Request For Authorization To Report Form Wr-30 Magnetically - New Jersey Division Of Revenue

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Rev. 3/04
NJ Division of Revenue
Request For Authorization To Report Form WR-30 Magnetically
Please print or type
SECTION I - Employer
FEIN
Company
Address
SECTION II. – Submitter (If Other Than Above)
FEIN
Company
Address
SECTION III. – Contact Person
Name
Title
Address
Telephone
FAX
SECTION IV. – Media Type you will be using:
e-mail
__
Tape - 9 Channel EBCDIC
__
CD
__
Cartridge - 3480 or 3490
__
Diskette 3 1/2"
__
Note the following media are not accepted:
Diskette 8"
Cartridge - 8mm
Diskette 5 1/4"
Diskettes must be IBM compatible
Fax completed form to: (609) 292-1777 or (609) 633-6706
Or mail completed form to: NJ Division of Revenue
PO Box 256
Trenton, NJ 08646-0256
Questions? Call (609) 984-7988 or (609) 633-2633
Or visit our web site at

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