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Are Forms 1099 filed for payments to all vendors and independent contractors for payments
in excess of $600 per year?
Is federal income tax withheld when required, due to invalid or missing Forms W-9?
Do Forms W-3, W-2 and 941 reconcile for the most recent calendar year?
If No, comment on the discrepancy and any actions needed or taken to resolve it.
Were there Federal Tax Deposit penalties assessed that could have been avoided? Yes No
Does the entity provide any fringe benefits (i.e., medical insurance, life insurance,
tribal/employer-provided vehicle, tribal/employer-provided housing, etc.)
If Yes, list the type and whether they are deemed taxable in whole or part by the Entity.
Were taxable fringe benefits included on Forms W-2 for the applicable employee? Yes No
Does the entity pay Tribal Council members for their services on the Council (i.e. salary, meetings
fees, stipends, etc.)?
Are the payments reported on Form W-2 or Form 1099? Yes
If reported on Form W-2, are there withholding for FICA, Medicare, and Federal Income Tax? Yes
Is the entity aware of Revenue Ruling 59-354?
Are internal controls present to ensure that a Form 1099 is not issued to an employee for an item
that should be reported on Form W-2 (i.e. bonuses, excess reimbursement of expenses, personal
use of a tribal asset, etc.)?
Is the level of tax filings consistent with the activity of the entity (i.e. Do the wages paid and withholding
remittances appear accurate based on the size of the entity and the number of employees)?
If No, comment on the discrepancy and any actions taken to resolve it.
Does the Entity utilize a payroll service or Employee Leasing entity to file any required employment
If Yes, list the name, address and EIN of the service provider as well as the specific forms filed on behalf of the entity.
Address City State Zip
Forms filed by payroll service on behalf of THIS entity
Is the entity required to file Form 940 (Employer’s Annual Federal Unemployment (FUTA) Tax Return?
If Yes, does the entity participate in the State Unemployment Tax Act (SUTA) program? Yes No
If yes, are you aware of the relief from Federal Unemployment Tax
that is available if you are in compliance with SUTA? Yes No
Catalog Number 48503Y www.irs.gov
Form 13797 (11-2006)