2. Wizard

Form 14439

(Rev. March 2022)

Employee Data Report

Catalog Number 60879D

Instructions

Important Things You Should Know

  • Only submit this form if you received a letter from the IRS requesting that you complete and submit this form.
  • Employers participating in a Gaming Industry Tip Compliance Agreement (GITCA) must provide certain information to the IRS each year to comply with your GITCA requirements.
  • You're required to provide the following information by March 31 of each year:
    • Form 14439, Employee Data Report, including entries for all non-participating employees that worked for you during the previous year if you are an employer who has a certified payroll.
    • Form 14439, Employee Data Report, including entries for all tipped employees that worked for you during the previous year if you are an employer who does not have a certified payroll.
    • We don’t require Form 14439 if you didn’t have any non-participating employees if you are an employer who has a certified payroll.
    • Complete the Excel version with Employee Data, and attach it to this file before submitting it.    
    • Excel version of Employee Data is available at this location.

 Employer

All fields marked with an asterisk (*) are required.

Enter the name of the entity (property).

Enter the employer identification number (EIN) used on your income tax returns (Enter all 9 digits without dash and spaces).

Enter street address.

Enter city.

Select your state from drop-down list.

Enter a valid 5-digit ZIP code. Ex: 12345.

Doing Business As (DBA)

All fields marked with an asterisk (*) are required.

Enter the name that the entity (property) is operating as.

Enter the EIN used on your employment tax returns (Enter all 9 digits without dash and spaces).

Physical address of the entity: Enter the street address.

Enter city.

Select your state from drop-down list.

Enter a valid 5-digit ZIP code. Ex:12345.

File Attachment

All fields marked with an asterisk (*) are required.

Enter the year of the data submitted (e.g. 2023).

    While creating a new spreadsheet, make sure you use same field names and columns as shown on the attached spreadsheet. If you change them, you may be asked to re-submit the spreadsheet.

    Click here to download the excel spreadsheet.

    All fields marked with an asterisk (*) are required.

    Review

    Review your information below. If you need to make changes, you can use the Edit links to go back to previous sections to ensure your information is accurate.

    Your Form Has Been Submitted

    Click here to download a pdf for your records