b"1099 PRE-PRINTED FORMS 1099 PRE-PRINTED FORMSTFP 1099-DIV & 1099-R Packaged Sets Apex 1099-MISC, 1099-NEC, 1099-INT SetsTFP 1099-DIV LASER PACKAGED SET APEX DWMR or DWMRSTFP 5130 TFP 5131 TFP 5132 TFP 51009191 VOIDCORRECTED CORRECTED (if checked) VOIDCORRECTED Do Not Staple 6969PAYERS name, street address, city or town, state or province, country, ZIP 1aTotal ordinary dividendsOMB No. 1545-0110PAYERS name, street address, city or town, state or province, country, ZIP 1aTotal ordinary dividendsOMB No. 1545-0110PAYERS name, street address, city or town, state or province, country, ZIP 1aTotal ordinary dividendsOMB No. 1545-0110Form1096 Annual Summary and Transmittal of OMB No. 1545-0108or foreign postal code, and telephone no.$1b Form1099-DIVDividends andor foreign postal code, and telephone no. INKS $1b Form1099-DIV Dividends and DETACH BEFORE MAILING or foreign postal code, and telephone no. USING HEATINKS $1b Form1099-DIVDividends and DETACH BEFORE MAILINGUSING HEATINKS Department of the TreasuryU.S. Information Returns 2023DETACH BEFORE MAILING DETACH BEFORE MAILINGRESISTANTUSING HEATRESISTANTRESISTANTMANUFACTUREDMANUFACTURED ON OCR LASER BOND PAPER USING HEAT RESISTANT INKSDETACH BEFORE MAILINGDETACH BEFORE MAILINGDETACH BEFORE MAILING(Rev. January 2022) Distributions(Rev. January 2022) Distributions(Rev. January 2022) DistributionsInternal Revenue ServiceFor calendar year For calendar year For calendar year FILERS name$2aTotal capital gain distr. $2bUnrecap. Sec. 1250 gainCopy A $2aTotal capital gain distr. $2bUnrecap. Sec. 1250 gainCopy B$2aTotal capital gain distr. $2bUnrecap. Sec. 1250 gainCopy C Street address (including room or suite number) APEX 1099-MISC LASER PACKAGED SET$ Copy APAYERS TIN RECIPIENTS TIN $2cSection 1202 gain2dCollectibles (28%) gainInternal Revenue ForPAYERS TINRECIPIENTS TIN $2cSection 1202 gain2dCollectibles (28%) gainFor RecipientPAYERS TINRECIPIENTS TIN $2cSection 1202 gain2dCollectibles (28%) gainFor Payer$$Service Center$$$$and/or State Copy 1 or Copy 2RECIPIENTS name$2eSection 897 ordinary dividends $2fSection 897 capital gainFile with Form 1096. RECIPIENT'S name, stret adres, city or town, state or province, country, and ZIP or foreign postal code $2eSection 897 ordinary dividends $2fSection 897 capital gainThis is important taxRECIPIENT'S name, stret adres, city or town, state or province, country, and ZIP or foreign postal code $2eSection 897 ordinary dividends $2fSection 897 capital gainFor Privacy ActCity or town, state or province, country, and ZIP or foreign postal code For Ofcial Use Only APEX LMA APEX LMB APEX LMCLM2 APEX L1096 BOND PAPERBOND PAPERBOND PAPER3Nondividend distributions 4Federal income tax withheld3Nondividend distributions 4Federal income tax withheld3Nondividend distributions 4Federal income tax withheld Name of person to contact Telephone number$$For Privacy Act$$information and is$$and PaperworkEmail address Fax number5Section 199A dividends 6Investment expensesand Paperwork5Section 199A dividends 6Investment expensesbeing furnished to5Section 199A dividends 6Investment expensesReduction Act9595 VOID CORRECTED CORRECTED (if checked)VOID CORRECTEDStreet address (including apt. no.)$$Reduction Act$$the IRS. If you are$$Notice, see the12 Social security number 3 Total number of forms $ 4 Federal income tax withheld5 Total amount reported with this Form 1096 PAYERS name, street address, city or town, state or province, country, ZIP PAYERS name, street address, city or town, state or province, country, ZIP PAYERS name, street address, city or town, state or province, country, ZIP OMB No. 1545-0115 $ 1 Rents Do Not Staple 6969 $ 1 Rents Annual Summary and Transmittal of OMB No. 1545-0108 ON OCR LASERON OCR LASERON OCR LASERCity or town, state or province, country, and ZIP or foreign postal code 7Foreign tax paid8Foreign country or U.S. possession Notice, see the7Foreign tax paid8Foreign country or U.S. possession return, a negligence7Foreign tax paid8Foreign country or U.S. possessioncurrent General6$ or foreign postal code, and telephone no. or foreign postal code, and telephone no.1 Rents or foreign postal code, and telephone no. Form1096 2 Royalties Information OMB No. 1545-0115 Miscellaneous2023Notice, see theOMB No. 1545-0115 MANUFACTUREDMANUFACTUREDMANUFACTURED ON OCR LASER BOND PAPER USING HEAT RESISTANT INKSMANUFACTURED ON OCR LASER BOND PAPER USING HEAT RESISTANT INKSMANUFACTURED ON OCR LASER BOND PAPER USING HEAT RESISTANT INKScurrent Generalpenalty or other $9Cash liquidation distributions10 Noncash liquidation distributions Instructions for Certain$9Cash liquidation distributions10 Noncash liquidation distributionssanction may be$9Cash liquidation distributions10 Noncash liquidation distributionsInstructions forW-2G 1097-BTC10981098-C1098-E1098-F1098-Q1098-T1099-A1099-B1099-C1099-CAP1099-DIV1099-G1099-INT1099-K $ 2 Royalties Form1099-MISC Miscellaneous 1099-MISC Miscellaneous U.S. Information Returnsimposed on you ifCertain(Rev. January 2022) 2 Royalties Department of the TreasuryForm1099-MISC InformationForm and the IRSInformation For calendar yearFor calendar year Internal Revenue Service$$Information$$ this income is taxable$$Information32 50 81 78 84 03 74 83 80 79 85 73 91 86 92 10 $ For calendar year$ (Rev. January 2022) $ (Rev. January 2022)Returns.determines that it hasReturns.FILERS name 2011requirement 12Exempt-interest dividends13bond interest dividends 11requirement 12Exempt-interest dividends13bond interest dividends not been reported.11requirement 12Exempt-interest dividends13bond interest dividends 3 Other income 4 Federal income tax withheld3 Other income 4 Federal income tax withheld 4 Federal income tax withheld Copy C$$$$$$1099-LS 1099-LTC1099-MISC 1099-NEC 1099-OID1099-PATR 1099-Q1099-QA 1099-R1099-S1099-SA 1099-SB 3921392254985498-ESA5498-QAPAYERS TIN RECIPIENTS TINPAYERS TIN $ $ $ Copy A$ payments $ 3 Other income Copy B$ 6 Medical and health careor For PayerStreet address (including room or suite number)$$$16 93 95 71 96 97 31 1A 98 75 94 43 25 26 28 72 2A 5 Fishing boat proceeds ForFor Recipient payments StateCopy2Account number (see instructions)2nd TIN not.14State 15 16State tax withheld Account number (see instructions)14State 15 16State tax withheld Account number (see instructions)2nd TIN not.14State 15 16State tax withheld 5 Fishing boat proceedsRECIPIENTS TIN6 Medical and health care paymentsPAYERS TIN Internal Revenue5 Fishing boat proceeds orCopyRECIPIENTS TIN6 Medical and health care Service Center$City or town, state or province, country, and ZIP or foreign postal codeForm(Rev. 1-2022) 41-0852411 www.irs.gov/Form1099DIV $Department of the Treasury - Internal Revenue Service Form1099-DIV(Rev. 1-2022) (keep for your records)www.irs.gov/Form1099DIV $Department of the Treasury - Internal Revenue Service Form1099-DIV(Rev. 1-2022) www.irs.gov/Form1099DIV $Department of the Treasury - Internal Revenue Service 5498-SARECIPIENTS name RECIPIENT'S name, stret ad $ 7totaling $5,000 or more of$ $ totaling $5,000 or more of$ $ 7totaling $5,000 or more of$ Telephone numberFor Privacy ActFor Ofcial Use Only$27 res, city or town, state or province, country, aRnEdC ZIPI EoNr Tfo'Sre niganm peo, starle ceto adedres File with Form 1096. 8 of dividends or interest Payer made direct sales8 of dividends or interest1099-DIVPayer made direct sales$ 8 of dividends or interest7consumer products toName of person to contact This is important taxSubstitute payments in lieuand Paperwork , city or town, state or province, country, and ZIP or foreign postal codeSubstitute payments in lieuSubstitute payments in lieu Payer made direct sales DoNotCutorSeparateFormsonThisPage DoNotCutorSeparateFormsonThisPage Street address (including apt. no.) consumer products to10 Gross proceeds paid to anFor Privacy Actattorney consumer products to$ Fax number Reduction Act5 Total amount reported with this Form 1096recipient for resale and Paperworkinformation and is Reduction Act $ being furnished to Return this entire page to the Internal Revenue Service. Photocopies are not acceptable.9 Crop insurance proceeds attorney recipient for resale Email address recipient for resale 10 Gross proceeds paid to anNotice, see the 9191 VOIDCORRECTED OMB No. 1545-0110CORRECTED (if checked) OMB No. 1545-0110VOIDCORRECTED OMB No. 1545-0110Send this form, with the copies of the form checked in box 6, to the IRS in a at mailer (not folded). City or town, state or province, country, and ZIP or foreign postal code $ 11 Fish purchased for resale $ $ Notice, see the1097-BTC 81 $ 1098-C the IRS. If you areattorney 1098-T1099-A current General 73 $ 1099-DIV1099-G1099-INT1099-K APEX 1099-NEC LASER PACKAGED SET* 9 Crop insurance proceeds 10 Gross proceeds paid to an 9 Crop insurance proceedscurrent General2 Social security number 3 Total number of forms 4 Federal income tax withheld1return, a negligence$PAYERS name, street address, city or town, state or province, country, ZIP 1aTotal ordinary dividendsPAYERS name, street address, city or town, state or province, country, ZIP 1aTotal ordinary dividendsPAYERS name, street address, city or town, state or province, country, ZIP 1aTotal ordinary dividendsUnder penalties of perjury, I declare that I have examined this return and accompanying documents and, to the best of my knowledge and belief, they are true, correct, and complete. Instructions forCertain$ 12 Section 409A deferrals penalty or otherInstructions for$6sanction may be or foreign postal code, and telephone no.$Form1099-DIVDividends andor foreign postal code, and telephone no.$Form1099-DIV Dividends andor foreign postal code, and telephone no.$Form1099-DIVDividends andSignature Title Date $ $ 12 Section 409A deferrals11 Fish purchased for resale 32$ 50 1098 11 Fish purchased for resale $ 12 Section 409A deferrals 80 1099-B Certain 91 86 92 10Information imposed on you if1098-Q 83 79 InformationW-2G1098-E1098-F 1099-C1099-CAP 84 this income is85$ Returns. $ 78 taxable and the IRS74 Returns.031b (Rev. January 2022) Distributions1b (Rev. January 2022) Distributions1b (Rev. January 2022) DistributionsInstructions number), and TIN in the spaces provided on the form. The name, address,13 requirement 14 Excess golden parachute15 compensation 14 Excess golden parachute15 compensation payments determines that it For calendar year For calendar year For calendar year Future developments. For the latest information about developmentspayments 13 requirement payments 1099-LS13 requirement $ 14 Excess golden parachute$ 15 compensation 1A 1099-R1099-S1099-SA 1099-SB 3921392254985498-ESA5498-QA $2aTotal capital gain distr. $2bUnrecap. Sec. 1250 gain$2aTotal capital gain distr. $2bUnrecap. Sec. 1250 gainCopy B$2aTotal capital gain distr. $2bUnrecap. Sec. 1250 gainCopy C related to Form 1096, such as legislation enacted after it was published, goupper left area of Form 1097, 1098, 1099, 3921, 3922, 5498, or W-2G. Account number (see instructions) 2nd TIN not. $ 16 State tax withheld $ $ $ 16 $ 1099-LTC1099-MISC $ 1099-NEC96 has not been1099-Q1099-QA98 $ 18 State income 94 43 25 26 28 72 2A STANDARD SETS (34 Sheets for 100 Recipients)95 71 1099-OID reported. 311099-PATRto www.irs.gov/Form1096. When to le. File Form 1096 as follows. Account number (see instructions) 17 State/Payers state no.16 State tax withheld18 State income 93 2nd TIN not.16 State tax withheld 97 17 State/Payers state no. 75Account number (see instructions) 17 State/Payers state no. 18 State income$Copy AForPAYERS TINRECIPIENTS TIN $For RecipientPAYERS TINRECIPIENTS TIN $2cSection 1202 gain2dCollectibles (28%) gainFor Payer Reminder. The only acceptable method of electronically through the FIRE February 28, 2024. Form1099-MISC(Rev. 1-2022)41-0852411 Form1099-MISC$ (keep for your records) $ 5498-SA$ $ $returns listed on this form in box 6 with the IRS is 1099-MISC $$ 27 Department of the Treasury - Internal Revenue ServiceDepartment of the Treasury - Internal Revenue ServicePAYERS TIN RECIPIENTS TIN $2cSection 1202 gain$2dCollectibles (28%) gainInternal Revenue$2cSection 1202 gain$2dCollectibles (28%) gain$2eSection 897 ordinary dividends $2fSection 897 capital gainand/or StateSystem. See Pub. 1220. anyWhere To File $ Form Department of the Treasury - Internal Revenue Service $ NEC959133-Part SET includes: (34 Sheets EACH) 1099-NEC Copy A, B, CService CenterCopy 1 or Copy 2 Purpose of form. Use this form to transmit paper Forms 1097, 1098,www.irs.gov/Form1099MISC (Rev. 1-2022) www.irs.gov/Form1099MISC1099, 3921, 3922, 5498, and W-2G to the IRS.(Rev. 1-2022) www.irs.gov/Form1099MISC$2eSection 897 ordinary dividends $2fSection 897 capital gainFile with Form 1096. $2eSection 897 ordinary dividends $2fSection 897 capital gain$$Caution: electronically but fail to do so, and you do not have anDo Not Cut or Separate Forms on This PageDo Not Cut or Separate Forms on This PageRECIPIENTS name$3Nondividend distributions$4Federal income tax withheldand PaperworkRECIPIENT'S name, stret adres, city or town, state or province, country, and ZIP or foreign postal code $3Nondividend distributions$4Federal income tax withheldThis is important taxRECIPIENT'S name, stret adres, city or town, state or province, country, and ZIP or foreign postal code $3Nondividend distributions$4Federal income tax withheld For Privacy Actapproved waiver, you may be subject to a penalty. The Taxpayer First ActIf your principal business, ofce orUse the following9595 VOID CORRECTED OMB No. 1545-0115 1 Rents Return this entire page to the Internal Revenue Service. Photocopies are not acceptable. Street address (including apt. no.)$5Section 199A dividends $6Investment expensesFor Privacy Act$5Section 199A dividends $6Investment expensesinformation and is$5Section 199A dividends $6Investment expensesand Paperworkof 2019, enacted July 1, 2019, authorized the Department of the Treasuryagency, or legal residence in theaddress PAYERS name, street address, city or town, state or province, country, ZIPor foreign postal code, and telephone no. Send this form, with the copies of the form checked in box 6, to the IRS in a at mailer (not folded). NEC959144-Part SET includes: (34 Sheets EACH) 1099-NEC Copy A, B, C, Cbeing furnished toand the IRS to issue regulations that reduce the 250-return requirement forcase of an individual, is located in CORRECTED (if checked)VOID CORRECTEDUnder penalties of perjury, I declare that I have examined this return and accompanying documents and, to the best of my knowledge and belief, they are true, correct, and complete.Reduction Actthe IRS. If you areReduction Act2022 tax returns. If those regulations are issued and effective for 2023 tax www.irs.gov/ Alabama, Arizona, Arkansas, Delaware,or foreign postal code, and telephone no. or foreign postal code, and telephone no.1 Rents OMB No. 1545-01151 Rents OMB No. 1545-0115 Title DatePAYERS name, street address, city or town, state or province, country, ZIP PAYERS name, street address, city or town, state or province, country, ZIP 7Foreign tax paid8Foreign country or U.S. possession Notice, see the7Foreign tax paid8Foreign country or U.S. possession return, a negligence7Foreign tax paid8Foreign country or U.S. possession Notice, see theForm1099 explaining the change. Until regulations are issued, however,Florida, Georgia, Kentucky, Maine,Internal Revenue Service $ Form1099-MISC $ Miscellaneous 1099-MISC $ Miscellaneous 1099-MISC Miscellaneous SignatureCity or town, state or province, country, and ZIP or foreign postal code $9Cash liquidation distributions10 Noncash liquidation distributions current General$9Cash liquidation distributions10 Noncash liquidation distributionspenalty or other$9Cash liquidation distributions10 Noncash liquidation distributionscurrent Generalinformation, see Massachusetts, Mississippi, NewP.O. Box 149213$ 2 Royalties (Rev. January 2022) $ 2 Royalties Form$ 2 Royalties Form20 Information NEC959155-Part SET includes: (34 Sheets EACH) 1099-NEC Copy A, B, C, C, 2sanction may beInformation Returns. part F in the 2023 General Instructions for CertainHampshire, New Jersey, New Mexico,Information For calendar yearInformation For calendar year InstructionsInstructions for Certainimposed on you ifInstructions for Certainreturns. New York, North Carolina, Ohio, Texas,Austin, TX 78714-9213 For calendar year(Rev. January 2022) (Rev. January 2022) number), and TIN in the spaces provided on the form. The name, address,this income is taxableInformationWho must le.Vermont, Virginia 3 Other income 4 Federal income tax withheld3 Other income Future developments. For the latest information about developmentsupper left area of Form 1097, 1098, 1099, 3921, 3922, 5498, or W-2G.Informationand the IRSAlaska, Colorado, Hawaii, Idaho,related to Form 1096, such as legislation enacted after it was published, goWhen to le. File Form 1096 as follows.to www.irs.gov/Form1096. 3 Other income$12Exempt-interest dividends $13bond interest dividends Returns.11requirement $12Exempt-interest dividends $13bond interest dividends determines that it has11requirement $12Exempt-interest dividends $13bond interest dividends Returns.Caution:Illinois, Indiana, Iowa, Kansas,Internal Revenue Service CenterPAYERS TIN RECIPIENTS TINPAYERS TIN $ $ $ Copy A4 Federal income tax withheld For Recipient 4 Federal income tax withheld or Copy Csubject to information return penalties. Do not use the name and/or TIN ofMontana, Nebraska, Nevada, North Kansas City, MO 64121-9256 5 Fishing boat proceeds Forpayments $ Copy B$ 6 Medical and health careFebruary 28, 2024.11requirement $$$$not been reported.$$the name and TIN used on your 94X series tax return(s) or you may beMichigan, Minnesota, Missouri,P.O. Box 2192565 Fishing boat proceedsRECIPIENTS TIN6 Medical and health care paymentsPAYERS TIN Reminder. The only acceptable method of electronically through the FIREFor PayerAccount number (see instructions)2nd TIN not.14State 15 16State tax withheld Account number (see instructions)14State 15 16State tax withheld Account number (see instructions)2nd TIN not.14State 15 16State tax withheld your paying agent or service bureau. Dakota, Oklahoma, Oregon, Southreturns listed on this form in box 6 with the IRS is paymentsanyStateCopy2 STANDARD SETS w/ Envelopes (34 Sheets for 100 Recipients)$System. See Pub. 1220. Internal Revenue 6 Medical and health care RECIPIENTS TIN 5 Fishing boat proceedsPurpose of form. Use this form to transmit paper Forms 1097, 1098, Carolina, South Dakota, Tennessee, Service Center orCopyUtah, Washington, Wisconsin, Wyoming1099, 3921, 3922, 5498, and W-2G to the IRS.Where To FileCaution: Form1099-DIV(Rev. 1-2022) LDA 41-0852411 5130 www.irs.gov/Form1099DIV $Department of the Treasury - Internal Revenue Service Form1099-DIV(Rev. 1-2022)LDB (keep for your records)5131 www.irs.gov/Form1099DIV $Department of the Treasury - Internal Revenue Service Form1099-DIV(Rev. 1-2022) LDC 5132 www.irs.gov/Form1099DIV $Department of the Treasury - Internal Revenue Service RECIPIENTS name RECIPIENT'S name, stret ad $ 7totaling $5,000 or more of$ $ File with Form 1096.electronically but fail to do so, and you do not have anIf your principal business, ofce orUse the following $ $ $$$$For more information and the Privacy Act and Paperwork Reduction Act Notice,L1096 41-0852411 5100 Form1096(2023) Street address (including apt. no.) res, city or town, state or province, country, aRndE CZIPI EoNr Tfo'Sre niganm peo, starle ceto dadedres 9, city or town, state or province, country, and ZIP or foreign postal code 7 Payer made direct sales$ 8 of dividends or interest For Privacy Actaddress NEC95913E3-Part SET includes: (34 Sheets EACH) 1099-NEC Copy A, B, C,see the 2023 General Instructions for Certain Information Returns. consumer products to$ 8 of dividends or interest7totaling $5,000 or more of8 of dividends or interesttotaling $5,000 or more ofSubstitute payments in lieuand Paperwork Payer made direct salesSubstitute payments in lieuFor Privacy Act Substitute payments in lieuThis is important taxagency, or legal residence in the Payer made direct sales approved waiver, you may be subject to a penalty. The Taxpayer First Act of 2019, enacted July 1, 2019, authorized the Department of the Treasury and Paperworkconsumer products tocase of an individual, is located inrecipient for resale consumer products to10 Gross proceeds paid to aninformation and isattorney Reduction ActInternal Revenue Service9 Crop insurance proceeds attorney recipient for resale and the IRS to issue regulations that reduce the 250-return requirement for www.irs.gov/ Alabama, Arizona, Arkansas, Delaware, Reduction Act $ recipient for resalebeing furnished to 2022 tax returns. If those regulations are issued and effective for 2023 tax Notice, see the the IRS. If you areNotice, see the 10 Gross proceeds paid to an Crop insurance proceeds attorney 9 Crop insurance proceeds 10 Gross proceeds paid to anFlorida, Georgia, Kentucky, Maine, City or town, state or province, country, and ZIP or foreign postal code $ 11 Fish purchased for resale $ $ current Generalpart F in the 2023 General Instructions for Certaincurrent General P.O. Box 149213+ DW19W (100)Form1099 explaining the change. Until regulations are issued, however, Instructions forCertain$ $ penalty or otherInstructions for Austin, TX 78714-9213information, see return, a negligenceMassachusetts, Mississippi, New Information Returns. 11 Fish purchased for resale $ 12 Section 409A deferrals Hampshire, New Jersey, New Mexico, 12 Section 409A deferrals11 Fish purchased for resale 12 Section 409A deferrals sanction may beNew York, North Carolina, Ohio, Texas, Certain Information imposed on you ifVermont, Virginiareturns. this income isInformationWho must le.$ Returns. $ $ $ Returns.$ $ taxable and the IRSAlaska, Colorado, Hawaii, Idaho,Internal Revenue Service Center payments 13 requirement payments Caution:13 requirement payments determines that itIllinois, Indiana, Iowa, Kansas, Kansas City, MO 64121-9256Account number (see instructions) 13 requirement $ 14 Excess golden parachute$ 15 compensation $ 14 Excess golden parachute$ 15 compensation $ 14 Excess golden parachute$ 15compensation Michigan, Minnesota, Missouri,P.O. Box 219256NEC95914E4-Part SET includes: (34 Sheets EACH) 1099-NEC Copy A, B, C, C, has not beenDakota, Oklahoma, Oregon, South the name and TIN used on your 94X series tax return(s) or you may beMontana, Nebraska, Nevada, North reported.subject to information return penalties. Do not use the name and/or TIN ofCarolina, South Dakota, Tennessee,Account number (see instructions) Account number (see instructions) your paying agent or service bureau. 17 State/Payers state no. Utah, Washington, Wisconsin, Wyoming TFP 1099-R LASER PACKAGED SET Form1099-MISC(Rev. 1-2022)LMA 41-0852411Form2nd TIN not. $ 16 State tax withheld 17 State/Payers state no.16 State tax withheld18 State income 17 State/Payers state no. $ 18 State income $ 18 State income L1096 41-0852411 5100 Form1096(2023) + DW19W (100)2nd TIN not.16 State tax withheld$ $ $$ $ For more information and the Privacy Act and Paperwork Reduction Act Notice, $ $ $1099-MISC $ LMB(keep for your records)5111(Rev. 1-2022) see the 2023 General Instructions for Certain Information Returns.(Rev. 1-2022) 1099-MISCwww.irs.gov/Form1099MISCLMC/LM2 www.irs.gov/Form1099MISC 51125110 www.irs.gov/Form1099MISC Form Department of the Treasury - Internal Revenue ServiceDepartment of the Treasury - Internal Revenue ServiceDepartment of the Treasury - Internal Revenue ServiceTFP 5140 TFP 5141 TFP 5142 TFP 5143 TFP 5100 NEC95915E5-Part SET includes: (34 Sheets EACH) 1099-NEC Copy A, B, C, C, 2,9898 VOID CORRECTED OMB No. 1545-0119 Distributions FromCORRECTED (if checked) OMB No. 1545-0119 Distributions FromCORRECTED (if checked) OMB No. 1545-0119 Distributions FromVOID CORRECTED OMB No. 1545-0119 Do Not Staple 6969 Annual Summary and Transmittal of OMB No. 1545-0108 + DW19W (100)PAYERS name, street address, city or town, state or province,$ 1Gross distribution 2023 PAYERS name, street address, city or town, state or province,$ 1Gross distribution 2023 PAYERS name, street address, city or town, state or province,$ 1Gross distribution 2023 PAYERS name, street address, city or town, state or province,$ 1Gross distribution 2023 Form1096 U.S. Information Returns 2023 (3) Transmittal 1096 forms are included with each set DETACH BEFORE MAILINGDETACH BEFORE MAILINGDETACH BEFORE MAILINGDETACH BEFORE MAILINGDETACH BEFORE MAILING MANUFACTURED ON OCR LASER BOND PAPER USING HEAT RESISTANT INKSMANUFACTURED ON OCR LASER BOND PAPER USING HEAT RESISTANT INKSMANUFACTURED ON OCR LASER BOND PAPER USING HEAT RESISTANT INKSMANUFACTURED ON OCR LASER BOND PAPER USING HEAT RESISTANT INKSMANUFACTURED ON OCR LASER BOND PAPER USING HEAT RESISTANT INKSDistributions From Pensions, Annuities, country, ZIP or foreign postal code, and telephone no. country, ZIP or foreign postal code, and telephone no.country, ZIP or foreign postal code, and telephone no. country, ZIP or foreign postal code, and telephone no. Pensions, Annuities, Pensions, Annuities, Pensions, Annuities,Retirement orRetirement orRetirement orRetirement or $ 2aTaxable amount Form 1099-R Prot-Sharing Plans,$ 2aTaxable amount Form 1099-R Prot-Sharing Plans,$ 2aTaxable amount Form 1099-R Prot-Sharing Plans,$ 2aTaxable amount Form 1099-R Prot-Sharing Plans,STANDARD SET w/ Self-Seal Envelopes (34 Sheets for 100 Recipients)Department of the Treasury Internal Revenue ServiceIRAs, InsuranceIRAs, InsuranceIRAs, InsuranceIRAs, Insurance Contracts, etc. Contracts, etc. Contracts, etc. FILERS nameContracts, etc.PAYERS TIN RECIPIENTS TIN 2bTaxable amount4 TotalPAYERS TINCopy ARECIPIENTS TIN 2bTaxable amount4 TotalPAYERS TINCopy CRECIPIENTS TIN 2bTaxable amount4 TotalPAYERS TINCopy CRECIPIENTS TIN 2bnot determined 4 TotalCopy D Taxable amount not determined distribution Fornot determined distribution For Recipient'snot determined distribution For Recipient's3Capital gain (included indistribution Street address (including room or suite number) r NEC95914ES 4-Part SET includes: (34 Sheets EACH) 1099-NEC Copy A, B, C, C, 3Capital gain (included inFederal income tax Internal Revenue3Capital gain (included inFederal income tax Records and/or 3Capital gain (included inFederal income tax Records and/or box 2a) Federal income tax For Payer box 2a) withheld Service Centerbox 2a) withheld State, box 2a) withheld State,City, withheld ad/orocatl Tax State,nCity,l$ contributions or$ employers securitiesFile with Form 1096. $ insurance premiums $ RECIPIENTS name, stret adres or or LCity, $ 5Employee contributions/$ 6appreciation in Tax Departmenor Locatl $ 5Employee contributions/$ Net unrealized City or town, state or province, country, and ZIP or foreign postal code For Ofcial Use Only APEX 1099-MISC LASER PACKAGED SET* Tax Departmen 2 orCopy2 LocatDepoartmenRECIPIENTS name 5Employee contributions/ 6Net unrealized RECIPIENTS name, stret adres, city or town, state or province, country and ZIP or foreign postal code 5Employee contributions/ 6appreciation in Copy contributions orNet unrealized RECIPIENTS name, stret adres, city or town, state or province, country and ZIP or foreign postal code Designated Roth6appreciation in Name of person to contact Telephone number + DW19WS (100)Designated Rothappreciation in For Privacy ActDesignated RothNet unrealized , city or town, state or province, country and ZIP or foreign postal code Designated Rothemployers securities insurance premiums employers securities For Privacy ActFax numberinsurance premiums and Paperworkcontributions oremployers securities insurance premiums contributions orEmail address Reduction Act and Paperwork Reduction Act Street address (including apt. no.) $ 7DistributionSIMPLE $ 8Other % Notice, see the$ 7DistributionSEP/ $ 8Other % This information is$ 7DistributionIRA/ $ 8Other % This information is$ 7DistributionIRA/ $ 8Other 1% Notice, see the2 Social security number 3 Total number of forms $ 4 Federal income tax withheld $ 5 Total amount reported with this Form 1096 STANDARD SETS (50 Sheets for 100 Recipients) MINI SETS (17 Sheets for 50 Recipients)IRA/2023 GeneralIRA/2023 General code(s) SEP/ code(s) SIMPLE code(s) SEP/ code(s) SEP/$ Instructions for Certain$ SIMPLE $ SIMPLE $ 6Instructions forCertainCity or town, state or province, country, and ZIP or foreign postal code9aYour percentage of total$ 9bTotal employee contributions Information9aYour percentage of total$ 9bTotal employee contributions being furnished to the IRS. 9aYour percentage of total$ 9bTotal employee contributions being furnished to the IRS. 9aYour percentage of total$ 9bTotal employee contributions 50 Information1098-C1098-E1098-F 1098-Q1098-T1099-A1099-B1099-C1099-CAP1099-DIV1099-G1099-INT1099-K10Amount allocable to IRR111st year of desig. 12 requirement$ 14 distribution % 15State/Payers state no.10 within 5 years Returns. 111st year of desig. 12 requirement$ 14 distribution % 15State/Payers state no.10Amount allocable to IRR111st year of desig. 12 requirement$ 14 distribution % 15State/Payers state no.10Amount allocable to IRR111st year of desig. 12 requirement$ 14 distribution % W-2G 1097-BTCReturns. 78 84 03 74 83 80 79 85 73 3921 91 86 92 10 959133-Part SET includes: (50 Sheets EACH) 1099-MISC Copy A, B, C NEC959184-Part SET includes: (17 Sheets EACH) 1099-NEC Copy A, B, C, C32 109881State tax withheld Amount allocable to IRRState tax withheld 16State distribution State tax withheld 16State distribution State tax withheld 15State/Payers state no.16State distribution16State distributionwithin 5 years Roth contrib. $ Roth contrib. within 5 years Roth contrib. within 5 years Roth contrib. $ 1099-LTC1099-MISC1099-NEC 1099-OID1099-PATR1099-Q1099-QA 1099-R1099-S1099-SA 1099-SB25 3922 54985498-ESA5498-QA $ $ 1099-LS93 95 71 96 97 31 1A 98 75 94 43 26 28 72 2A$ Account number (see instructions) 13Date of$ 17Local tax withheld 18Name of locality $ $ 19Local distribution 13Date of$ 17Local tax withheld 18Name of locality $ $ 19Local distribution 13Date of$ 17Local tax withheld 18Name of locality $ $ 19Local distribution 13Date of$ 17Local tax withheld 18Name of locality 16 $ 19Local distribution 959144-Part SET includes: (50 Sheets EACH) 1099-MISC Copy A, B, C, C MINI SETS w/ Envelopes (17 Sheets for 50 Recipients)Account number (see instructions) Account number (see instructions) Account number (see instructions)payment$ $ payment$ $ payment$ $ payment$ $$ $ $ $ $ $ $ 5498-SA 27 $Form 1099-R 41-0852411 www.irs.gov/Form1099R Department of the Treasury - Internal Revenue Service www.irs.gov/Form1099R Department of the Treasury - Internal Revenue Service www.irs.gov/Form1099R Department of the Treasury - Internal Revenue Service www.irs.gov/Form1099R Department of the Treasury - Internal Revenue ServiceForm 1099-R (keep for your records) Form 1099-R (keep for your records) Form 1099-RDoNotCutorSeparateFormsonThisPage DoNotCutorSeparateFormsonThisPage Return this entire page to the Internal Revenue Service. Photocopies are not acceptable.959155-Part SET includes: (50 Sheets EACH) 1099-MISC Copy A, B, C, C, 29898 VOID CORRECTED CORRECTED (if checked) CORRECTED (if checked) VOID CORRECTED Send this form, with the copies of the form checked in box 6, to the IRS in a at mailer (not folded). NEC95918E4-Part SET includes: (17 Sheets EACH) 1099-NEC Copy A, B, C, C,PAYERS name, street address, city or town, state or province,$ 1Gross distribution OMB No. 1545-0119PAYERS name, street address, city or town, state or province,$ 1Gross distribution OMB No. 1545-0119PAYERS name, street address, city or town, state or province,$ 1Gross distribution OMB No. 1545-0119PAYERS name, street address, city or town, state or province,$ 1Gross distribution OMB No. 1545-0119 Under penalties of perjury, I declare that I have examined this return and accompanying documents and, to the best of my knowledge and belief, they are true, correct, and complete. + DW19W (50)country, ZIP or foreign postal code, and telephone no. Distributions FromDistributions FromDistributions FromDistributions FromTitle Date STANDARD SETS w/ Envelopes (50 Sheets for 100 Recipients)Pensions, Annuities, country, ZIP or foreign postal code, and telephone no. country, ZIP or foreign postal code, and telephone no. Pensions, Annuities,country, ZIP or foreign postal code, and telephone no. Pensions, Annuities, Pensions, Annuities, Signature Retirement or Retirement orRetirement orRetirement or 2aTaxable amount 2023 Prot-Sharing Plans,2aTaxable amount 2023 Prot-Sharing Plans,2aTaxable amount 2023 Prot-Sharing Plans,2aTaxable amount 2023 Prot-Sharing Plans,number), and TIN in the spaces provided on the form. The name, address, IRAs, InsuranceIRAs, InsuranceIRAs, InsuranceInstructionsIRAs, Insurance $ 2bTaxable amountForm 1099-R Contracts, etc. $ 2bTaxable amountForm 1099-R Contracts, etc. $ 2bTaxable amountForm 1099-R Contracts, etc. $ 2bTaxable amountForm 1099-R Future developments. For the latest information about developmentsupper left area of Form 1097, 1098, 1099, 3921, 3922, 5498, or W-2G. 95913E3-Part SET includes: (50 Sheets EACH) 1099-MISC Copy A, B, C, MINI SETS w/ Self-Seal Envelopes (17 Sheets for 50 Recipients)Contracts, etc.related to Form 1096, such as legislation enacted after it was published, go to www.irs.gov/Form1096. When to le. File Form 1096 as follows.PAYERS TIN RECIPIENTS TIN not determined TotalPAYERS TINCopy ARECIPIENTS TIN not determined 4 TotalPAYERS TINCopy CRECIPIENTS TIN not determined 4 TotalPAYERS TINCopy CRECIPIENTS TIN not determined 4 TotalReminder. The only acceptable method of electronically through the FIREFebruary 28, 2024.distribution For3Capital gain (included indistribution For Recipient's3Capital gain (included indistribution For Recipient's3Capital gain (included indistribution Copy D returns listed on this form in box 6 with the IRS is$ 3Capital gain (included in$ 4Federal income tax Internal Revenue$ box 2a) $ Federal income tax Records and/or $ box 2a) $ Federal income tax Records and/or $ box 2a) $ Federal income tax Caution:Tax For PayerranyWhere To File + DWMR (100)System. See Pub. 1220.d/oror Local or Locatl State,anCity,lRECIPIENTS name box 2a) withheld Service Center5Employee contributions/withheld RECIPIENTS name, stret ad State,City, 5Employee contributions/withheld RECIPIENTS name, stret ad State,City, 5Employee contributions/withheld Purpose of form. Use this form to transmit paper Forms 1097, 1098,If your principal business, ofce orUse the followingNEC95918ES 4-Part SET includes: (17 Sheets EACH) 1099-NEC Copy A, B, C, C,1099, 3921, 3922, 5498, and W-2G to the IRS. File with Form 1096. Tax Department Tax Departmen 2 LocatorCopy2 orCopy DepoartmenRECIPIENTS name, stret adres, city or town, state or province, country and ZIP or foreign postal code res, city or town, state or province, country and ZIP or foreign postal code res, city or town, state or province, country and ZIP or foreign postal codeelectronically but fail to do so, and you do not have an $ 5Employee contributions/ $ 6appreciation in For Privacy Act$ Designated Roth$ 6appreciation in $ Designated Roth$ 6appreciation in $ contributions or$ 6appreciation in approved waiver, you may be subject to a penalty. The Taxpayer First Actagency, or legal residence in theaddress 95914E4-Part SET includes: (50 Sheets EACH) 1099-MISC Copy A, B, C, C,+ DW19WS (50)Designated RothNet unrealized and Paperworkcontributions orNet unrealized contributions orNet unrealized Designated RothNet unrealized and the IRS to issue regulations that reduce the 250-return requirement forcase of an individual, is located incontributions oremployers securities Reduction Actinsurance premiums employers securities insurance premiums employers securities insurance premiums employers securities For Privacy ActAlabama, Arizona, Arkansas, Delaware, of 2019, enacted July 1, 2019, authorized the Department of the Treasury insurance premiums and Paperwork code(s) IRA/ 8Other Notice, see the7DistributionIRA/ 8Other This information is7DistributionSEP/ 8Other This information is7DistributionIRA/ 8Other 2022 tax returns. If those regulations are issued and effective for 2023 tax www.irs.gov/ Florida, Georgia, Kentucky, Maine,Internal Revenue ServiceReduction Act SIMPLE % Information9a SIMPLE $ % 9a IRA/ $ % 9a SEP/ $ % Notice, see theMassachusetts, Mississippi, NewAustin, TX 78714-9213Street address (including apt. no.) 7DistributionSEP/ $ Total employee contributions2023 Generalcode(s) SEP/ 9bTotal employee contributions being furnished to the IRS. code(s) SIMPLE 9bTotal employee contributions being furnished to the IRS. code(s) SIMPLE 9b Form1099 explaining the change. Until regulations are issued, however,Hampshire, New Jersey, New Mexico,P.O. Box 149213+ DWMR (100) VALUE SETS w/ Self-Seal Envelopes (7 Sheets for 20 Recipients) 2023 GeneralInstructions for CertainInformation Returns. part F in the 2023 General Instructions for CertainNew York, North Carolina, Ohio, Texas, information, seeInstructions forCertainVermont, Virginiareturns. Information City or town, state or province, country, and ZIP or foreign postal code9aYour percentage of total 9b Returns. Your percentage of totalYour percentage of totalYour percentage of totalTotal employee contributions Returns. Alaska, Colorado, Hawaii, Idaho, $ 10Amount allocable to IRR111st year of desig. 12 requirement$ 14 distribution %$ 15State/Payers state no.10Amount allocable to IRR111st year of desig. 12 requirement$ 14 distribution %$ 15State/Payers state no.10Amount allocable to IRR111st year of desig. 12 requirement$ 14 distribution %$ 15State/Payers state no.10Amount allocable to IRR111st year of desig. 12 requirement$ 14 distribution %$ Who must le.Illinois, Indiana, Iowa, Kansas,Internal Revenue Service Center95915E5-Part SET includes: (50 Sheets EACH) 1099-MISC Copy A, B, C, C, 2,State tax withheld 16State distribution State tax withheld 16State distribution State tax withheld 16State distribution State tax withheld 15State/Payers state no.16State distribution Michigan, Minnesota, Missouri,P.O. Box 219256 within 5 years Roth contrib. 13Date of$ 17Local tax withheld 18Name of locality $ within 5 years Roth contrib. 13Date of$ 17Local tax withheld 18Name of locality $ within 5 years Roth contrib. 13Date of$ 17Local tax withheld 18Name of locality $ within 5 years Roth contrib. 13Date of$ 17Local tax withheld 18Name of locality Caution:Montana, Nebraska, Nevada, North Kansas City, MO 64121-9256 NEC95903ES 3-Part SET includes: (7 Sheets EACH) 1099-NEC Copy A, B, C,$ $ $ the name and TIN used on your 94X series tax return(s) or you may beDakota, Oklahoma, Oregon, South $$ $ $ subject to information return penalties. Do not use the name and/or TIN ofUtah, Washington, Wisconsin, Wyoming $ Carolina, South Dakota, Tennessee,Account number (see instructions) Account number (see instructions) Account number (see instructions) Account number (see instructions) your paying agent or service bureau.Form 1099-R LRA 41-0852411 5140 payment$ Form $ 19Local distribution LRC/LR2 payment$ 5142 Form $ 19Local distribution LRC/LR2 payment$ 5142 Form $ 19Local distribution 5143 payment$ $ 19Local distribution L1096 41-0852411 5100 Form1096(2023) + DWMR (100)$ $ (keep for your records) $ $ (keep for your records) $ $ LRD1 www.irs.gov/Form1099R $ For more information and the Privacy Act and Paperwork Reduction Act Notice,+ DW19WS (20)$1099-R 1099-R 1099-R see the 2023 General Instructions for Certain Information Returns.www.irs.gov/Form1099R Department of the Treasury - Internal Revenue Service www.irs.gov/Form1099R Department of the Treasury - Internal Revenue Service www.irs.gov/Form1099R Department of the Treasury - Internal Revenue Service Department of the Treasury - Internal Revenue ServiceSTANDARD SET w/ Self-Seal Envelopes (50 Sheets for 100 Recipients) NEC95904ES 4-Part SET includes: (7 Sheets EACH) 1099-NEC Copy A, B, C, C, Required Envelope: 95914ES4-Part SET includes: (50 Sheets EACH) 1099-MISC Copy A, B, C, C,+ DW19WS (20)(3) 1096 Transmittal forms are included with each set TFP: 77771 or 77772 + DWMRS (100)MINI SETS (25 Sheets 50 Recipients) APEX 1099-INT LASER PACKAGED SET* TFP 1099-DIV LASER PACKAGED SET* TFP 1099-R LASER PACKAGED SET959184-Part SET includes: (25 Sheets EACH) 1099-MISC Copy A, B, C, CMINI SETS w/ Envelopes (25 Sheets for 50 Recipients) STANDARD SETS (50 Sheets for 100 Recipients)FOR 50 EMPLOYEES FOR 50 EMPLOYEES 95918E4-Part SET includes: (25 Sheets EACH) 1099-MISC Copy A, B, C, C, 95924E4-Part SET includes: (50 Sheets EACH) 1099-INT Copy A, B, C, C, 61074-Part PRE-PACKAGED CONVENIENCE SET includes: 56466-Part PRE-PACKAGED CONVENIENCE SET includes: + DWMR (50) + DWMR (100)5130 (50), 5131 (50), 5132 (100), 5100 - 1096 (3) 5140 (50), 5141 (50), 5142 (100), 5143 (100), 5100 - 1096 (3) MINI SETS w/ Self-Seal Envelopes (25 Sheets for 50 Recipients) VALUE SETS w/ Self-Seal Envelopes (10 Sheets for 20 Recipients)FOR 25 EMPLOYEES FOR 25 EMPLOYEES 95918ES4-Part SET includes: (25 Sheets EACH) 1099-MISC Copy A, B, C, C, 95907ES3-Part SET includes: (10 Sheets EACH) 1099-INT Copy A, B, C 6107254-Part PRE-PACKAGED CONVENIENCE SET includes: 5644254-Part PRE-PACKAGED CONVENIENCE SET includes: + DWMRS (50) + DWMRS (20)5130 (25), 5131 (25), 5132 (50), 5100 - 1096 (3) 5140 (25), 5141 (25), 5142 (25), 5143 (25), 5100 - 1096 (3) VALUE SETS w/ Self-Seal Envelopes (10 Sheets for 20 Recipients)5646256-Part PRE-PACKAGED CONVENIENCE SET includes: 95904ES4-Part SET includes: (10 Sheets EACH) 1099-MISC Copy A, B, C, C, 5140 (25), 5141 (25), 5142 (50), 5143 (50), 5100 - 1096 (3) + DWMRS (20)48 49"