Form Ftb 1096 – Fill Out and Use This PDF

STATE OF CALIFORNIA

TAX FORMS DEVELOPMENT AND DISTRIBUTION

FRANCHISE TAX BOARD

PO BOX 1468

SACRAMENTO CA 95812-1468

AGREEMENT TO COMPLY WITH FTB PUB. 1098

Computerized tax processors, tax software developers, commercial printers, and others who develop tax forms in a scannable format or as substitute copies of official California Franchise Tax Board tax forms, must complete this form. Please FAX your completed form to (916) 845-4788, Attn: Raul Guzman/Kathy Bridges or mail it to us at:

Tax Forms Development and Distribution Section M/S B5

Franchise Tax Board

PO Box 1468

Sacramento CA 95812-1468

I am a representative of

(name of company) ________________________________________________________________________________________________________

and I am authorized to agree to and answer the following on behalf of the above named company.

In an effort to maintain current records, please take a moment to answer the following questions. If these questions do not apply, complete the form on Side 2 and FAX it or mail it to us using the information above.

Has your company experienced a recent merger? YES NO

If YES, please indicate new company name, forms contact person, and telephone number.

Company Name: _____________________________________________________________________

Forms Contact Person Name: ___________________________________________________________

Telephone (______) _________________________________________ ext. ____________________

If NO, please go to the next question.

Our company will (check all applicable boxes):

Develop scannable/substitute tax forms using our tax software programs. We plan to develop the following scannable forms:

Form 540	Form 540A
Form 540-ES	Form 541-ES
FTB 3519	FTB 3563

FTB 3582

Develop tax software programs to be used with scannable/substitute tax forms developed by

____________________________________________________________________________(provide company name);

Develop scannable/substitute tax forms for other companies to use with their tax software programs. We plan to develop the following scannable forms:

Form 540	Form 540A
Form 540-ES	Form 541-ES
FTB 3519	FTB 3563
FTB 3582

FTB 1096 (REV 05-2003) SIDE 1

Our company agrees to comply with FTB Pub. 1098, Guidelines for the Development and Use of Substitute, Scannable, and Reproduced Tax Forms, published by the Franchise Tax Board.

Specifically, our company agrees to:

1.Refrain from requesting approval of scannable/substitute tax forms based on preliminary versions of our forms, or using preliminary versions of our forms to prepare returns for filing with the Franchise Tax Board, or distributing preliminary versions of our forms to the public.

2.Submit to the Franchise Tax Board for its review and approval, prior to their release to customers or clients, any scannable/electronically processed substitute tax forms or any products that produce these forms and, in case of Paperless Schedules K-1 565 or 568, use FTB provided Schedules K-1 565 or 568 TestWare or submit Schedules K-1 565 or 568 test files before sending production files.

3.When notified by the Franchise Tax Board, promptly correct errors in our company’s scannable/substitute tax forms and substantiate to the Franchise Tax Board that our company has corrected the errors and notified customers or clients of the corrections. Continue to educate customers to prevent problem returns from being generated.

4.Notify customers or clients of the computer hardware requirements, including printers, printer fonts, font cartridges, etc., necessary to produce our company’s scannable/substitute tax forms that were approved by the Franchise Tax Board.

5.Identify to the Franchise Tax Board all scannable/substitute tax forms and tax software programs using our company’s identification code.

6.Notify Franchise Tax Board of any critical software problems identified after releasing products to customers.

7.Agree to abide by the provisions of Senate Bill 1724 signed into law on September 30, 2000, (amending Sections 17530.5, 22251, and 22253 of the Business and Professions Code and adding Sections 1799.1a to the Civil Code and 18621.7 to the Revenue and Taxation Code). This law requires the Franchise Tax Board to approve only those commercially developed tax preparation forms that are compliant with the provisions of Section 6 of Senate Bill 1724, codified in Revenue and Taxation Code Section 18621.7.

Our company also specifically authorizes the Franchise Tax Board to include the name of our company in various public information material designed to inform tax practitioners and the public about vendors who have agreed, complied, or failed to comply with the Franchise Tax Board’s policies, procedures, guidelines, and specifications.

Authorized representative’s name	Computerized Tax Processor Identification (CTP ID)*		Date
Signature by	Mailing address			PMB no.
Title	City, State, ZIP Code
Forms contact name	Telephone number
	(	)		ext.
Forms contact email address, if more than one contact, use next line	FAX number
	(	)
Additional contact name	Telephone number
	(	)		ext.
Additional contact email address	Telephone number for public distribution
	(	)		ext.

*Please refer to the assigned number given in the acknowledgement letter, if applicable.

FTB 1096 (REV 05-2003) SIDE 2