Form 96-T - Idaho Magnetic Media Transmittal

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96-T
F
IDAHO MAGNETIC MEDIA TRANSMITTAL
O
for Tax Year __________
R
M
EFO00107
1099 INFORMATION REQUIRED
06-17-09
You must complete each section of this form. If you don't, we will return your media.
1. Name of transmitter
4. Number and type of media:
_______ CD (s)
Address
_______ Diskette (s)
State
Zip code
City
2. Name of person to contact about this magnetic media file
5. Type of submission
Address
W-2G
1098
1099-A
1099-B
State
Zip code
City
1099-C 1099-Misc 1099-R
1099-S
3. Telephone number of contact person
Summary of Payers Included on Magnetic Media
6.
10.
7.
8.
9.
Federal Employer
Number
Total Idaho Withholding
Identification
of
from 1099s reported on
Idaho Withholding
Name of Payer
Number
Payees
Form 967
Account Number
$
MAILING ADDRESS
FOR STATE USE ONLY
Magnetic media is due March 1, 2010
Times run
#1
#2
#3
#4
#5
MAIL MEDIA TO:
Electronic Filing Coordinator
Idaho State Tax Commission
Date received
PO Box 36
Boise, ID 83722-0410
Uploaded by:
Reformat by:
Physical Address:
Electronic Filing Coordinator
VALID
VALID
VALID
VALID
VALID
Idaho State Tax Commission
800 Park Blvd Plaza IV
INVALID
INVALID
INVALID
INVALID
INVALID
Boise, ID 83712-7763
Date:
TELEPHONE:
(208) 334-7787
Confirmed:
FOR STATE USE ONLY

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