Form 4419 - Application For Filing Information Returns Electronically (Fire) Page 2

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Form 4419
(Rev. 6-2012)
Page
General Instructions
Block 5
Enter the tax year that you wish to begin filing electronically.
Paperwork Reduction Act Notice. We ask for the information
on these forms to carry out the Internal Revenue Laws of the
Block 6
United States. You are not required to provide the information
Indicate if you are requesting this transmitter control code solely
requested on a form that is subject to the Paperwork Reduction
for filing electronic files for an extension of time to file
Act unless the form displays a valid OMB control number.
information returns.
Books or records relating to a form must be retained as long as
Block 7
their contents may become material in the administration of any
Only check the box next to the returns you need to file with IRS
Internal Revenue law. Generally, tax returns and return
electronically. A separate TCC will be assigned for each box
information are confidential, as required by Code section 6103.
checked in Block 7. Please be sure to submit your electronic
The time needed to provide this information would vary
files using the correct TCC. For further information concerning
depending on individual circumstances. The estimated average
the electronic filing of information returns, access IRS.gov for
time is:
the current tax year publications. These are:
Preparing Form 4419 . . . . . . . . . . . . . . . . . . . . . 20 min.
Publication 1220, Specifications for Filing Form 1097, 1098,
If you have comments concerning the accuracy of this time
1099, 3921, 3922, 5498, 8935, and W2-G Electronically
estimate or suggestions for making this form simpler, we would
Publication 1187, Specifications for Filing Form 1042-S,
be happy to hear from you. You can write to the Internal
Foreign Person’s U.S. Source Income Subject to Withholding,
Revenue Service, Tax Forms Committee, Western Area
Electronically
Distribution Center, Rancho Cordova, CA 95743-0001.
DO NOT SEND THE FORM TO THIS OFFICE.
Publication 1239, Specifications for Filing Form 8027,
Instead, see the instructions below on where to file. When
Employers Annual Information Return of Tip Income and
completing this form, please type or print clearly.
Allocated Tips, Electronically
Purpose of Form. File Form 4419 to request authorization to
Publication 4810, Specifications for Filing Form 8955-SSA,
file any of the forms shown in Block 7 electronically. Please be
Annual Registration Statement Identifying Separated
sure to complete all appropriate blocks. Transmitters who file
Participants and Deferred Vested Benefits, Electronically
for multiple payers may submit one application and use the
assigned TCC for all payers. If your application is approved, a
Block 8
five-character alphanumeric Transmitter Control Code (TCC)
Indicate if your company will be filing your data with a software
will be assigned to your organization. If any information on the
package (and provide the name of the software) or if you have
form should change, please write to IRS/Information Returns
contracted to have a service provider file your data for you.
Branch so we can update our database. It is not necessary to
submit a new Form 4419.
Note: The FIRE System does not provide an on-line fill-in
Forms W-2: Do not use Form 4419 to request authorization
option for the forms listed in Box 7. You must transmit your
to file Forms W-2 electronically, since Form W-2 information is
data in a specific format required by IRS.
only sent to the Social Security Administration (SSA). Contact
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SSA if you have any questions concerning the filing of
The form must be signed and dated by an official of the
Forms W-2 electronically at 1-800-772-6270.
company or organization requesting authorization to report
electronically.
Specific Instructions
Due Date: In order to ensure timely filing, submit Form 4419
Mailing Address:
at least 45 days before the due date of the return.
Send your Form 4419 to the address below:
Block 1
Internal Revenue Service
Enter the legal name (associated with the EIN in box 3) and
Information Reporting Program
the complete address of the organization that will submit the
230 Murall Drive Mail Stop 4360
electronic files (transmitter and/or payer).
Kearneysville, WV 25430
Block 2
If you prefer, Form 4419 can be faxed to the IRS, Information
Enter the name, title, email address (if available) and
Returns Branch at (877) 477-0572 from within the U.S. or
telephone number (with area code) of the person to contact
(304) 579-4105 from outside the U.S.
about this application. This should be a person who is
knowledge able about electronic filing of information returns.
You may contact the IRS, Information Returns Branch at
(866) 455-7438 from within the U.S. or (304) 263-8700 from
Block 3
outside the U.S., Monday through Friday, between the hours
Enter the Employer Identification Number (EIN) of the
of 8:30 a.m. and 4:30 p.m. Eastern Time (ET).
organization transmitting the electronic files. Social Security
Numbers are not permitted.
We will not issue a TCC over the phone or by email. If you do
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not receive a reply from IRS within 45 days, contact us at the
If you are a foreign transmitter who does not have a nine-digit
telephone number shown above. Do not submit any files until
Taxpayer Identification Number, check this box.
you receive your TCC.

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