Free Form 8596-A (Rev. May 1999) - Federal

Form

8596-A

(Rev. May 1999)
Department of the Treasury Internal Revenue Service

Quarterly Transmittal of Information Returns for Federal Contracts
2

Attach Form(s) 8596

1

Name of Federal executive agency

Employer identification number

3a Name and address of person IRS can contact to request a tax offset

3b Title of person listed in 3a

4

Quarter ending

5

Number of Forms 8596 transmitted

Under penalties of perjury, I declare that I have examined this return and accompanying documents, that they are prepared pursuant to the requirements of section 6050M, and that, to the best of my knowledge and belief, they are compiled from agency records maintained in the normal course of business for the purpose of making a true, correct, and complete return as required by section 6050M. Signature Title Date

Instructions
Purpose of form. Use Form 8596-A to transmit paper Forms 8596, Information Return for Federal Contracts, to the Internal Revenue Service. Prepare only one Form 8596-A to transmit all Forms 8596 for each quarter. When to file. The due dates for each quarter are as shown below. Do not file before the end of the quarter. Quarter Due Date January, February, March April 30 April, May, June July 31 July, August, September October 31 October, November, December January 31 If the regular due date falls on a Saturday, Sunday, or legal holiday, file by the next business day. Where to file. File Forms 8596 and 8596-A with Internal Revenue Service Center, Kansas City, MO 64999-2222. Who must file. The head of every Federal executive agency or his or her delegate must file Forms 8596 and 8596-A to report Federal contracts. For more information, see Form 8596.

Boxes 1 and 2. Enter the name and employer identification number (EIN) of the Federal executive agency that entered into the contract. If one central office is responsible for filing for the entire agency, use only one name and EIN when filing Forms 8596 and 8596-A. Boxes 3a and 3b. Enter the name, mailing address, and title of the person to whom requests for an offset against any unpaid tax liability of the contractor can be sent. Box 4. Enter the date the quarter ended. For example, for the quarter ending March 31, 1999, enter 03311999; June 30, 1999, enter 06301999; September 30, 1999, enter 09301999; December 31, 1999, enter 12311999. Box 5. Enter the number of Forms 8596 being transmitted with this Form 8596-A. Signature. The head of the Federal executive agency or his or her delegate must sign and date the form. See Form 8596 for additional information.

Cat. No. 12307S

Form

8596-A

(Rev. 5-99)