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Get and Sign 1096 Form 2011
Employer Returns Online, and we’ll mail you the
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See IRS Publications 1141, 1167, 1179 and other IRS resources for information
about printing these tax forms.
6969
Do Not Staple
OMB No. 1545-0108
Form
Annual Summary and Transmittal of
U.S. Information Returns
1096
Department of the Treasury
Internal Revenue Service
2011
FILER’S name
Street address (including room or suite number)
City, state, and ZIP code
Name of person to contact
For Official Use...
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