Form Ftb 2049c - Magnetic Media Transmittal Form
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10$*1(7,& 0(',$
STATE OF CALIFORNIA
FRANCHISE TAX BOARD
SERVICE AND SUPPLY
ATTN: MAGNETIC MEDIA FIDM
75$160,77$/ )250
9645 BUTTERFIELD WAY
SACRAMENTO, CA 95827
Financial institutions complete and send this form with their magnetic media to the Franchise Tax Board.
File Creation Date_______________
Number of Records ______________
Financial Institution Name _____________________________________________________________
r
r
FEIN ________________________
Type of Reporting:
Method 1
Method 2
Address _____________________________________________________________________________
City
_______________________________________________ State _____
Zip _______________
Contact Person _______________________________________ Phone ________________ Ext. ____
If Transmitting Agency is different than above, please supply the following information:
Transmitting Agency Name _____________________________________________________________
FEIN ________________________
Address_____________________________________________________________________________
City ________________________________________________ State _____ Zip ________________
Contact Person _______________________________________ Phone _________________ Ext. ____
Media Characteristics:
Tapes and cartridges:
____ EBCDIC
____ ASCII
Diskettes:
____ 3 ½
____ 5 ¼
____ STD LBL
____ NO LBL
Filename used on diskette reporting:
Cartridge compatibility: ____ 3480
____ 3490
_______________________________
Send this form with your magnetic media file to:
Shipping
:
U.S. Mail:
(preferred method)
Franchise Tax Board
Franchise Tax Board
Service and Supply
Attn: Magnetic Media FIDM
Attn: Magnetic Media FIDM
PO Box 942840
9645 Butterfield Way
Sacramento, CA 95827
Sacramento, CA 95827
If you need assistance completing any part of this form, please call Franchise Tax Board’s Magnetic Media
Unit at (916) 845-3778.
FTB 2049C (NEW 07-1998)
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