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  • 1096 Department the Treasury Revenue Service  
Annual Summary and Transmittal of U.S. Information Returns  
No.  
FILER'S  
address  
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foreign  
Name  
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For Official Use Only  
address  
number  
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1098-0  
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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).  
Signature  
Title  
Date  
Instructions  
Future developments. For the latest information about developments related to Form 1096, such as legislation enacted, go to www.irs.gov/Form1096.  
Who must file. Any person or entity who files any form checked in box 6 must file Form 1096 to transmit those

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