
INSTRUCTIONS
You may use federal Form 1096 instead of this form.
1. File this form by February 28, 2013.
2. Report and include only the forms listed that apply to you. The other information forms required by the IRS that are
not listed are not required by Idaho. Forms 1099-R that claim Idaho withholding must be submitted on Form 967.
3. Penalties.
MAIL TO: Idaho State Tax Commission, PO Box 36, Boise ID 83722-0410
INFORMATION FORMS INCLUDED
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Idaho or the service was performed in Idaho ................................................................................................... 3
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Number of
Forms Included
Title
Signature
IDAHO ANNUAL INFORMATION RETURN
96
01-02-13
F
O
R
M
Name of person or organization