . . . . . . . . . .
$
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 on page 2.
If this is your FINAL return, enter an “X” here (see instructions)
Please return this entire page to the Internal Revenue Service.
Sign
Here
Under penalties of perjury, I declare that I have examined this return and accompanying documents and, to the best of my knowledge and
belief, they are true, correct, and complete.
Your signature Title Date Daytime phone number
For more information and the Privacy Act and Paperwork Reduction Act Notice, see Form 1042-S.
Cat. No. 28848W
Form 1042-T (2018)
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Form 1042-T (2018)
Page 2
Instructions
Future Developments
For the latest information about developments related to Form
1042-T and its instructions, such as legislation enacted after
they were published, go to www.irs.gov/Form1042T.
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 1 below).
Electronic Filing Requirement
If you file 250 or more Forms 1042-S, you are required to submit
them electronically. If you submit fewer than 250 Forms 1042-S,
you are encouraged to file them electronically. If you are a
financial institution, you are required to submit Forms 1042-S
electronically irrespective of the number of Forms 1042-S you
submit. If you submit Forms 1042-S electronically, do not use
Form 1042-T. See the Instructions for Form 1042 for the
definition of financial institution.
Filing Forms 1042 and 1042-S
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 2018, you may send
in more than one Form 1042-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 1042-T.
If you have already filed a Form 1042 for 2018 and an
attached Form 1042-S caused the gross income or tax withheld
information previously reported on line 62c or 63e of your Form
1042 to change, you must file an amended Form 1042.
Where and When To File
File Form 1042-T (and Copy A of the paper Forms 1042-S being
transmitted) with the Ogden Service Center, P.O. Box 409101,
Ogden, UT 84409, by March 15, 2019. Send the forms in a flat
mailing (not folded).
Line Instructions
Identifying information at top of form. The name, address,
EIN, and chapter 4 and 3 status codes of the withholding agent
named on this form must be the same as those you enter on
Forms 1042 and 1042-S. See the Instructions for Form 1042 for
definition of withholding agent. See the Instructions for Form
1042-S for the withholding agent codes for the chapter 4 and 3
status codes. You must enter both a chapter 4 and a chapter 3
withholding agent status code regardless of the type of payment
being made.
Line 1. You must file a separate Form 1042T for each type of
paper Form 1042S you are transmitting.
Line 1a. Withholding agents are not permitted to file a single
Form 1042T to transmit both chapter 4 and chapter 3 amounts.
Withholding agents must indicate either chapter 4 or chapter 3
to designate the chapter for which they are filing a given Form
1042T. The chapter you designate on this form must be the
same as that on all attached Forms 1042S. See Chapter
indicator in the Form 1042S instructions for additional
information.
Line 1b. Check either the Original or Amended box (but not
both).
Line 1c. Check the box on this line 1c if you are filing prorata
Forms 1042S (see Form 1042S instructions).
As a result of the above rules, there are eight possible types
of Form 1042S that may be transmitted, and each type requires
a separate Form 1042T.
• Chapter 4, original, prorata.
• Chapter 4, original, nonprorata.
• Chapter 4, amended, prorata.
• Chapter 4, amended, nonprorata.
• Chapter 3, original, prorata.
• Chapter 3, original, nonprorata.
• Chapter 3, amended, prorata.
• Chapter 3, amended, nonprorata.
Each type must be transmitted with a separate Form 1042-T.
For example, you must transmit only Chapter 3, original, pro-
rata Forms 1042-S with one Form 1042-T.
Line 2. Enter the total of the gross income amounts shown on
the Forms 1042-S (box 2) being transmitted with this Form
1042-T.
Line 3. Enter the total of the federal tax withheld amounts
shown on all Forms 1042-S (total of amounts reported in boxes
10 and 11) being transmitted with this Form 1042-T. On this
Form 1042-T, complete either line 3a or line 3b, but not both. If
you indicated “Chapter 4” on line 1a, complete line 3a to report
the total amounts withheld pursuant to chapter 4. If you
indicated “Chapter 3” on line 1a, complete line 3b to report the
total amounts withheld pursuant to chapter 3.
Final return. If you will not be required to file additional Forms
1042-S, including amended Forms 1042-S for the 2018 year (on
paper or electronically), enter an “X” in the “FINAL return” box.
Paperwork Reduction Act Notice. The time needed to
complete and file this form will vary depending on individual
circumstances. The estimated average time is 12 minutes.
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