Form Ftb 4800 Meo C1 - Federally Tax-Exempt Non-California Bond Interest And Interest-Dividend Payment Information Media Transmittal Page 4
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4Preparation Instructions
A. Form Preparation
Write 'Password Protected' on the top of your
completed transmittal that you mail with your CD. Do
Follow the steps below to complete each transmittal
not send your password via the U.S. mail as this will
required based on media type.
delay the processing of your information.
1. Transmitter Information
Mailing Instructions
Indicate whether the data on the media file is the
Complete this form as described above and send it with
original installment, a correction of specific original
the media files to:
records, or a replacement for the original file. Enter
the name, address, city, state, ZIP code, and FEIN
U.S. Postal Services (USPS)
of the organization transmitting the media.
DATA EXCHANGE TEBI MS L120
2. Payer Information
FRANCHISE TAX BOARD
PO BOX 1468
List the payer name, FEIN, the number of payee
SACRAMENTO CA 95812-1468
documents, and the corresponding dollar amount. If
more room is needed to list additional payers, fill
Private Mail Carriers
out and attach additional forms.
DATA EXCHANGE TEBI MS L120
Accumulate and enter (1) the total number of payee
SERVICE AND SUPPLY
returns reported by all payers and (2) the total of all
FRANCHISE TAX BOARD
payment amounts reported by all payers. If this
9646 BUTTERFIELD WAY
information is reported on an attached computer list,
SACRAMENTO CA 95827
it must be carried forward to the Grand Total line.
Customer Service Assistance
The signature line must be properly signed and
dated by the person delegated this responsibility by
For technical assistance with media reporting and other
the organization. An organization transmitting for
questions regarding this reporting requirement, call
others becomes the payer's agent and assumes
800.852.5711 to speak with a customer service
responsibility for data quality and completeness.
representative.
3. Media Characteristics
Facsimile Customer Assistance
Acceptable media is CD. Provide the file name used
You may also fax your response or questions to us at
for reporting.
916.843.0943.
4. Contact Information
Due Date
Enter the name, telephone number, and email
The due date for furnishing information returns for
address of a person we can contact for technical
payments of interest or interest-dividends made during
information or to resolve media problems.
the 2012 tax year is June 1, 2013. Provide this
information to FTB separately from the other interest
B. Password Protection
or dividend information returns that are due by
February 28, 2013.
If you choose to password protect your CD before
sending it to FTB, please send your password to the
Franchise Tax Board Privacy Notice
email address desbond@ftb.ca.gov.
Get FTB 1131, Franchise Tax Board Privacy Notice, at
Enter "Interest and Interest-Dividend Payments on
ftb.ca.gov or call us at 800.338.0505. If outside the
Federally Tax-Exempt Bonds" on the subject line and
United States, call 916.845.6500.
include your:
●
Business name.
●
Transmitter number or other identification number.
●
Password.
FTB 4800 MEO C1 (REV 10-2012) PAGE 4
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