Form G-141/otx0013 - Transmittal Of Tax Returns Reported On Magnetic Media May 2015
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1OTX0013
Oklahoma Tax Commission
Form G-141
Transmittal of Tax Returns Reported on Magnetic Media
Revised 5-2015
Form G-141/OTX0013
Oklahoma Tax Commission - Transmittal of Magnetic Media Tax Return
Type of Tax
Total Number of Records
Total Amount Reported
OTC Account Number
Period Reported
CD/DVD/Flash Drive Identification number(s): ________________
Original
Replacement
_____________________________________________________
Correction
Test
Media Type:
CD
DVD
Flash Drive
_______________________________________________
FEIN/SSN
Number of Media Volumes in this Shipment: __________________
_______________________________________________
_____________________________________________________
Name of Taxpayer
Name of Contact Person
_______________________________________________
_____________________________________________________
Address
Address
_______________________________________________
_____________________________________________________
City
State
Zip
City
State
Zip
I declare the information contained on this magnetic media is true and
_____________________________________________________
correct to the best of my knowledge and belief.
Telephone Number
Signature
Date
Total Amount Paid $ ____________________________________
General Instructions
Complete Form G-141 as it must accompany each tax filing by Compact Disc (CD), DVD or Flash Drive.
Please label CD, DVD or Flash Drive as directed in specific tax type instructions. If your return resides on more than one
CD, DVD or Flash Drive each must be labeled, 1 of ___________ , 2 of _________ , etc.
Payment
To assist us in processing your return accurately and assure proper credit to your account, please send a separate check
with each report submitted. Please put your OTC Account Number (item 2) on your check.
Mandatory inclusion of Social Security and/or Federal Empolyer’s Identification numbers is required on forms filed with
the Oklahoma Tax Commission pursuant to Title 68 of Oklahoma Statutes and regulations thereunder, for identification
purposes, and are deemed part of the confidential files and records of the Oklahoma Tax Commission.
The Oklahoma Tax Commission is not required to give actual notice of changes in any state tax law.
Please sign and date this return. If you have any questions, please call the Oklahoma Tax Commission at (405) 521-3160.
Mail all returns and media to:
Oklahoma Tax Commission
P.O. Box 26940
Oklahoma City, OK 73126-0940
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