
Do Not Staple
6969
Form 1096
Department of the Treasury
Internal Revenue Service
Annual Summary and Transmittal of
U.S. Information Returns
OMB No. 1545-0108
2025
FILER’S name
Street address (including room or suite number)
City or town, state or province, country, and ZIP or foreign postal code
Name of person to contact Telephone number
Email address Fax number
For Official Use Only
1
Employer identification number
2 Social security number 3 Total number of forms 4 Federal income tax withheld
$
5
Total amount reported with this Form 1096
$
6 Enter an “X” in only one box below to indicate the type of form being filed.
W-2G
32
1097-BTC
50
1098
81
1098-C
78
1098-E
84
1098-F
03
1098-Q
74
1098-T
83
1099-A
80
1099-B
79
1099-C
85
1099-CAP
73
1099-DA
7A
1099-DIV
91
1099-G
86
1099-INT
92
1099-K
10
1099-LS
16
1099-LTC
93
1099-MISC
95
1099-NEC
71
1099-OID
96
1099-PATR
97
1099-Q
31
1099-QA
1A
1099-R
98
1099-S
75
1099-SA
94
1099-SB
43
3921
25
3922
26
5498
28
5498-ESA
72
5498-QA
2A
5498-SA
27
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.
Signature Title Date
Instructions
Future developments. For the latest information about developments
related to Form 1096, such as legislation enacted after it was published, go
to www.irs.gov/Form1096.
Caution: You may be required to electronically file (e-file) information
returns as the e-file threshold is 10 (calculated by aggregating all
information returns), effective for information returns required to be filed on
or after January 1, 2024. Go to www.irs.gov/InfoReturn for e-file options.
Also, see part F in the current General Instructions for Certain Information
Returns.
Purpose of form. Use this form to transmit paper Forms 1097, 1098,
1099, 3921, 3922, 5498, and W-2G to the IRS.
Who must file. Any person or entity who files any form checked in box 6
above must file Form 1096 to transmit those forms to the IRS.
Caution: Your name and taxpayer identification number (TIN) (employer
identification number (EIN) or social security number (SSN)) must match
the name and TIN used on your 94X series tax return(s) or you may be
subject to information return penalties. Do not use the name and/or TIN of
your paying agent or service bureau.
Enter the filer’s name, address (including room, suite, or other unit
number), and TIN in the spaces provided on the form. The name, address,
and TIN of the filer on this form must be the same as those you enter in the
upper left area of Form 1097, 1098, 1099, 3921, 3922, 5498, or W-2G.
When to file. If any date shown falls on a Saturday, Sunday, or legal
holiday in the District of Columbia or where the return is to be filed, the due
date is the next business day. File Form 1096 in the calendar year following
the year for which the information is being reported, as follows.
• With Forms 1097, 1098, 1099, 3921, 3922, or W-2G, file by February 28.*
• With Forms 1099-NEC, file by January 31.
• With Forms 5498, file by May 31.
* Leap years do not impact the due date. See Announcement 91-179,
1991-49 I.R.B. 78, for more information.
Where To File
Send all information returns filed on paper with Form 1096 to the following.
If your principal business, office or
agency, or legal residence in the
case of an individual, is located in:
Use the following
address:
Alabama, Arizona, Arkansas, Delaware,
Florida, Georgia, Kentucky, Maine,
Massachusetts, Mississippi, New
Hampshire, New Jersey, New Mexico,
New York, North Carolina, Ohio, Texas,
Vermont, Virginia
Internal Revenue Service
P.O. Box 149213
Austin, TX 78714-9213
Alaska, Colorado, Hawaii, Idaho,
Illinois, Indiana, Iowa, Kansas,
Michigan, Minnesota, Missouri,
Montana, Nebraska, Nevada, North
Dakota, Oklahoma, Oregon, South
Carolina, South Dakota, Tennessee,
Utah, Washington, Wisconsin, Wyoming
Internal Revenue Service Center
P.O. Box 219256
Kansas City, MO 64121-9256
For more information and the Privacy Act and Paperwork Reduction Act Notice,
see the current General Instructions for Certain Information Returns.
Cat. No. 14400O
Form 1096 (2025) Created 3/20/25