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

    Your Form Has Been Submitted

    Click here to download a pdf for your records