State of Rhode Island Division of Taxation 
     2023 RI Schedule PTW 
     Pass-through Withholding Transmittal Schedule                                                                  23114099990101

Name                                                                                                                         Federal employer identification number

   Cannot distribute due to Federal or                Income is exempt from tax                                              Members with less than $1,000 in RI 
   State restrictions (see instructions)                                                                                     source income (see instructions)
   All nonresident income reported on Form RI-1040C - A PTE election was made for all individual members 
   Composite Income Tax Return                        and Form RI-PTE was filed for the taxable year.

Part A - Nonresident Rhode Island Source Income Calculation

1  Apportioned Rhode Island taxable income from RI-1065, line 6 or RI-1120S, line 6...................................................                               1

2  Profit percentage or current year allocation percentage of ALL members/partners that are nonresidents.........................                                    2
                                                                                                                                                                         _ . _ _ _ _ _ _  
3  Rhode Island source income of ALL nonresident members (multiply line 1 by line 2).................................................                                3

                                                                                                                    Column A                                             Column B
Part B - Pass-through Withholding Calculation                                                                                                                          Sub S Corps, Individuals,  
                                                                                                                    C Corporations only                              LLCs, Partnerships & Trusts
4  Rhode Island source income of nonresident members by entity type .....................                       4a                                                   4b
5  Rhode Island source income of nonresident members that cannot be distributed                                 5a                                                   5b
   to Federal or State restrictions ............................................................................
6  Rhode Island source income of nonresident members exempt from tax.................                           6a                                                   6b

7  Rhode Island source income of those nonresident members with income of less                                  7a                                                   7b
   than $1,000 net of modifications (attach schedule).................................................
8  Rhode Island source income of nonresident reported on Form RI-1040C ..............                           8a                                                   8b

9  Rhode Island source income of nonresident members reported on Form RI-PTE ..                                 9a                                                   9b
   Rhode Island source income of nonresident members subject to PT withholding 
10                                                                                                              10a                                                  10b
   (For Column A, subtract 5a - 9a from 4a; For Column B, subtract 5b - 9b from 4b)
11 Rhode Island nonresident pass-through withholding rate........................................               11a 7.0%                                             11b 5.99%

12 Rhode Island pass-through withholding. For each col. multiply line 10 by line 11 ...                         12a                                                  12b

13 TOTAL Rhode Island pass-through withholding due.  Add lines 12a and 12b.  Enter here and on Form RI-1065,                                                         13
   line 7c; or Form RI-1120S, line 7c................................................................................................................................

                                                                                                                                                                                          New 
                                                                                                                                                                                 06/2023

     State of Rhode Island Division of Taxation 
     2023 RI Schedule PTW 
     Pass-through Withholding Transmittal Schedule 23114099990102

Name                                                                                                                                                   Federal employer identification number

Part C - Pass-through Withholding Paid on Entity’s Behalf by Another Pass-through Entity
     Name                                       Federal Employer Identification Number                                                                 Pass-through Withholding Amount

14 a

b

c

d

e

f

g

h

i

j

k

l

m

n

o

p

q

r

s

t

u
v Total Pass-through withholding (add amounts from lines 14a thru 14u).  Enter here and on Form RI-1065, 
    line 9b; or Form RI-1120S, line 9b.................................................................................................................