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Form 4419 (Rev. 6-2009)
Page
2
General Instructions
Paperwork Reduction Act No
tice. We ask for the
information on these forms to carry out the Internal
Revenue Laws of the United States. You are not required
to provide the information requested on a form that is
subject to the Paperwork Reduction Act unless the form
displays a valid OMB control number. Books or records
relating to a form must be retained as long as their
contents may become material in the administration of any
Internal Revenue law. Generally, tax returns and return
information are confidential, as required by Code section
6103.
The time needed to provide this information would vary
depending on individual circumstances. The estimated
average time is:
Preparing Fo
rm 4419 20 min.
If you have comments concerning the accuracy of this
time estimate or suggestions for making this form simpler,
we would be happy to hear from you. You can write to the
Internal Revenue Service, Tax Products Coordinating
Committee, SE:W:CAR:MP:T:T:SP, 1111 Constitution
Ave. NW, IR-6406, Washington, DC 20224.
DO NOT SEND THE FORM TO THIS OFFICE. Instead,
see the instructions below on where to file. When
completing this fo
rm, please type or print clearly in
BLACK ink.
Purpose of Form. File Form 4419 to request authorization
to file any of the forms shown in Block 7 electronically.
Please be sure to complete all appropriate blocks. If your
application is approved, a five-character alpha-numeric
Transmitter Control Code (TCC) will be assigned to your
organization.
If any information
on the form should change, please write
to IRS/Enterprise Computing Center - Martinsburg so we
can update our database. It is not necessary to submit a
new Form 4419.
NOTE: Do
NOT use Form 4419 to request authorization
to file Forms W-2 electronically. Contact SSA at
1-800-772-6270 if you have any questions concerning
the filing of Forms W-2.
Specific Instructions
Block 1
Enter the name and complete address of the organization
that will submit the electronic files (transmitter).
Block 2
Enter the name, title, email address (if availab
le) and
telephone number (with area code) of the person to
contact about this application if IRS needs additional
information. This should be a person who is knowledge-
able about electronic filing of information returns.
Block 3
Enter the Employer Identification Number (EIN) of the
organization transmitting the electronic files. Social
Security Numbers are not permitted.
Block 4
If you are a foreign transmitter who does not have a
nine-digit Taxpayer Identification Number, check this box.
Block 5
Enter the tax year that you wish to start filing electronically.
Block 6
Indicate if you are requesting this Transmitter Control
Code solely for filing electronic requests for an extension
of time to file information returns.
Block 7
Check the box next to all of the returns you will file with
IRS electronically.
A separate TCC will be assigned for each box checked
in Block 7. Please make sure you submit your electronic
files using the correct TCC.
Thereafter, if you need to add any of the forms identified
in
Block 7, it will be necessary to submit another Form
4419 to IRS so another TCC can be assigned.
Block 8
Indicate if your company will be filing your data with a
software package or if you have contracted to have a
service provider file your data for you. Note: The FIRE
System do
es not provide an on-line fill-in option for
the forms listed in Box 7. You must transmit your
data in a specific format required by IRS.
Block 9
The form must be signed and dated by an official of the
company or organization requesting authorization
to
report electronically.
Mailing Address:
Send your Form 4419 to the address below:
Internal Revenue Service
Enterprise Computing Center - Martinsburg
Information Reporting Program
230 Murall Drive
Kearneysville, WV 25430
In order to ensure timely filing, submit Form 4419 at
least 30 days before the due date of the return. If you
prefer, the Form 4419 can be faxed toll-free to
(877) 477-0572, but do not do both (faxing and mailing).
The Form 4419 is subject to revie
w before the approval
to transmit electronically is granted and may require
additional documentation at the request of IRS. If your
application is approved, IRS will assign a TCC to your
organization. We will not issue your TCC without a
signed Form 4419, and we will not issue a TCC over the
phone or by email. If you do not receive a reply from
IRS within 30 days, contact us at the telephone number
shown below. Do not submit any files until you receive
your TCC.
For further information concerning the filing of
information returns with IRS electronically, you may
access
www.irs.gov for Publication 1220 for the current
tax year.
If you do not have internet access, you may contact the
IRS Enterprise Computing Center - Martinsburg toll-free
at (866) 455-7438 between 8:30 a.m. and 4:30 p.m.
Eastern Standard Time.
