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
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
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
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
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
(REV. 2013) PAGE 2