Form 9400 579A PDF Details

Every year, the IRS releases a list of new tax scams that they are seeing throughout the year. This year is no different, and one of the scams on their list is Form 9400 579A. So what exactly is this scam, and what can you do to protect yourself from it? Keep reading to find out. Form 9400 579A is a phone scam in which callers pose as representatives from the IRS and try to get taxpayers to provide them with sensitive information like their Social Security number or driver's license number. The scammer will then use this information to steal the taxpayer's identity and file fraudulent tax returns in their name. To protect yourself from this scam, never provide any personal information over the phone unless you are absolutely sure who you are talking to. If you receive a call from someone claiming to be from the IRS and you are not sure if it is legitimate, hang up and call the IRS directly to verify. You can also contact your state's attorney general's office for more information

Form NameForm 9400 579A
Form Length1 pages
Fillable fields0
Avg. time to fill out15 sec
Other names9400 579A wisconsin captive wildlife and fur farm annual report form

Form Preview Example

Mail Report To: State of Wisconsin

Captive Wildlife and Fur Farm Annual Report

Department of Natural Resources

Form 9400-579A (R 2/05)

Bureau of Customer Service and Licensing


PO Box 7924, Madison WI 53707-7924


Due: On or before January 30 each year

Notice: This form is authorized by s. 169.36(10)(b), Wis. Stats., and may be used by any person who holds a license issued under ch. 169, Wis. Stats., which authorizes the holder to possess live captive wild animals, including the holder of a Wild Fur Farm License. Submittal of an annual report to the Department is mandatory and must be submitted on or before January 30 following the license year that the report covers. Failure to submit a complete annual report to the Department may result in a maximum forfeiture of $200 plus costs and assessments. Extra forms are available or this form may be photocopied if needed. A license holder may use their own annual report form or document (such as a computer-generated record), provided it includes all the information asked for below. Personal information collected will be used for program administration and enforcement purposes and may be made available to requesters as required by Wisconsin's Open Records law [ss. 19.31-19.39, Wis. Stats.].

License Type: (Select the license type this report covers – One license per report)

Captive Wild Animal Farm License

Wild Fur Farm License

Scientific Research License

Bird Dog Training License

Hound Dog Training License

Hound Dog Trial License

Non-Profit Educational Exhibitors License

Bird Dog Trial License

Dog Club Training License

License Number

Report Year

Licensee Last Name

Street Address

First Name


Daytime Telephone Number

E-mail Address




















ZIP Code









Total Number


Total Number

Total Number

Total Number


Total Number


Possessed at

Total Number

Purchased or

Sold or

that Died or

Total Number

Possessed at


Start of Year




were Killed


End of Year












I hereby certify the foregoing information is true and correct. I understand that providing incorrect information may result in revocation of my license and possible penalties.

Signature of Licensee

Date Signed

Attach additional sheets as needed