Agreement to Comply with FTB Pub. 1098
Annual Requirements and Specifications
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 e-mail your completed form to Substituteforms@ftb.ca.gov or mail it to us at:
Substitute Forms MS F284
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 Side 2 and e-mail or mail this agreement to comply to us using the information above.
Has your company experienced a recent merger? YES NO
If NO, please skip to the next question.
If YES, please indicate new company name, forms contact person, email address, and telephone number.
Company name: ______________________________________________________________________
Forms contact name: __________________________________________________________________
Email address: _______________________________________________________________________
Telephone (______) _________________________________________ Ext. _____________________
Our company will (check all applicable boxes):
Develop scannable tax form or voucher(s) using our tax software programs.
Form 100-ES FTB 3519
FTB 3539 FTB 3587
FTB 3563 FTB 3588
Form 540-ES FTB 3537
Form 541-ES FTB 3538
Develop tax software programs to be used with scannable tax forms developed by
______________________________________________________________________________(provide company name)
Develop scannable tax form or voucher(s) for other companies to use