U.S. TREAS Form treas-irs-8027-t-2004
4
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I.R.S. SPECIFICATIONS
TO BE REMOVED BEFORE PRINTING
INSTRUCTIONS TO PRINTERS
FORM 8027-T, PAGE 1 of 2 (PAGE 2 IS BLANK)
MARGINS: TOP 13mm (1/2"), CENTER SIDES. PRINTS: FACE ONLY
PAPER: WHITE, WRITING, SUB. 20 INK: BLACK
FLAT SIZE: 216mm (8 1/2") x 93mm (3 2/3")
PERFORATE: (NONE)
DO NOT PRINT — DO NOT PRINT — DO NOT PRINT — DO NOT PRINT
8027-T
Department of the Treasury
Internal Revenue Service
Action
Revised proofs
requested
Transmittal of Employer’s Annual
Information Return of Tip Income and Allocated Tips
�
Signature
O.K. to print
For Privacy Act and Paperwork Reduction Act Notice, see
the Instructions for Form 8027.
Employer’s name
Type or print employer’s
name, address, and
employer identification
number as shown on
Form 941.
Date
OMB No. 1545-0714
2004
Employer identification number
Number and street (or P.O. box number, if mail is not delivered to street address.)
Apt. or suite no.
Number of accompanying Forms 8027
City or town, state, and ZIP code
Use Form 8027-T to send Forms 8027 to the
Internal Revenue Service Center if you have more
than one establishment for which you have to file
Form 8027.
File Form 8027-T along with accompanying Forms
8027 with the Internal Revenue Service
Cincinnati, OH 45999 by February 28, 2005.
Cat. No. 61006A
Form
8027-T
(2004)