20
5503B
5225RB
14 State tax withheld
17 Local tax withheld
15 State/Payer’s state no.
18 Name of locality
16 State distribution
19 Local distribution
12 FATCA
filing requirement
13 Date of payment
PRINTED IN USA
FROM:
First-Class Mail
Important Tax Document Enclosed
MW1304
1A
SEE REVERSE SIDE FOR OPENING INSTRUCTIONS
PAYER’S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.
PAYER’S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.
PAYER’S TIN
PAYER’S TIN
Account number (see instructions)
Account number (see instructions)
1 Gross distribution
2a Taxable amount
2b 
2b 
Taxable amount
Taxable amount
 not determined
 not determined
3 
3 
Capital gain (included
Capital gain (included
 in box 2a)
 in box 2a)
6 
6 
Net unrealized appreciation
Net unrealized appreciation
 in employer’s securities
 in employer’s securities
9a 
9a 
Your percentage of total distribution
Your percentage of total distribution
14 
14 
State tax withheld
State tax withheld
17 
17 
Local tax withheld
Local tax withheld
RECIPIENT’S name, street address (incl. apt. no.), city or town, state or province, country, and ZIP or foreign postal code
RECIPIENT’S name, street address (incl. apt. no.), city or town, state or province, country, and ZIP or foreign postal code
4 Federal income tax withheld
7 
7 
Distribution code(s)
Distribution code(s)
9b 
9b 
Total employee contributions
Total employee contributions
15 
15 
State/Payer’s state no.
State/Payer’s state no.
18 
18 
Name of locality
Name of locality
8 
8 
Other
Other
%
%
5 
5 
Employee contributions
Employee contributions
/Designated Roth contributions or
/Designated Roth contributions or
insurance premiums
insurance premiums
%
%
16 
16 
State distribution
State distribution
19 
19 
Local distribution
Local distribution
Department of the Treasury - Internal Revenue Service
Department of the Treasury - Internal Revenue Service
25
25
OMB No. 1545-0119
OMB No. 1545-0119
Form 
Form 
1099-R
1099-R
Total
Total
distribution
distribution
Distributions From
Distributions From
Pensions, Annuities,
Pensions, Annuities,
Retirement or
Retirement or
Profit-Sharing
Profit-Sharing
Plans, IRAs,
Plans, IRAs,
Insurance
Insurance
Contracts, etc.
Contracts, etc.
Copy B
Report this income on your
federal tax return. If this form
shows 
federal 
income 
tax
withheld in box 4, attach this
copy 
to 
your 
return. 
This
information is being furnished to
the IRS.
Copy 2
File this copy with
your state, city, or
local income tax
return, when
required.
Copy C 
For Recipient’s
Records
This information is being furnished
to the IRS.
Form 1099-R
Form 1099-R
CORRECTED (if checked)
CORRECTED (if checked)
RECIPIENT’S TIN
RECIPIENT’S TIN
PAYER’S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.
PAYER’S TIN
Account number (see instructions)
1 Gross distribution
2a Taxable amount
2b Taxable amount
 not determined
3 Capital gain (included
 in box 2a)
6 Net unrealized appreciation
 in employer’s securities
9a Your percentage of total distribution
RECIPIENT’S name, street address (incl. apt. no.), city or town, state or province, country, and ZIP or foreign postal code
4 Federal income tax withheld
7 Distribution code(s)
9b Total employee contributions
IRA/
SEP/
SIMPLE
8 Other
%
5 Employee contributions
/Designated Roth contributions or
insurance premiums
%
Department of the Treasury - Internal Revenue Service
25
OMB No. 1545-0119
Form 1099-R
Total
distribution
Distributions From
Pensions, Annuities,
Retirement or
Profit-Sharing
Plans, IRAs,
Insurance
Contracts, etc.
Form 1099-R
CORRECTED (if checked)
RECIPIENT’S TIN
IRA/
IRA/
SEP/
SEP/
SIMPLE
SIMPLE
O
G
O
G
S2032B
9400006363
(keep for your records)
1 Gross distribution
2a Taxable amount
4 Federal income tax withheld
A
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
11 
11 
1st year of desig. Roth contrib.
1st year of desig. Roth contrib.
10 
10 
Amount allocable to IRR within 5 years
Amount allocable to IRR within 5 years
$
$
$
$
$
$
$
$
11 1st year of desig. Roth contrib.
10 Amount allocable to IRR within 5 years
$
$
$
www.irs.gov/Form1099R
www.irs.gov/Form1099R
www.irs.gov/Form1099R
12
12
FATCA
FATCA
filing requirement
filing requirement
13 
13 
Date of payment
Date of payment
1A
REVERSE SIDE FOR
NING INSTRUCTIONS
S2032B
O
G
O
G
PRINTED IN USA
FROM:
First-Class Mail
Important Tax Document Enclosed
MW1289
A
8510020608
5117B
Eccentric
Z – Fold
Eccentric
Z – Fold
Z – Fold
FILER’S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone number
FILER’S employer identification no.
STUDENT’S name, street address (including apt. no.), city or town, state or province, country, and ZIP or foreign postal code
Service Provider/Acct. No. (see instructions)
1
Payments received for qualified
tuition and related expenses
CORRECTED (if checked)
25
Form 1098-T
Form 1098-T
(keep for your records)
Department of the Treasury - Internal Revenue Service
Copy B
For Student
OMB No. 1545-1574
First-Class Mail
Important Tax Return
Document Enclosed
2
STUDENT’S TIN
Tuition
Statement
8
Checked if at least
half-time student
PRINTED IN USA
10 Ins. contract reimb./refund
SEE REVERSE SIDE FOR OPENING INSTRUCTIONS
1A
©2018, All rights reserved.
S2020
O
G
O
G
8510019246
4
Adjustments made for a
prior year
$
$
$
5
Scholarships or grants
$
6
Adjustments to
scholarships or grants
for a prior year
7
Checked if the amount
in box 1 includes
amounts for an
academic period
beginning January -
March 2026
A
$
9
Checked if a
graduate student
3
$
MW359 1098-T
www.irs.gov/Form1098T
This is important
tax information
and is being
furnished to the
IRS.
This form must
be used to complete
Form 8863 to claim
education credits.
Give it to the
tax preparer or
use it to
prepare the tax
return.
Instructions for Student
You, or the person who can claim you as a dependent, may be able to claim an education
credit on Form 1040 or 1040-SR. This statement has been furnished to you by an eligible
educational institution in which you are enrolled, or by an insurer who makes reimbursements
or refunds of qualified tuition and related expenses to you. This statement is required to
support any claim for an education credit. Retain this statement for your records. To see if you
qualify for a credit, and for help in calculating the amount of your credit, see Pub. 970, Form
8863, and the Instructions for Form 1040. Also, for more information, go to
www.irs.gov/Credits-Deductions/Individuals/Qualified-Ed-Expenses and www.irs.gov/Education.
Account number. May show an account or other unique number the filer assigned to
distinguish your account.
Box 1. Shows the total payments received by an eligible educational institution in 2025
from any source for qualified tuition and related expenses less any reimbursements or
refunds made during 2025 that relate to those payments received during 2025.
Box 2. Reserved for future use.
Box 3. Reserved for future use.
Box 4. Shows any adjustment made by an eligible educational institution for a prior year
for qualified tuition and related expenses that were reported on a prior year Form 1098-T.
This amount may reduce any allowable education credit that you claimed for the prior
year (may result in an increase in tax liability for the year of the refund). See "recapture"
in the index to Pub. 970 to report a reduction in your education credit or tuition and fees
deduction.
Box 5. Shows the total of all scholarships or grants administered and processed by the
eligible educational institution. The amount of scholarships or grants for the calendar year
(including those not reported by the institution) may reduce the amount of the education
credit you claim for the year.
TIP: You may be able to increase the combined value of an education credit and certain
educational assistance (including Pell Grants) if the student includes some or all of the
educational assistance in income in the year it is received. For details, see Pub. 970.
Box 6. Shows adjustments to scholarships or grants for a prior year. This amount may
affect the amount of any allowable tuition and fees deduction or education credit that you
claimed for the prior year. You may have to file an amended income tax return (Form
1040-X) for the prior year.
Box 7. Shows whether the amount in box 1 includes amounts for an academic period
beginning January-March 2026. See Pub. 970 for how to report these amounts.
Box 8. Shows whether you are considered to be carrying at least one-half the normal
full-time workload for your course of study at the reporting institution. 
Box 9. Shows whether you are considered to be enrolled in a program leading to a
graduate degree, graduate-level certificate, or other recognized graduate-level educational
credential.
Box 10. Shows the total amount of reimbursements or refunds of qualified
tuition and related expenses made by an insurer. The amount of reimbursements or refunds
for the calendar year may reduce the amount of any education credit you can claim for the
year (may result in an increase in tax liability for the year of the refund).
Future developments. For the latest information about developments related to Form
1098-T and its instructions, such as legislation enacted after they were published, go to
www.irs.gov/Form1098T.
Free File Program. Go to www.irs.gov/FreeFile to see if you qualify for no-cost online
federal tax preparation, e-filing, and direct deposit or payment options.
Student’s taxpayer identification number (TIN). For your protection, this form may show
only the last four digits of your TIN (SSN, ITIN, ATIN, or EIN). However, the issuer has
reported your complete TIN to the IRS. Caution: If your TIN is not shown in this box, your
school was not able to provide it. Contact your school if you have questions.
Your institution must include its name, address, and information contact telephone
number on this statement. It may also include contact information for a service provider.
Although the filer or the service provider may be able to answer certain questions about
the statement, do not contact the filer or the service provider for explanations of the
requirements for (and how to figure) any education credit that you may claim.
1099 PRE-PRINTED & BLANK FORMS
Pressure Seal 1099 Forms
	 Sheets per pack
	 500	
FORM DESCRIPTION
	 5503B	
14" Printed 1099-R 3-Up Horizontal Copy B, C, 2 – EZ-Fold Simplex – 1 Sheet Equals 1 Form 
	 5225RB 
14" Blank 1099-R 4-Up Box with Instructions – 1 Sheet Equals 1 Form 
	 5117B	
11" Printed 1098-T Copy B – Z-Fold Simplex – 1 Sheet Equals 1 Form
	 5506B	
11" Blank 1098-T – Z-Fold Simplex – 1 Sheet Equals 1 Form
	 5177B          	
11" 1099-R 4Up Box Copy B,C,2,2 - V-Fold Duplex - 1 Sheet Equals 1 Form
First-Class Mail
Important Tax Return
Document Enclosed
MW379 1098-T
PRINTED IN USA
SEE REVERSE SIDE FOR OPENING INSTRUCTIONS
1A
S2020
O
G
O
G
8610024336
A
5506B
Form 1099-R
Form 1099-R
Form 1099-R
Form 1099-R
CORRECTED (if checked)
CORRECTED (if checked)
CORRECTED (if checked)
CORRECTED (if checked)
OMB No. 1545-0119
OMB No. 1545-0119
OMB No. 1545-0119
OMB No. 1545-0119
1 Gross distribution
2a Taxable amount
2b
2b
2b
2b
 Taxable amount
 Taxable amount
 Taxable amount
 Taxable amount
not determined
not determined
not determined
not determined
Total
Total
Total
Total
distribution
distribution
distribution
distribution
Distributions From Pensions,
Distributions From Pensions,
Distributions From Pensions,
Distributions From Pensions,
Annuities, Retirement or
Annuities, Retirement or
Annuities, Retirement or
Annuities, Retirement or
Profit-Sharing Plans, IRAs,
Profit-Sharing Plans, IRAs,
Profit-Sharing Plans, IRAs,
Profit-Sharing Plans, IRAs,
Insurance Contracts, etc.
Insurance Contracts, etc.
Insurance Contracts, etc.
Insurance Contracts, etc.
PAYER’S TIN
PAYER’S TIN
PAYER’S TIN
PAYER’S TIN
RECIPIENT’S TIN
RECIPIENT’S TIN
RECIPIENT’S TIN
RECIPIENT’S TIN
3
3
3
3
 Capital gain (included
 Capital gain (included
 Capital gain (included
 Capital gain (included
in box 2a)
in box 2a)
in box 2a)
in box 2a)
4 Federal income tax withheld
5 
5 
5 
5 
Employee contributions
Employee contributions
Employee contributions
Employee contributions
/Designated Roth contributions
/Designated Roth contributions
/Designated Roth contributions
/Designated Roth contributions
or insurance premiums
or insurance premiums
or insurance premiums
or insurance premiums
6
6
6
6
 Net unrealized appreciation
 Net unrealized appreciation
 Net unrealized appreciation
 Net unrealized appreciation
in employer’s securities
in employer’s securities
in employer’s securities
in employer’s securities
7 
7 
7 
7 
Distribution code(s)
Distribution code(s)
Distribution code(s)
Distribution code(s)
8
8
8
8
 Other
 Other
 Other
 Other
9a
9a
9a
9a
 Your percentage of total distribution
 Your percentage of total distribution
 Your percentage of total distribution
 Your percentage of total distribution
9b
9b
9b
9b
 Total employee contributions
 Total employee contributions
 Total employee contributions
 Total employee contributions
RECIPIENT’S name, street address (including apt. no.), city or town, state or province, country, and ZIP or foreign postal code
RECIPIENT’S name, street address (including apt. no.), city or town, state or province, country, and ZIP or foreign postal code
RECIPIENT’S name, street address (including apt. no.), city or town, state or province, country, and ZIP or foreign postal code
RECIPIENT’S name, street address (including apt. no.), city or town, state or province, country, and ZIP or foreign postal code
Account number (see instruc.)
Account number (see instruc.)
Account number (see instruc.)
Account number (see instruc.)
10 
10 
10 
10 
Amount allocable to IRR within 5 years
Amount allocable to IRR within 5 years
Amount allocable to IRR within 5 years
Amount allocable to IRR within 5 years
16 
16 
16 
16 
State distribution
State distribution
State distribution
State distribution
19 
19 
19 
19 
Local distribution
Local distribution
Local distribution
Local distribution
14 
14 
14 
14 
State tax withheld
State tax withheld
State tax withheld
State tax withheld
17 
17 
17 
17 
Local tax withheld
Local tax withheld
Local tax withheld
Local tax withheld
18 
18 
18 
18 
Name of locality
Name of locality
Name of locality
Name of locality
File this copy with your state, city, or
local income tax return, when required.
Department of the Treasury
Internal Revenue Service
Copy C For Recipient’s Records
Copy B
%
%
%
%
Department of the Treasury
Internal Revenue Service
Department of the Treasury
Internal Revenue Service
MW284
25
25
25
25
Report this income on your federal tax return. If this form shows federal
income tax withheld in box 4, attach this copy to your return.
This information is being furnished to the IRS.
This information is being furnished to the IRS.
PRINTED IN USA
IRA/
IRA/
IRA/
IRA/
SEP/
SEP/
SEP/
SEP/
SIMPLE
SIMPLE
SIMPLE
SIMPLE
1A
S2001
O
G
O
G
(keep for your records)
Copy 2
File this copy with your state, city, or
local income tax return, when required.
Copy 2
1 Gross distribution
2a Taxable amount
4 Federal income tax withheld
1 Gross distribution
2a Taxable amount
4 Federal income tax withheld
1 Gross distribution
2a Taxable amount
4 Federal income tax withheld
A
%
%
%
%
Department of the Treasury - Internal Revenue Service
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
11 
11 
11 
11 
1st year of desig. Roth contrib.
1st year of desig. Roth contrib.
1st year of desig. Roth contrib.
1st year of desig. Roth contrib.
15 
15 
15 
15 
State/Payer’s state no.
State/Payer’s state no.
State/Payer’s state no.
State/Payer’s state no.
$
$
$
$
www.irs.gov/Form1099R
www.irs.gov/Form1099R
www.irs.gov/Form1099R
www.irs.gov/Form1099R
PAYER’S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.
PAYER’S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.
PAYER’S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.
PAYER’S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.
12
12
12
12
FATCA filing
FATCA filing
FATCA filing
FATCA filing
requirement
requirement
requirement
requirement
13 
13 
13 
13 
Date of payment
Date of payment
Date of payment
Date of payment
5177B
V – Fold
Catalog images may not reflect official IRS revisions at the time of publication. Final products will be in compliance with official IRS revisions.

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