Date: February 27, 2013

Bulletin Number: 1231



Form 1042-S (Foreign Person’s U.S. Source Income Subject to Withholding) for Calendar Year 2012


To inform agencies of the content information for the 2012 Form 1042-S.


According to the IRS instructions for Form 1042-S, amounts subject to reporting on Form 1042-S are those that are paid to foreign persons (including persons presumed to be foreign) that are subject to withholding, even if no amount is deducted and withheld from the payment because of a Treaty or Exemption code.

2012 Form

2012 Form 1042-S will include earnings paid in paychecks dated:

Administration:                   1/4/12 through 12/19/12
Institution:                          1/12/12 through 12/27/12

The information which will appear on the Form 1042-S Statement is described below:

Box 1

Income Code

The two digit code populated in this box identifies the type of income received.  This code is populated on the 1042 Tax Balances page.

Box 2

Gross Income
The amount is the gross sum of all payments made for the calendar year 2012.

Box 3

Withholding Allowances
This box contains the value of the withholding allowance(s) as claimed in the Federal Tax Data page.

Box 4

Net Income

This box is only populated if there is an amount in box 3.

Box 5

Tax Rate
This box is populated with the tax rate applied to the amount in box 2 or box 4.

Box 6

Exemption Code

The exemption code identifies the authority for the exemption or tax rate.  The only exemption codes that
apply to the types of payments made by the State of
New York are Exemption Code 04 (Exempt under tax treaty) and 00 (Not Applicable).

Box 7

Federal Tax Withheld

This box is populated with the value of the Federal tax withheld.  This box will contain a value of “0” if no taxes were withheld.  

Box 8

Withholding by Other Agents

The State of New York does not withhold for other agents.  This box will be populated with the value “0”.

Box 9

Total Withholding Credit

The amount in this box should always match the amount in box 7.

Box 10   

Amount repaid to Recipient

Not applicable.

Box 11

Withholding Agent’s EIN

This box is populated with the Employer Identification Number for the company the Form 1042-S is being issued under.

CUNY 13-3893536
NYS  14-6013200

Box 12a

Withholding Agent’s Name

This box is populated with the name of the Company the Form 1042-S is being issued under.

City University of New York  (CNY)
State of New York  (NYS)

Box  12b-12d 

Withholding Agent’s Address

This box is populated with the address of the Company the Form 1042-S is being issued under.

Box 13a 

Recipient’s Name

This box is populated with the name of the recipient.

Box 13b  

Recipient Code

This box is populated with the recipient code.  The recipient code that applies to Form 1042-S issued by the State of New York is recipient code (01) individual.

Box 13c-13e 

Recipient’s Address

This box is populated with the address of the recipient   from personal data.

Box 14

Recipient’s U.S. TIN (if applicable)

This box is populated with the employee’s Social Security (SSN) Number as written in the National ID field on the Modify a Person page or the Taxpayer Identification Number (ITIN) as written on the Federal Tax Data page.

If the employee has no SSN or ITIN, this box will be blank.  The SSN or ITIN box will also be blank.

Box 15  

Recipient’s Foreign Tax Identifying Number (if applicable)

Populating this box is optional and the information is not maintained in PayServ.

Box 16  

Country Code

This box contains the two character country code for the country the recipient claims residency.  This value will differ from the value populated on the Federal Tax Data page due to the number of characters permitted.

Box 17-25  


Not applicable


The Office of the State Comptroller will create and mail Form 1042-S directly to agency payroll offices on or around March 1, 2013.  Please note that Federal regulations mandate that forms be delivered to employees on or before March 15, 2013.


Questions regarding this bulletin may be e-mailed to the Tax and Compliance mailbox.