Employer Withholding Electronic Filing Waiver Request - W-2s/1099s

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Employer Withholding Electronic Filing Waiver Request
W-2s/1099s
Complete this form to request a waiver if you are unable to file your W-2/1099s electronically or need
more time to do so. Provide all information requested below.
Business Information
Tax Preparers submitting requests for multiple businesses - Provide your contact information below.
Attach a list of all businesses represented in this request and include the Business Name, Sole Proprietor
Name if applicable, and Federal Employer Identification Number (FEIN) of each. The Approval or Denial
letter will be sent to the employer.
All others provide the information requested below.
Business Name: ______________________________________________________________________
If a Sole Proprietor, First and Last Name of Owner: __________________________________________
Number of Employees: _________________________________________________________________
FEIN: ______________________________________________________________________________
Mailing Address: ______________________________________________________________________
______________________________________________________________________
Contact Name: __________________________ Phone Number: _______________________________
Reason for Waiver
Check the reason a waiver is being requested and provide all information requested.
No Computer
No Internet Access Available in Area
Business Closed / Closing – Provide the date the business closed or is closing. ______________
Other – State the specific reason. __________________________________________________
_____________________________________________________________________________
Fax to: (804) 367-3015
OR
Mail to: Virginia Department of Taxation
Waiver Requests
P.O. Box 27423
Richmond, VA 23261
Electronic Filing Waiver Request – W-2/1099s
Rev. 10/2016

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