Form Ftb 4800 - Federally Tax Exempt Non-California Bond Interest And Interest-Dividend Payment Information Magnetic Media Transmittal Page 2

ADVERTISEMENT

FEDERALLY TAX EXEMPT NON-CALIFORNIA
STATE OF CALIFORNIA
FRANCHISE TAX BOARD
BOND INTEREST & INTEREST-DIVIDEND PAYMENTS
PO BOX 942840
SACRAMENTO CA 94240-6090
HARDCOPY REPORTING FORM
PAYER INFORMATION
*Name _________________________________________________ *FEIN ____________________________________________
*Street _________________________________________________
*City __________________________________________________
*State _________________________________________________
*ZIP Code ______________________________________________ Payment Year: ____________________
PAYEE INFORMATION
1. SSN
7. Amount Earned:
2. Name
8. Acct. No.:
3. Street
9. Fund Distribution Percentage:
4. City
10. CUSIP No.
5. State
CUSIP Description:
6. ZIP Code
1. SSN
7. Amount Earned:
2. Name
8. Acct. No.:
3. Street
9. Fund Distribution Percentage:
4. City
10. CUSIP No.
5. State
CUSIP Description:
6. ZIP Code
1. SSN
7. Amount Earned:
2. Name
8. Acct. No.:
3. Street
9. Fund Distribution Percentage:
4. City
10. CUSIP No.
5. State
CUSIP Description:
6. ZIP Code
1. SSN
7. Amount Earned:
2. Name
8. Acct. No.:
3. Street
9. Fund Distribution Percentage:
4. City
10. CUSIP No.
5. State
CUSIP Description:
6. ZIP Code
1. SSN
7. Amount Earned:
2. Name
8. Acct. No.:
3. Street
9. Fund Distribution Percentage:
4. City
10. CUSIP No.
5. State
CUSIP Description:
6. ZIP Code
CUSTOMER SERVICE INFORMATION
Name _____________________________________________
Mail to: Franchise Tax Board
Telephone (
) ___________________
Ext. __________
Attn: Mag Media TEB
PO Box 942840
Address ____________________________________________
Sacramento CA 94240-6090
_________________________________ ZIP ____________
FTB 4800 (REV 12-2000) PAGE 5

ADVERTISEMENT

00 votes

Related Articles

Related forms

Related Categories

Parent category: Financial
Go
Page of 2