Cat. No. 52695Z
Form 8935-T
(June 2009)
Transmittal of Airline Payments Reports
Department of the Treasury
Internal Revenue Service
OMB No. 1545-2140
4343
1
FILER’S name
Street address (including room or suite number)
City, state, and ZIP code
2 Employer identification number
3a Name of person to contact
3b Telephone number
( )
3c Email address
4 Payment date(s)
5 Total amount reported
$
6 Number of Forms 8935 transmitted
Under penalties of perjury, I declare that I have examined this transmittal and accompanying forms, and, to the best of my knowledge and belief, they are true,
correct, and complete.
Signature
Title
Date
Instructions
Purpose of form. Use Form 8935-T to transmit paper Forms
8935, Airline Payments Report, to the Internal Revenue
Service.
Who must file. Every commercial passenger airline carrier
that pays one or more airline payment amounts as defined in
section 125(b)(1) of Public Law 110-458 must file
Form 8935-T to transmit paper Forms 8935.
When to file. File Forms 8935 and 8935-T within 90 days of
the date of making the airline payment(s) to qualified current
and former employees. For payments made before
December 24, 2008, file Forms 8935 and 8935-T by March
23, 2009.
Attach all Forms 8935 to only one Form 8935-T for
payments made before December 24, 2008. For payments
made after December 23, 2008, attach Forms 8935 to only
one Form 8935-T per payment date. You can attach Forms
8935 for more than one payment date as long as all payment
dates are within 90 days of the filing date.
Where to file. Send Form 8935-T with attachments to:
Department of the Treasury
Internal Revenue Service Center
Kansas City, MO 64999
Boxes 1 and 2. Enter the name, address, and employer
identification number (EIN) of the carrier or other filer of this
form.
Boxes 3a, 3b, and 3c. Enter the name, telephone number,
and email address of the person at the airline carrier who can
be contacted for more information.
Box 4. Enter the date(s) the payments were made.
Box 5. Enter the total amount(s) paid as reported on the
attached Form(s) 8935.
Box 6. Enter the number of Forms 8935 being transmitted
with this Form 8935-T.
Signature. The contact or other responsible person at the
commercial passenger airline carrier must sign and date
Form 8935-T.
Privacy Act and Paperwork Reduction Act Notice. We ask
for the information on these forms to carry out the Internal
Revenue laws of the United States. You are required to give
us the information. We need it to figure and collect the right
amount of tax.
Public Law 110-458 section 125, and Internal Revenue
Code section 408A and its regulations, require you to file an
information return with the IRS and furnish a statement to
recipients. Section 6109 and its regulations require you to
provide your taxpayer identification number on what you file.
Routine uses of this information include giving it to the
Department of Justice for civil and criminal litigation, and to
cities, states, and the District of Columbia for use in
administering their tax laws. We may also disclose this
information to other countries under a tax treaty, to federal
and state agencies to enforce federal nontax criminal laws,
or to federal law enforcement and intelligence agencies to
combat terrorism. If you fail to provide this information in a
timely manner, you may be subject to penalties.
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 or its instructions 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
section 6103.
The time needed to complete and file this form will vary
depending on individual circumstances. The estimated
average time is:
Learning about the law or the form
10 min.
Preparing the form
15 min.
If you have comments concerning the accuracy of these
time estimates 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-6526, Washington, DC 20224. Do not send these
forms to this address. Instead, see Where to file earlier.
Form 8935-T (6-2009)
