Attention filers of Form 1096:
This form is provided for informational purposes only. It appears in red, similar to the official IRS form. The official printed version of this IRS form is scannable, but a copy, printed from this website, is not. Do not print and file a Form 1096 downloaded from this website; a penalty may be imposed for filing with the IRS information return forms that can’t be scanned. See part O in the current General Instructions for Certain Information Returns, available at www.irs.gov/form1099, for more information about penalties.
To order official IRS information returns, which include a scannable Form 1096 for filing with the IRS, visit www.IRS.gov/orderforms. Click on Employer and Information Returns, and we’ll mail you the forms you request and their instructions, as well as any publications you may order.
Information returns may also be filed electronically. To file electronically, you must have software, or a service provider, that will create the file in the proper format. More information can be found at:
•IRS Filing Information Returns Electronically (FIRE) system (visit www.IRS.gov/FIRE), or
•IRS Affordable Care Act Information Returns (AIR) program (visit www.IRS.gov/AIR).
See IRS Publications 1141, 1167, and 1179 for more information about printing these tax forms.
Do Not Staple 6969
Form 1096 |
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Annual Summary and Transmittal of |
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OMB No. 1545-0108 |
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2022 |
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Department of the Treasury |
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U.S. Information Returns |
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Internal Revenue Service |
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FILER’S name |
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Street address (including room or suite number) |
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City or town, state or province, country, and ZIP or foreign postal code |
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For Official Use Only |
Name of person to contact |
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Telephone number |
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Email address |
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Fax number |
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1 Employer identification number |
2 Social security number |
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3 Total number of forms |
4 Federal income tax withheld |
5 Total amount reported with this Form 1096 |
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$ |
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$ |
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6 Enter an “X” in only one box below to indicate the type of form being filed.
1098-C |
1098-E |
1098-F |
1098-Q |
1098-T |
1099-A |
78 |
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84 |
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03 |
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74 |
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83 |
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80 |
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1099-B |
1099-C |
1099-CAP 1099-DIV |
1099-G |
1099-INT |
1099-K |
1099-LS |
79 |
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85 |
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73 |
91 |
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86 |
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92 |
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10 |
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16 |
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1099-LTC 1099-MISC 1099-NEC |
1099-OID 1099-PATR |
1099-Q |
1099-QA |
1099-R |
1099-S |
1099-SA 1099-SB |
3921 |
93 |
95 |
71 |
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96 |
97 |
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31 |
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1A |
98 |
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75 |
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94 |
43 |
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25 |
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Return this entire page to the Internal Revenue Service. Photocopies are not acceptable.
Send this form, with the copies of the form checked in box 6, to the IRS in a flat mailer (not folded).
Under penalties of perjury, I declare that I have examined this return and accompanying documents and, to the best of my knowledge and belief, they are true, correct, and complete.
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Signature ▶ |
Title ▶ |
Date ▶ |
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Instructions |
Enter the filer’s name, address (including room, suite, or other unit |
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Future developments. For the latest information about developments |
number), and taxpayer identification number (TIN) in the spaces |
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provided on the form. The name, address, and TIN of the filer on this |
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related to Form 1096, such as legislation enacted after it was |
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form must be the same as those you enter in the upper left area of |
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published, go to www.irs.gov/Form1096. |
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Forms 1097, 1098, 1099, 3921, 3922, 5498, or W-2G. |
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Reminder. The only acceptable method of electronically filing |
When to file. File Form 1096 as follows. |
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information returns listed on this form in box 6 with the IRS is through |
• With Forms 1097, 1098, 1099, 3921, 3922, or W-2G, file by |
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the FIRE System. See Pub. 1220. |
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February 28, 2023. |
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Purpose of form. Use this form to transmit paper Forms 1097, 1098, |
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• With Forms 1099-NEC, file by January 31, 2023. |
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1099, 3921, 3922, 5498, and W-2G to the IRS. |
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• With Forms 5498, file by May 31, 2023. |
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Caution: If you are required to file 250 or more information returns of |
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any one type (excluding Form 1098-F), you must file electronically. If |
Where To File |
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you are required to file electronically but fail to do so, and you do not |
Send all information returns filed on paper with Form 1096 to the |
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have an approved waiver, you may be subject to a penalty. The |
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Taxpayer First Act of 2019, enacted July 1, 2019, authorized the |
following. |
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Department of the Treasury and the IRS to issue regulations that |
If your principal business, office |
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reduce the 250-return requirement for 2021 tax returns. If those |
Use the following |
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or agency, or legal residence in |
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regulations are issued and effective for 2022 tax returns required to be |
the case of an individual, is |
address |
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filed in 2023, we will post an article at www.irs.gov/Form1099 |
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located in |
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explaining the change. Until regulations are issued, however, the |
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▲ |
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number remains at 250, as reflected in these instructions. For more |
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information, see part F in the 2022 General Instructions for Certain |
Alabama, Arizona, Arkansas, Delaware, |
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Information Returns. |
Florida, Georgia, Kentucky, Maine, |
Internal Revenue Service |
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Massachusetts, Mississippi, New |
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Forms 1099-QA and 5498-QA can be filed on paper only, regardless |
P.O. Box 149213 |
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Hampshire, New Jersey, New Mexico, |
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of the number of returns. |
New York, North Carolina, Ohio, Texas, |
Austin, TX 78714-9213 |
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Who must file. Any person or entity who files any of the forms shown |
Vermont, Virginia |
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in line 6 above must file Form 1096 to transmit those forms to the IRS. |
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Caution: Your name and TIN must match the name and TIN used on |
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your 94X series tax return(s) or you may be subject to information |
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return penalties. Do not use the name and/or TIN of your paying agent |
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or service bureau. |
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For more information and the Privacy Act and Paperwork Reduction Act Notice, |
Cat. No. 14400O |
Form 1096 (2022) |
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see the 2022 General Instructions for Certain Information Returns. |
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