Form 96-T - Magnetic Media Transmittal
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1
296-T
F
IDAHO MAGNETIC MEDIA TRANSMITTAL
O
for Tax Year __________
R
RO01531
W-2 AND 1099 INFORMATION REQUIRED
M
08-23-05
You must complete each section of this form. If you do not, we will return your media.
1. Name of transmitter
4. Number and type of media:
Address
_______ Cartridge (s)
_______ CD (s)
State
Zip code
City
_______ Diskette (s)
2. Name of person to contact about this magnetic media file
5. Type of submission (check one only):
Address
W-2
W-2G
1098
1099-A
State
Zip code
City
1099-B
1099-C 1099-Misc 1099-R
1099-S
3. Telephone number of contact person
Summary of Employers Included on Magnetic Media
11.
6.
7.
8.
9.
10.
Total Idaho
Withholding from
Federal Employer
Number of
Total Idaho Wages
W-2s or 1099s that
Identification
Employees
Idaho Withholding
from W-2s that match
match Form 956, line 14
Name of Employer or Payer
Account Number
Number
or Payees
Form 956, line 1
$
$
FOR STATE USE ONLY
MAGNETIC MEDIA IS DUE FEBRUARY 28, 2006
Times run
#1
#2
#3
#4
#5
MAIL MEDIA TO:
Date Received
Magnetic Media Coordinator
Idaho State Tax Commission
Uploaded By:
800 Park Blvd Plaza IV
PO Box 36
Reformat By:
Boise Idaho 83722-0410
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1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1
VALID
VALID
VALID
VALID
VALID
1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1
1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1
1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1
TELEPHONE:
INVALID
1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1
INVALID
INVALID
INVALID
INVALID
1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1
1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1
(208) 334-7787
Date:
Confirmed:
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