PDF document

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(See instructions on back)
Department of the Treasury -- Internal Revenue Service IRS Use Only OMB No.
1545-0314
Form 6466 Transmittal of Forms W-4 Reported
(Rev. Oct. 1999) Magnetically/Electronically
Please type or print clearly in BLACK ink
1. Type of files represented by this transmittal 2. Tax year of 2a. Tax quarter of
media media
Original Replacement

3.Transmitter control code 4.Name of transmitter
(Required)

5. Name of person to contact regarding magnetic media files 7. Type of media filed
9 track tape 3 1/2" diskette
Telephone number:
7a. Tape cartridge
6. Name/address of company and name/title of person to whom
problem files are to be returned (street, city, state, and ZIP Code) 36 track 18 track4mm 8mm QIC

Name
7b. Electronic filers only
Contact File Name:
Address 8. Total number of records on all magnetic media in this shipment

City State Zip 9. Total pieces of magnetic media in shipment

10. Please use this section to report information for up to four additional employers. If additional space is needed, please
use Form 6467, Transmittal of Magnetic Media of Form W-4, Employee's Withholding Allowance Certificate (Continuation),
and attach it to this form.
Name of Employer Employer Identification Number Total Empoyee Records

Affidavit IRS Use Only

Under penalties of perjury, I declare that I have examined this
transmittal, including accompanying documents, and, to the
best of my knowledge and belief, it is correct and complete.
(Normally, the payer must sign the affidavit above. The authorized
agent of the payer may sign if all conditions are met as stated
on the back.)

SIGNATURE ( REQUIRED )

Title Date

Cat. No. 43381W Form 6466(Rev. 10-1999)

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Instructions for Form 6466
General Instructions
Block 6
Paperwork Reduction Act Notice. We ask for the information on
Enter the name and address of the company, along with the name/
these forms to carry out the Internal Revenue Laws of the United
title of the person to whom unprocessed media is to be returned.
States. You are not required to provide the information requested
on a form that is subject to the Paperwork Reduction Act unless
NOTE: IRS will not return media that has been successfully
the form displays a valid OMB control number. Books or records processed.
relating to a form must be retained as long as their contents may
become material in the administration of any Internal Revenue law.
Block 7
Generally, tax returns and return information are confidential, as
Indicate whether you are filing on 9 track tape, 3 1/2 inch diskettes.
required by Code section 6103.
Block 7a
The time needed to provide this information will vary Indicate whether your tape cartridge is 18 or 36 track, 4mm or 8mm
depending on individual circumstances. The estimated average
or QIC.
times are:
Block 7b
Indicate the file name assigned by our system.
Preparing Form 6466 . . . . . . . . . . . . . . . . . . . . . . . 18 min.
Preparing Form 6467 . . . . . . . . . . . . . . . . . . . . . . . 20 min.Block 8
Enter the combined number of all records listed in Section 10
If you have comments concerning the accuracy of these
and any attached Forms 6467.
time estimates or suggestions for making this form simpler, we
would be happy to hear from you. You can write to the Tax Forms
Block 9
Committee, Western Area Distribution Center, Rancho Cordova, CA Enter the total number of media included in your shipment.
95743-0001.
Block 10
DO NOT SEND THE FORMS TO THIS OFFICE. Instead, see the
Enter the employer name, employer identification number and total
instructions below on where to file.
number of employee records for each employer on your media.
The first employer name entered may be same as the transmitter
When completing this form, please type or print clearly in BLACK
listed in Block 4.
ink.
Note: Forms 6466 must be signed before IRS can process your
Purpose of Form. Use Form 6466 to transmit Form W-4
files.
magnetically/electronically. You must include Form 6466 with each
file you submit to the Internal Revenue Service.
Mailing Address:
Specific Instructions

Block 1 Send your media with transmittal Forms 6466/6467 to the appropriate
Indicate whether the data in this shipment is an original or
address below:
replacement file by checking the appropriate box.
Internal Revenue Service
Block 2, 2a
Martinsburg Computing Center
Indicate the tax year and tax quarter for which media is being Special Projects
submitted.
230 Murall Drive
Kearneysville, WV 25430
Block 3
Enter the five-character alpha/numeric transmitter control code
Form 6467 Transmittal of Forms W-4 Reported Magnetically/
assigned by IRS. Electronically (Continuation)
In addition to the Form 6466, use Form 6467 if you are reporting
Block 4
more than four employers.
Enter the name of the transmitter. (Reference Affidavit
Requirements below.)

Block 5
Enter the name and telephone number of the person to contact
about the magnetic/electronic files.

Affidavit Requirements
A transmitter, service bureau, paying agent, or disbursing agent (all hereafter referred to as “agent”) may sign Form 6466 on behalf
of the payer (or other person required to file), if the conditions in items 1 and 2 are met:
1. The agent has the authority to sign the form under an agency agreement (oral, written, or implied) that is valid under state law.
2. The agent signs the form and adds the caption “For: (Name of payer or other person required to file)”.
The authorized agent’s signing of the affidavit on the payer’s behalf does not relieve the payer of the responsibility for filing a correct,
complete, and timely Form 6466, with attachments, and will not relieve the payer of any penalties for not complying with those requirements.

Form 6466(Rev. 10-1999)

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