Form Fr-900a - Employer'S/payor'S Withholding Tax - 2011 Page 9

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Filling out the form
Write your FEIN/SSN, tax period, business name and address on any
To aid us in processing your return, please follow these rules:
statements submitted with the return or filed separately. The FEIN/SSN is used
for tax administration purposes only.
Using black ink, print in
R O B E R
T S
CAPITAL letters.
Incomplete forms will delay processing
Complete the identification section and then complete the applicable withholding
Leave a space between words
8
E L M
Line 1 on the FR-900A, otherwise processing your return will be delayed.
and between numbers and words.
Yes
No
3 7
Write 3s with rounded tops,
not flat tops.
Write 7s without middle bars.
Round cents to the nearest dollar.
5 7 2 0 4
.
00
$
Do not enter cents.
-7-

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