Form 4419 - Application For Filing Information Returns Electronically (Fire) Page 2
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General Instructions
Block 8 – Affidavit. This application must be completed and submitted
by: (a) the owner, if the applicant is a sole proprietorship, (b) the
Purpose of Form: Submit Form 4419 to request authorization to
president, vice president, or other principal officer, if the applicant is a
electronically file any of the forms shown in Block 7. Complete all
corporation, (c) a responsible and duly authorized member or officer
required information. Transmitters who file for multiple payers may
having knowledge of its affairs, if the applicant is a partnership,
submit one application and use the assigned Transmitter Control Code
government entity, or other unincorporated organization, or (d) the
(TCC) for all payers. If your application is approved, a five-character
fiduciary, if the applicant is a trust or an estate.
alphanumeric TCC will be assigned to your organization.
Check the box to confirm that you have read the affidavit and are
Form 4419 can be completed online at https://fire.irs.gov.
authorized to sign on behalf of the transmitter and/or payer. Required.
Forms W-2: Do not use Form 4419 to request authorization to
Block 9 - The form must be signed and dated by an official of the
electronically file Forms W-2. Form W-2 information is only sent to the
company or organization requesting authorization to file electronically.
Social Security Administration (SSA). Contact SSA if you have any
Required.
questions concerning the electronic filing of Forms W-2 at
1-800-772-6270.
For further information concerning the electronic filing of information
returns, visit IRS.gov. The following publications are available:
We will delete your TCC if you don’t file your information returns for two
consecutive tax years. Once deleted, from our database, you will need to
• Publication 1220, Specifications for Electronically Filing Form
submit another Form 4419.
1097, 1098, 1099, 3921, 3922, 5498, and W-2G
Revised Form 4419 information: Check the box located at the top of
• Publication 1187, Specifications for Electronically Filing Form
Form 4419 and provide the current TCC assigned to the business. A
1042-S, Foreign Person's U.S. Source Income Subject to
revised Form 4419 can only be submitted if you are updating information
Withholding
for a previously submitted and approved Form 4419 for the following
• Publication 1239, Specifications for Electronically Filing Form
information:
8027, Employers Annual Information Return of Tip Income and
• Block 1 - Legal name and address
Allocated Tips
• Block 3 - Person to contact or contact information
• Publication 4810, Specifications for Electronically Filing Form
Changes to the blocks listed below require you to submit a new Form
8955-SSA, Annual Registration Statement Identifying Separated
4419. A new TCC will be assigned to the transmitter/payer.
Participants and Deferred Vested Benefits Paperwork
(Do not check the Revised box.)
Mail or Fax Form 4419 to:
• Block 2 - EIN
Internal Revenue Service
• Block 7 - Type of return to be reported
230 Murall Drive, Mail Stop 4360
Kearneysville, WV 25430
Note: A revised Form 4419 can only be submitted on paper.
Fax: (877) 477-0572 (within the U.S)
Specific Instructions
(304) 579-4105 (International)
Due Date: In order to ensure timely filing, submit Form 4419 at least 45
Contact the IRS Monday through Friday
days before the due date of the return.
• (866) 455-7438 (Toll Free)
When completing this form, please print or type clearly.
• (304) 263-8700 (International)
Block 1 - Enter the legal name associated with the EIN in Block 2 and
Note: A TCC will not be issued over the phone or via email.
the complete address of the organization that will submit electronic files
If you don’t receive your TCC within 45 days, contact the IRS at the
(transmitter and/or payer). Required.
phone numbers listed above.
Block 2 - Enter the Employer Identification Number (EIN), Qualified
Paperwork Reduction Act Notice: We ask for the information on these
Intermediary Number (QI-EIN), Withholding Partnership Number
forms to carry out the Internal Revenue Laws of the United States. You
(WP-EIN), or Withholding Trust Number (WT-EIN) of the organization
are not required to provide the information requested on a form that is
transmitting the electronic files. Social Security Numbers (SSN) are not
subject to the Paperwork Reduction Act unless the form displays a valid
permitted. Required.
OMB control number. Books or records relating to a form must be
retained as long as their contents may become material in the
Block 3 - Enter the name, title, email address and telephone number
administration of any Internal Revenue law. Generally, tax returns and
(with area code) of the person to contact about this application. This
return information are confidential, as required by Code section 6103.
should be a person who is knowledgeable about the electronic filing of
your information returns. Required.
The time needed to provide this information would vary depending on
individual circumstances. The estimated average time is:
Block 4 - Check the appropriate box to indicate if you are requesting a
Transmitter Control Code (TCC) solely for the electronic filing of Form
Preparing Form 4419 . . . . . . . . . . . . . . . . . . . . . . . 20 minutes.
8809, Application for Extension of Time To File Information Returns.
If you have comments concerning the accuracy of this time estimate or
Block 5 - Check the appropriate box to indicate if you are a foreign
suggestions for making this form simpler, we would be happy to hear
transmitter who does not have a nine-digit Taxpayer Identification
from you. Write to the Tax Forms Committee, Western Area Distribution
Number. Required.
Center, Rancho Cordova, CA 95743-0001. DO NOT SEND FORM 4419
TO THIS OFFICE. Refer to the instructions above on where to mail or
Block 6 - Enter the tax year that you wish to begin filing electronically.
fax.
Required.
Block 7 - Only check the box next to the returns you will electronically
file with the IRS. A separate TCC will be assigned for each box checked
in Block 7.
4419
Catalog Number 41639J
Form
(Rev. 6-2015)
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