Form R-210NRA Fillable 2013 Nonresident Professional Athlete Underpayment Penalty Return
(all forms fillable on Windows, Mac, Android tablets, and iPad using Adobe Reader XI)

Name shown on tax return Social Security Number (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) 1 2013 tax liability See instructions 11 Exception 2 Prior Year s Tax Liability 12 Exception 3 Prior Year s Income 13 Exception 4 Annualized Income 14 Exception 5 Installment Period Income 15 Amount of underpayment (from Line 9 above) 16 Date of Payment See instructions 17 Number of days from due date of installment 18 Penalty See instructions 2 2012 tax liability See instructions 3 Enter the smaller of Line 1 or Line 2 4 Number of payments required for year 5 from Line 8 A positive number indicates an 6 Amount paid for each period See instructions 8 Amount available for period Add Lines 6 and 7 amount on Line 3 by the amount on Line 4 See available can be a positive number or a negative number Carryforward amounts from the previous period Carryforward Overpayment or underpayment Computation 2013 Taxable Year Exception 1 See worksheet on page 3 If you meet this exception you do not owe an underpayment penalty STOP from previous period on Line 9 of each column instructions Line 7 in next column no exception Nonresident Professional Athlete Note: No carryforward amount can be shown for overpayment A negative number indicates an overpayment Print the total here and on Form IT 540B NRA Line 32 if you have a balance due Penalty Add amounts on Line 18 Print the total here and on Form IT 540B NRA Line 17 if you have an PLEASE PRINT OR TYPE R 210NRA (1/14) Required payment From Section 1 divide Section 1 Required Annual Payment Section 2 Underpayment Computation 04/15/13 06/15/13 09/15/13 01/15/14 Section 3 Exceptions Section 4 Penalty Computation Spouse s the first period See instructions underpayment Move the number on this line to Underpayment of Individual Income Tax Penalty Underpayment or overpayment Subtract Line You do not need to file this form Yours