Form 77-100 - Registration For Substitute Forms Approval Form

Iowa Department of Revenue

Registration for Substitute Forms Approval

This agreement must be completed by computerized tax processors, tax software developers, commercial

printers and others who develop substitute copies of official Iowa tax forms as stated in the Iowa Administrative

Code 701.8.3, “Substitution of Official Forms.”

If more than one person is responsible for tax forms, each person must complete this registration form. Complete

and mail this form to Substitute Forms Approval, TIM Division, Iowa Department of Revenue, P.O. Box 10460, Des

Moines IA 50306-0460 or fax it to 515/242-6040.

The department intends to present on its Web site ( /forms/taxsoft/taxsoft.html) forms which are in

varying degrees of development. It is the user’s responsibility to recognize that forms may change substantially.

I am a representative of ___________________________________________________ and am authorized to agree to

and answer the following on behalf of the above-named company.

Our company will (check all that apply):

Develop substitute copies of official Iowa tax forms using our tax software programs.

Develop tax software programs to be used with substitute copies of official Iowa tax

forms developed by another company. That company’s name is __________________________________

Develop substitute copies of official Iowa tax forms for other companies to use with their

tax software programs.

Reproduce substitute copies of official Iowa tax forms for publications in a paper format,

only.

Specifically, our company agrees to:

1. Request approval of substitute copies of official Iowa tax forms based on final versions only (not preliminary

drafts) of Iowa forms.

2. Use only final approved versions of official Iowa tax forms to prepare returns for filing, not preliminary drafts.

3. Distribute only final approved versions of official Iowa tax forms to the public.

4. Use as master copies only those official Iowa tax forms found on the software developers secure area on the

department’s Web site.

5. Submit to the Iowa Department of Revenue, Technology and Information Management Division, substitute Iowa

tax forms prior to their release to customers or clients for approval. Forms should be sent to TIM Division, Iowa

Department of Revenue, Hoover Building 4th floor, 1305 E Walnut, Des Moines IA 50319.

6. When notified by TIM, correct errors and notify customers or clients of the corrections.

7. Allow the Iowa Department of Revenue to include the name of our company in various public information

material designed to inform tax practitioners and the public about vendors who have agreed, complied, or failed

to comply with the department’s policies, procedures, guidelines and specifications regarding substitute Iowa tax

forms.

8. Include a 3-digit alpha code that signifies your company on all Iowa forms. For example, Iowa Department of

Revenue might be represented by IDR or DOR. This 3-digit designation allows Revenue to identify which

substitute forms are being submitted to our department. Please list the code you will be using in the appropriate

space below.

Name of the company

Name of person to contact about forms (please print)

Street address

Signature of contact person

Date

City, state, ZIP code

Three-digit Company Identification Code

Telephone number

Fax number

FOR OFFICE USE ONLY

Company identification code:

E-mail address

Company password to Web site:

77-100 (07/01/08)

Form 77-100 - Registration For Substitute Forms Approval Form - Iowa

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