Form 4598 Form W-2, 1098, or 1099 Not Received, or Incorrect or Lo

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4598

Form
(Revised August 2004)

Department of the Treasury - Internal Revenue Service

OMB No. 1545-0597

Form W-2, 1098, or 1099 Not Received, Incorrect or Lost
Date:

1. Taxpayer Identification Number (SSN/EIN)

6. Dates of Employment or Employment Period

2. Telephone Number

7. Telephone Number

3. Taxpayer’s (Employee’s or Payee’s) Name

8. Employer’s or Payer’s Name

4. Street

9. Street

5. City, State, and Zip Code

10. City, State and Zip Code

NOTE: FAILURE TO PROVIDE THIS INFORMATION COULD RESULT IN A $50 PENALTY.
The taxpayer named above advises us that:

FOLD HERE

Form W-2, Wage and Tax Statement,
was not received.

Form W-2 incorrect because

Form 1099, which reports interest,
dividends, or other payments, was not received.

Form 1099-

Form 1098, Mortgage Interest
Statement, was not received.

Form 1098 incorrect because

incorrect because

Other

If you sent the above referenced form, the taxpayer didn’t receive it. Please send a duplicate to the
taxpayer. If the Form W-2 you sent wasn’t correct, please complete Form W-2c, Statement of Corrected
Income and Tax Amounts. If the Form 1098/1099 was incorrect, please send a correct Form 1098/1099. If
you haven’t prepared the form, please do so within 10 calendar days of the receipt of this form. Use the
enclosed forms and distribute the original and copies per form instructions. Each employer or payer is
required by law to provide this information to each employee or payee by furnishing a Form W-2, Form
1098, or Form 1099, or by making the information available on an employer web site, by January 31st
following the calendar year (CY) of employment or payment. If employment ends before the close of the
CY, you must furnish Form W-2 within 30 calendar days after the employee or payee requests it. If you owe
additional payroll tax, please determine the correct amount and amend your employment tax return as
explained in the instructions on the return.
FOLD HERE
Paperwork Reduction Act Notice: We ask for the information on this form to carry out the Internal Revenue laws of the United States. You are required
to give us the information. We need it to ensure that you are complying with these laws and to figure and collect the right amount of tax. 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 or its instructions 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 complete this
form will vary depending on individual circumstances. The estimated average time is 15 minutes. If you have comments concerning the accuracy of this
time estimate or suggestions for making this form simpler, we would be happy to hear from you. You can write to the Tax Forms Committee, Western
Area Distribution Center, Rancho Cordova, CA 95743-0001. DO NOT send this form to this office. Instead, use the self-addressed envelope provided.

Please complete, sign, and date the statement below and return this form in the enclosed preaddressed envelope within
10 calendar days of receipt of this form.
Your information is correct. I will send the taxpayer all required copies of Forms W-2, W-2c, 1098, or 1099 and file Copy A of
Form W-2 or W-2c with the Social Security Administration.
Your information isn’t correct. The taxpayer didn’t work for me or receive other reportable payments during the time stated.
I mailed the form to a different address. I will send a duplicate, using the taxpayer’s address provided on this form.
With the taxpayer’s consent, I furnished the information electronically, making it available on a web site.
Other (explain):

Signature:
Catalog No. 23205B

Title:
Employer’s or Payer’s Copy (Part 1)

Date:
Form 4598 (Rev. 8-2004)

4598

Form
(Revised August 2004)

Department of the Treasury - Internal Revenue Service
OMB No. 1545-0597

Form W-2, 1098, or 1099 Not Received, Incorrect or Lost
Date
:

1. Taxpayer Identification Number (SSN/EIN)

6. Dates of Employment or Employment Period

2. Telephone Number

7. Telephone Number

3. Taxpayer’s (Employee’s or Payee’s) Name

8. Employer’s or Payer’s Name

4. Street

9. Street

5. City, State, and Zip Code

10. City, State and Zip Code

NOTE: PAYER HAS BEEN ADVISED THAT FAILURE TO PROVIDE THIS INFORMATION
COULD RESULT IN A $50 PENALTY.
FOLD HERE

Form W-2, Wage and Tax Statement,
was not received.

Form W-2 incorrect because

Form 1099, which reports interest,
dividends, or other payments, was not received.

Form 1099-

Form 1098, Mortgage Interest
Statement, was not received.

Form 1098 incorrect because

incorrect because

Other

If you don’t receive the Form W-2 or W-2c, Statement of Corrected Income and Tax Amounts, by the date
your tax return should be filed, please file your return with the enclosed Form 4852 showing an estimate of
your wages and withholding. If you don’t receive Form 1098 or 1099 in time to file your income tax return,
prepare and file your return estimating interest, dividends, and/or other payments received and federal
income tax withheld. Also attach this form and any Form W-2, W-2-c, 1098, or 1099 from other employers
or payers.
If you have already filed a return on which you estimated your wages, payments, interest, dividends, and
withholdings, we will process it based upon the information it contains.
If you later receive the Form W-2, W-2c, 1098, or 1099, and the amounts do not agree with those on the
return you filed, please file an amended return using the enclosed Form 1040X. If the amounts agree, just
keep the Form W-2, 1098, or 1099 for your records.
FOLD HERE
Paperwork Reduction Act Notice: We ask for the information on this form to carry out the Internal Revenue laws of the United States. You are required to
give us the information. We need it to ensure that you are complying with these laws and to figure and collect the right amount of tax. 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 or its instructions 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 complete this form will vary depending on
individual circumstances. The estimated average time is 15 minutes. If you have comments concerning the accuracy of this time estimate or suggestions for
making this form simpler, we would be happy to hear from you. You can write to the Tax Forms Committee, Western Area Distribution Center, Rancho
Cordova, CA 95743-0001.

Catalog No. 23205B

Taxpayer’s Copy (Part 2)

Form 4598 (Rev. 8-2004)