Fill - Free fillable 20__ N-196 Annual Summary and Transmittal of Hawaii (Hawaii) PDF form

FORM

STATE OF HAWAII — DEPARTMENT OF TAXATION

N-196

Annual Summary and Transmittal of

(REV. 2013)

Hawaii Information Returns

20__

 CORRECTED

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

( )

1099-

DIV



1099-



1099-

INT



1099-



1099-

MISC



1099-

OID



1099-

PATR



1099-



I hereby declare under penalties by 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

above.

(Authorized Signature) (Title) (Date)

- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - DETACH HERE ------------------------------------------

GENERAL INFORMATION

Purpose of Form — Use this form to transmit State copies of paper

1099 forms to the Department of Taxation. The use of federal Forms

1099-DIV, 1099-G, 1099-INT, 1099-K, 1099-MISC, 1099-OID, 1099-

PATR, and 1099-R are required, as the Department of Taxation is not

printing its own version of these forms. Also use this form to transmit

State copies of corrected 1099 forms to the Department of Taxation.

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: tax.hawaii.gov.

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 Hawaii Department of

Taxation 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 of Taxation 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

Airplanes

— Form 1098-E, Student Loan Interest Statement

— Form 1098-T, Tuition Statement

— Form 1099-A, Acquisition or Abandonment of Secured

Property,

— Form 1099-B, Proceeds From Broker and Barter Exchange

Transactions,

— Form 1099-C, Cancellation of Debt

— Form 1099-CAP, Changes in Corporate Control and Capital

Structure

— Form 1099-H, Health Coverage Tax Credit (HCTC) Advance

Payments

— Form 1099-LTC, Long-Term Care and Accelerated Death

Beneﬁts

— 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 Information.

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

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

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 of Taxation

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 with the Hawaii Department of Taxation at: P.O. Box 3559,

Honolulu, HI 96811-3559 or 830 Punchbowl St., Room 126,

Honolulu, Hi 96813-5094

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.

INSTRUCTIONS FOR COMPLETING AND FILING FORM N-196

FORM N-196

(REV. 2013) PAGE 2

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