Form K-96t - Kansas Magnetic Media Transmittal Required W-2 And 1099 Information Page 2

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K-96T
KANSAS MAGNETIC MEDIA TRANSMITTAL Continued
TAX YEAR
Kansas Payer Summary
(Rev. 10/04)
Page _____ of _____
TRANSMITTER
TRANSMITTER EIN (Employer Identification Number)
Name and Address
EMPLOYER Name and Address
9. Employer Identification Number
10. Kansas Withholding Acct Numbe
11. Total Kansas Wages
12. Total Kansas Withholding
EMPLOYER Name and Address
9. Employer Identification Number
10. Kansas Withholding Acct Numbe
11. Total Kansas Wages
12. Total Kansas Withholding
EMPLOYER Name and Address
9. Employer Identification Number
10. Kansas Withholding Acct Numbe
11. Total Kansas Wages
12. Total Kansas Withholding
EMPLOYER Name and Address
9. Employer Identification Number
10. Kansas Withholding Acct Numbe
11. Total Kansas Wages
12. Total Kansas Withholding
EMPLOYER Name and Address
9. Employer Identification Number
10. Kansas Withholding Acct Numbe
11. Total Kansas Wages
12. Total Kansas Withholding
EMPLOYER Name and Address
9. Employer Identification Number
10. Kansas Withholding Acct Numbe
11. Total Kansas Wages
12. Total Kansas Withholding
EMPLOYER Name and Address
9. Employer Identification Number
10. Kansas Withholding Acct Numbe
11. Total Kansas Wages
12. Total Kansas Withholding
CHANNEL MANAGEMENT MEDIA NUMBER

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