Annual Summary and Transmittal of
(REV. 2020)
Hawaii Information Returns
FILER’S name
In Box 1 or 2 below, enter the identification number used when
filing the information returns being transmitted. Fill in either box
1 or 2, not both.
Street address
1 Federal Employer I.D. Number 2 Social Security Number
3 Total number of forms 4 Total amount reported with
this Form N-196.
City, State, and Postal/ZIP code
Check only one box below to indicate the type of form being transmitted: If this is your FINAL return, check here.
Name of person to contact if
the Department of Taxation
needs more information.
Telephone Number
( )
I hereby declare under penalties set forth in section 231-36, HRS, that to the best of my knowledge and belief, the accompanying documents constitute a true
and complete return of payments of the above described classes of income made by the person or organization named above during the calendar year indicated
(Authorized Signature) (Title) (Date)
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Purpose of Form — Use this form to transmit State copies of paper 1099
forms to the Department of Taxation (Department). The use of federal
Forms 1099-DIV, 1099-G, 1099-INT, 1099-K, 1099-MISC, 1099-NEC,
1099-OID, 1099-PATR, and 1099-R are required, as the Department is
not printing its own version of these forms. Also use this form to transmit
State copies of corrected 1099 forms to the Department.
Who Must File Forms 1099 With the Hawaii Department of
Taxation — Every person engaged in a trade or business in Hawaii
or having a place of business or a fiscal or paying office in Hawaii and
making payments in the course of such trade or business to another
person must make a separate information return on Form 1099.
Internet Address — Forms and other tax information may be
downloaded from the Department’s website at:
Foreign Items — In the case of foreign items, i.e., interest upon the bonds
of a foreign country or of a nonresident corporation organized and existing
under the laws of a foreign country not having a fiscal agent or paying
agent in Hawaii, or any items of dividends upon stock of such corporation,
a return on Form 1099 shall be filed by any person who accepts the items
for collection, such as a bank as defined in section 241-1, HRS, if the
amount paid to a resident individual of Hawaii, a fiduciary of a resident
estate or trust, or a resident partnership, any member of which is a
resident of Hawaii, during the calendar year is $600 or more.
Nominee/Middleman Returns — Generally, anyone receiving amounts
that actually belong to another person should file a Form 1099 showing
the actual owner as the recipient and the nominee as the payer.
Use of Substitute Forms Persons wishing to use a substitute of
Form N-196 must comply with the Department’s most current Forms
Reproduction Policy. Persons using substitute Forms 1099 may use
any forms approved for federal filing.
Electronic Filing — The State of Hawaii participates in the combined
federal/state electronic filing program which was established to simplify
information returns filing for taxpayers. The Internal Revenue Service
(IRS) will accept, upon prior approval, electronic files containing Hawaii
reporting information. No other report to the Department is necessary.
If properly coded, corrections filed with the IRS electronically will be
forwarded to the Department, otherwise, corrected returns must be filed
with the Department on the appropriate paper forms. The Department
does not accept any Form N-196 or Form 1099 filed electronically directly
from the taxpayer. For further information, see federal Publication 1220.
Certain Federal Filings Not the Same for Hawaii — Hawaii has no
plans at this time to require the filing of the following forms since there
are no statutory provisions requiring such filing:
Form 1098, Mortgage Interest Statement,
Form 1098-C, Contributions of Motor Vehicles, Boats, and
Form 1098-E, Student Loan Interest Statement
Form 1098-T, Tuition Statement
Form 1099-A, Acquisition or Abandonment of Secured
Form 1099-B, Proceeds From Broker and Barter Exchange
Form 1099-C, Cancellation of Debt
Form 1099-CAP, Changes in Corporate Control and Capital
Form 1099-H, Health Coverage Tax Credit (HCTC) Advance
Form 1099-LTC, Long-Term Care and Accelerated Death
Form 1099-Q, Payments From Qualified Education
Programs (Under Sections 529 and 530)
Form 1099-S, Proceeds From Real Estate Transactions,
Form 1099-SA, Distributions From an HSA, Archer MSA, or
Medicare Advantage MSA
Form 5498, IRA Contribution Information,
Form 5498-ESA, Coverdell ESA Contribution Information, and
Form 5498-SA, HSA, Archer MSA or Medicare Advantage MSA
In addition, the Hawaii Income Tax Law does not conform to the federal
reporting requirements of the following:
Backup withholding, and
Electronic reporting for interest, dividends, and broker and
barter exchange transactions.
FORM N-196
Clear Form
Completing Form N-196
1. Enter the last two digits of the calendar year (upper right corner)
for which this Form N-196 is being completed.
2. Enter the filer’s name and address in the appropriate area on
the form.
3. Enter the filer’s taxpayer identification number in either Box 1
or Box 2. Individuals not in a trade or business should enter their
social security number in Box 2. Sole proprietors and all others
should enter their federal employer identification number in Box 1.
Sole proprietors who are not required to have a federal employer
identification number should enter their social security number in
Box 2. Do not fill in both Boxes 1 and 2.
4. In Box 3, enter the number of 1099 forms you are filing with this
Form N-196. Do not include blank or voided forms in your total.
Enter the number of correctly completed forms, not the number of
pages, being filed. For example, if you send one page of three-to-
a-page Forms 1099-DIV with a Form N-196 and you have correctly
completed two Forms 1099-DIV on that page, enter 2 in Box 3 of
Form N-196.
5. Enter in Box 4 the total of the amounts from the specific boxes of
the forms listed below:
Form 1099-DIV Boxes 1a, 2a, 3, 8, and 9
Form 1099-G No entry needed.
Form 1099-INT Boxes 1, 3, and 8
Form 1099-K Box 1
Form 1099-MISC Boxes 1, 2, 3, 5, 6, 7, 8, 10, 13, and 14
Form 1099-NEC Box 1
Form 1099-OID Boxes 1, 2, and 8
Form 1099-PATR Boxes 1, 2, 3, and 5
Form 1099-R Box 1
6. Check the appropriate box to indicate the type of 1099 form you
are filing. If you must file several different 1099 forms, each type
must be filed with a separate Form N-196. For example, if you pay
both interest and dividends, file Forms 1099-INT with one Form
N-196 and Forms 1099-DIV with a second Form N-196.
7. If this is your final filing of Forms 1099, check the box under Box 4.
8. In the appropriate box, indicate the name and telephone number
of a contact person if the Department needs more information.
9. Form N-196 must be signed by someone having the authority
to do so. Under certain conditions, a transmitter, service bureau,
paying agent, or disbursing agent may sign the affidavit on behalf
of the payer. The transmitter, service bureau, paying agent, or
disbursing agent must meet all the following conditions:
a. Have the authority to sign the affidavit under an agency
agreement (either oral, written, or implied) that is valid
under State law;
b. Have the responsibility (either oral, written, or implied)
conferred on it by the payer to request the taxpayer
identifying numbers; and
c. Sign the affidavit and add the caption “For (Name of payer).
Preparing Corrected Forms — If you are preparing corrected
Forms 1099, place an “X” in the “CORRECTED” box at the top of
Form N-196 and on the corrected Forms 1099 being submitted.
Do not include original Forms 1099 with your corrected forms
being filed. Complete all the requested information on the
corrected forms since these forms replace the forms previously
submitted. Statements issued to recipients must be identified as
“CORRECTED.” Corrected forms may be filed electronically. See
Electronic Filing for information.
FILING FORM N-196 Form N-196 and Forms 1099 must be
filed on the basis of the calendar year even though your income tax
return is filed on the basis of a fiscal year.
When to File — File Form N-196 and State copies of Forms 1099
on or before February 28 of the following year. If the due date falls
on a Saturday, Sunday, or legal holiday, file by the next regular
workday. Hawaii has adopted the Internal Revenue Code provision
to allow documents and payments delivered by a designated private
delivery service to qualify for the “timely mailing treated as timely
filing/paying rule.” The Department will conform to the Internal
Revenue Service listing of designated private delivery service and
type of delivery services qualifying under this provision. Timely filing
of mail which does not bear the U.S. Post Office cancellation mark
or the date recorded or marked by the designated delivery service
will be determined by reference to other competent evidence. The
private delivery service can tell you how to get written proof of the
mailing date.
Where to File — File Form N-196 and State copies of Forms 1099
to the Hawaii Department of Taxation at: P.O. Box 3559, Honolulu,
HI 96811-3559, or at 830 Punchbowl St., Room 126, Honolulu, HI
Shipping and Mailing — If you are sending a large number of
forms, you may send them in conveniently sized packages. On
each package, write your name and identifying number. Number the
packages consecutively and place Form N-196 in package number
one. At the top of Form N-196, show the number of packages.
Postal regulations require that forms and packages be sent by first
class mail.
Statements to Recipients — Statements to income recipients are
to be in a form that is permitted by the Internal Revenue Service.
Statements may be furnished electronically to income recipients
who have consented to receive electronic copies. Statements are
to be furnished to income recipients by February 28 of the following
year. Federal provisions require the statements to be furnished
by January 31 of the following year. It is not necessary to provide
a separate State statement. Statements may be issued earlier in
some situations. You may, for example, furnish a statement if it
is with a final interest payment for the year, after redemption or
maturity of an obligation, or after final withdrawal if it is after April
30th of the year.
FORM N-196
(REV. 2020) PAGE 2