Rev. Proc. 67-42

SECTION 1. PURPOSE.

The purpose of this Revenue Procedure is to state the position of the Internal Revenue Service relating to acceptance of substitutes for Form 941a, Continuation Sheet for Schedule A of Form 941, 941-M, 941SS or 943, for filing purposes in lieu of the official form.

SEC. 2. BACKGROUND.

.01 Schedule A (Form 941), Quarterly Report of Wages Taxable Under the Federal Insurance Contributions Act, provides space for listing the account numbers, names, wages and taxable tips, if any, of employees. Form 941a is available to employers who need additional space for listing of employees.

.02 Substitutes for Form 941a may be privately printed and used without specific approval of the Internal Revenue Service only if all specifications are completely met.

SEC. 3. SPECIFICATIONS.

.01 Basic Form .-The latest revision of the prescribed Form 941a should be used as the basis for the privately printed form. A copy may be obtained from any District Director of Internal Revenue.

.02 Typography .-Type may not be smaller than the corresponding type of the official form and should be as nearly as possible of the same font.

.03 Dimensions .-The official Form 941a is 8 inches by 11 inches. Forms may vary in width from 7 7/8 inches to 8 1/2 inches plus/minus 0.031 inch. Depth of form must be 11 inches plus/minus 0.031 inch. These dimensions must be maintained at time of manufacture. Grain must run the 11-inch way.

.04 Paper Requirements .-

(a) General .-The paper must be white 100 percent bleached chemical wood (no optical brighteners may be added to the pulp or paper during manufacture, minimal trace amounts will be acceptable).

(b) Basis weight .-The basis weight of 1,000 sheets measuring 17 x 22 inches must be 40 pounds plus or minus 5 percent.

(c) Caliper .-The thickness of the paper must be 0.0038 inch, tolerance plus 0.0004 and minus 0.0002.

(d) Smoothness .-The smoothness (finish) of the document must give a reading of at least 100, but not greater than 200, as measured by a Sheffield Smoothness Tester. Paper with a smoothness reading of 150 will give the best result.

(e) Stiffness .-Document stiffness as measured by a Taber V-5 Tester must be as follows: machine direction, minimum 2.0, maximum 5.0, recommended 3.8, cross direction, minimum 1.0, maximum 3.0, recommended 2.0. If a Gurley Tester is used to measure stiffness, the readings should be: 150 machine direction; 72 cross direction.

(f) Paper reflectance .-To be acceptable, a paper must attain certain minimum reflectance readings when tested by a Beckman DK2A Ratio Recording Spectroreflectometer. The test must be made with one sheet of the sample paper with a black matte backing.

If the magnesium oxide reading is considered as 100 percent, these minimum reflectance readings must be:

    Wave length in angstroms           Reflectance reading (percent)

An alternate method for measuring paper reflectance is to use Specification T-452 of the Technical Association of the Pulp and Paper Industry (TAPPI). With this test, the paper must have a reflectance of at least 80 percent.

Marks or imperfections are permissible if they do not cause the reflectance from an area 0.006 inch in diameter to vary more than 10 percent from the background reflectance of the paper.

Reflectance as measured by a Kidder Mark Read Tester (MR-8) must be at least 52 millivolts.

.05 Color and Quality of Ink .-All printing must be accomplished with black non-reflective inks with good heavy coverage. A non-reflective ink is one which has a 10 percent reflectance or less when measured on a Reflectometer that simulates the spectral response of the scanner and 19 millivolts or less when measured on a Kidder Mark Read Tester (MR-8) or equivalent device. When measured on a Kidder Model 081 OCR tester with infrared probe, reflectance of 20 percent or less is acceptable. The sample measured by the Kidder Mark Read Tester must have minimum dimensions equal to or greater than the `Initial Positioning Mark.' The 10 percent reflectance is referenced to magnesium oxide which is 100 percent.

.06 Printing Locations and Tolerances .-Printers requesting reproduction proofs will be furnished engineering drawings containing the timing track indicia printing locations and tolerances. The dimensions specified on these drawings must be maintained, within the stipulated tolerances, during printing.

.07 Taxable Tips Reported Column .-If this column is not needed for reporting tip income, it may be used for information not called for on the official Form 941a such as State unemployment compensation. No block out will be permitted on the original copy.

.08 Printer Identification .-Private printers of substitutes for Form 941a should identify themselves as having printed the substitutes by printing their Employer's Identification Number on the forms. Such identification must consist of the number only, set in 6-point or smaller type. The number must be positioned 1/4 inch below the dollar mark, appearing on the official Form 941a, in the `Taxable Tips Reported' column and 1/8 inch to the right of the `Taxable F.I.C.A. Wages' column track (see Exhibit I).

.09 No printing may appear on the reverse side of Form 941a.

.10 The Government Printing Office Symbols .-To be omitted.

SEC. 4. VARIATIONS IN WIDTH OF COLUMNS AND DEPTH OF FORM.

If users do not prefer to use the standard form and overlay furnished by the Service, they must redesign the form within the exact tolerances shown on the engineering drawing. After redesign the user must submit a written request with two samples of the proposed reproduction to the Commissioner of Internal Revenue, Attention: D:S :Pl, Washington, D.C. 20226, for consideration. In general, substitute forms may deviate from the official form only as follows:

.01 A proposed substitute form may vary in depth from 8 1/2 inches to 11 inches plus/minus 0.031 inch.

.02 The first three columns from the left, namely `Employee's Social Security Account Number,' `Name of Employee,' and `Taxable F.I.C.A. Wages,' of a proposed substitute form may not be wider than the columns of the official form. The same columns of substitute forms may be narrower than the columns of the official form; however, each column must be adequate for reporting information therein. To facilitate employer's recordkeeping, the extreme right column may be wider than that of the official form.

.03 Printers and/or users requesting substitute forms that vary as listed in .01 and .02 above will be required to prepare artwork for the overlay that will meet the highly critical dimensions given in the engineering drawing.

SEC. 5. ADDITIONAL INSTRUCTIONS.

.01 Only the originals of privately printed forms should be filed with the Internal Revenue Service; copies and reproductions of any kind are not acceptable.

.02 If the forms are printed in continuous style, they must be separated before filing. Marginal holes for pin feed devices and stubs at the top or bottom of the form must be removed before filing with the Service. The forms when filed must be within the dimensions specified in Sections 3.03 and 4.01 above.

.03 It is preferred that the names and account numbers of employees to whom no taxable wages were paid during the quarter covered by the report be omitted. If listed, they should be grouped at the end of the report. In the event this is not feasible, the items may be listed within the report.

.04 Clear, black typing is a prerequisite for optical scanning. Employers processing Form 941a over equipment such as typewriters, accounting machines, high-speed printers, etc. are requested to use a black ribbon and to take any other measures that will guarantee a clear, sharp image to facilitate scanning. In addition, all typing must be positioned at least 1/16 inch from all tracks and rules printed in the reporting area, the page totals should be no closer than 1/8 inch.

SEC. 6. REPRODUCTION PROOFS.

.01 Order blanks for reproduction proofs are mailed annually to requesters of record and, on request, to other users. Printers and others wishing to obtain reproduction proofs and/or dimensionally stable film positive overlays of the timing track indicia, for the standard 7 7/8 to 8 1/2 inches by 11 inches size only, may send their requests to the Commissioner of Internal Revenue, Attention: A:FM:P, 1111 Constitution Avenue N.W., Washington, D.C. 20224.

.02 Engineering drawings containing the timing track indicia, printing locations, and tolerances will be furnished with each order for reproduction proofs and/or film positive overlays. The drawings are available to other users upon request.

.03 A charge of $0.75 for each reproduction proof and $3.00 for each dimensionally stable film positive overlay of the timing track indicia will be made. Invoices will be mailed after orders have been filled. There will be no charge for engineering drawings.

SEC. 7. EFFECT ON OTHER DOCUMENTS.

This Revenue Procedure supersedes Revenue Procedure 64-46, C.B. 1964-2, 983.

 EXHIBIT 1