Form 13460 Employer/Payer Information

Department of the Treasury - Internal Revenue Service

Form 13460
(Rev. July 2003)

OMB No.
1545-1849

Employer/Payer Information

1. Employer/Payer information
Company Name

Address

City

Contact Person

Phone Number

ZIP Code

Email Address

Taxpayer Identification Number

2. Company Submitting form, if different above.
Company Name

Address

City

Contact Person

Phone Number

ZIP Code

Email Address

Please provide a brief explanation of your relation ship to the payer

3. Tax Year

4. Type of Return
(one per form)

7. Transmitter Control Code (TCC) for forms 1099, if applicable.
(Form W-2 does not use a TCC)

5. Number of Employess or
Payees Affected

6. Total Number of Returns Filed

4. Filing Method

Electronic

Magnetic Media

Paper

9. Please provide a brief explanation of the error. Notices if any notices have been received by the employees. Attach any document
needed.

Signature

Date

FAX TO - (304) 264-5602

Attention - Underreporting
Catalog Number 36998F

Form 13460 (Rev. 7-2003)

General Instructions
Paperwork Reduction Act Notice. We ask for the information on
these forms to carry out the Internal Revenue Laws of the
United States. You are not required to provide the information
requested on a form that is subject to the Paperwork Reduction
Act unless the form displays a valid OMB control number.
Books or records relating to a form must be retained as long as
their contents may become material in the administration of any
Internal Revenue law. Generally, tax returns and return
information are
confidential, as required by Code section 6103.
The time needed to provide this information would vary
depending on individual circumstances. The estimated average
time is:
Preparing Form 13460 ....................................................15 min.
If you have comments concerning the accuracy of these time
estimates or suggestions for making this form simpler, we would
be happy to hear from you. You can write to the Tax Products
Coordinating Committee, Western Area Distribution Center,
Rancho Cordova, CA 95743-0001. DO NOT SEND THE
FORMS TO THIS OFFICE. Instead, see the instructions below
on where to file. When completing this form, please type or
print clearly in BLACK ink.
Purpose of Form. Use Form xxxx when duplicate/incorrect
reporting of Forms 1098, 1099, 5498, W-2G or W-2, has
occurred. This form requests all necessary information to
research and help resolve duplicate reporting issues.

Block 3
Indicate the Tax Year in which the duplicate/incorrect reporting
occurred.
Block 4
Indicate which information return was duplicate/incorrectly
reported, i.e., 1099-R, 5498 or W-2. Use a separate Form 13460
for each different type of return that was duplicate/incorrectly
reported.
Block 5
Indicate the number of employees/payees, affected by the
duplicate/incorrect reporting.
Block 6
Indicate the total number of returns for the document type in
box 4.
Block 7
If you filed your information returns electronically or
magnetically, indicate your 5-digit alpha/numeric
Transmitter Control Code (TCC). Filers of Form W-2 will not
have this number.

Specific Instructions

Block 8
Indicate what method of filing you used to submit your Forms
1098, 1099, 5498, W-2G or W-2.

Block 1

Block 9

Provide the complete company name, address, Taxpayer
Identification Number (TIN), contact person and telephone
number of the employer/payer with the problem reporting. The
contact person should be someone familiar with the filing
problem. Include an email address if available.

Provide a brief explanation of the error. Indicate any notices the
payer, payees or employees may have receive from IRS or SSA,
i.e., CP2000. Attach any additional documentation which may
help explain the problem.
Block 10

Block 2
Provide complete information on the company submitting the
information returns if different from the employer/payer, For
example you may be a service bureau who has submitted returns
for another company. Provide the complete company name,
address, telephone number, and contact name and email if
available. Also, provide a brief explanation of your relationship
to the payer.

Sign and date the form. A signature is required to research
taxpayer information. Fax documentation to:

Catalog Number 36998F

Form 13460 (Rev. 7-2003)