b"1099 PRE-PRINTED FORMSIndividual Laser Packs1099-A (ACQUISITION) 1099-B (BROKER) 1099-C (CANCELLATION OF DEBT)8080 VOID CORRECTED 7979 VOID CORRECTED OMB No. 1545-0715 Proceeds FromZIP or foreign postal code, and telephone no. VOID CORRECTED 1 OMB No. 1545-1424PAYERS name, street address, city or town, state or province, country, ZIP Applicable checkbox on Form 8949 CREDITORS name, street address, city or town, state or province, country,DETACH BEFORE MAILINGDETACH BEFORE MAILING MANUFACTURED ON OCR LASER BOND PAPER USING HEAT RESISTANT INKSMANUFACTURED ON OCR LASER BOND PAPER USING HEAT RESISTANT INKSLENDERS name, street address, city or town, state or province, country, ZIP orOMB No. 1545-0877 or foreign postal code, and telephone no. Broker and2 Amount of debt discharged Form1099-C Cancellation foreign postal code, and telephone no. Form1099-A Acquisition or2024 Barter Exchange$ (Rev. January 2022) of Debt(Rev. January 2022) Abandonment ofForm1099-B Transactions 3 Interest, if included in box 2 For calendar year LENDERS TIN BORROWERS TIN 1 Date of lenders acquisition orFor calendar yearSecured Property 1a Description of property (Example: 100 sh. XYZ Co.) CREDITORS TIN DEBTORS TIN $ 4 Debt description Copy A20knowledge of abandonment 2 Balance of principalCopy A 1b Date acquired 1cDate sold or disposed For outstanding For BORROWERS name 3 $ 4 Fair market value of property Internal RevenuePAYERS TIN RECIPIENTS TIN 1d Proceeds 1eCost or other basis Copy A DEBTORS name Internal Revenue Service Center Service CenterFile with Form 1096.$ $ File with Form 1096. 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CORRECTED Form1099-CCORRECTED (if checked) DETACH BEFORE MAILINGMANUFACTURED ON OCR LASER BOND PAPER USING HEAT RESISTANT INKSDETACH BEFORE MAILINGMANUFACTURED ON OCR LASER BOND PAPER USING HEAT RESISTANT INKSPAYERS name, street address, city or town, state or province, country, ZIPNotice, see the foreign postal code, and telephone no. (Rev. January 2022) Acquisition orAccount number (see instructions) 10 Applicable 9checkbox on Form 8949 2024 General ZIP or foreign postal code, and telephone no. VOID OMB No. 1545-1424 (Rev. January 2022) of Debt8080 VOID CORRECTED OMB No. 1545-0877For calendar yearAbandonment ofCUSIP number requirement $ open contracts12/31/2024 $ 2024 Barter ExchangeCREDITORS name, street address, city or town, state or province, country,$ 3 Interest, if included in box 2 For calendar year 2024 on closed contractsInstructions forLENDERS name, street address, city or town, state or province, country, ZIP or1 Date of lenders acquisition or20Acquisition or Secured Property 14State name 15 16State tax withheld $ 11on contracts 1cDate sold or disposed Certain Transactions CREDITORS TIN DEBTORS TIN $ 2 Amount of debt discharged 4 Form1099-C CancellationCopy B1099-BInformationforeign postal code, and telephone no. Form1099-A 2 Balance of principalCopy B 1a Description of property (Example: 100 sh. XYZ Co.) (Rev. January 2022) of DebtLENDERS TIN BORROWERS TIN (Rev. January 2022) Abandonment ofFor Borrower $ IRS $ Returns. DEBTOR'Sname,stret adres, cityortown,stateorprovince, country,andZIP 3 Interest, if included in box 2 Debt descriptionFor calendar yearFor Debtorknowledge of abandonment outstandingFor calendar yearSecured Property 12Check if basis reported to 1b Date acquired13BarteringLENDERS TIN BORROWERS TIN knowledge of abandonment 20 $ ForThis is important taxForm1099-B PAYERS TIN $ RECIPIENTS TIN www.irs.gov/Form1099B $ $ 1eCost or other basis Copy B CREDITORS TIN DEBTORS TIN $ orforeignpostalcode Copy A This is important tax BORROWER'S name, stret adres, city or town, state or province, country, and ZIP or foreign postal code 2 Balance of principal 4 Fair market value of propertyinformation and is being41-0852411 $ 1d ProceedsDepartment of the Treasury - Internal Revenue Service For Recipient 4 Debt description information and is being 1 Date of lenders acquisition or 3 outstanding Copy A furnished to the IRS. If furnished to the IRS. If $ $ Internal Revenue return, a negligenceDo Not Cut or Separate Forms on This PageDo Not Cut or Separate Forms on This Page DEBTORS name 5 If checked, the debtor was personally liable for. . . . . . . .Forreturn, a negligence 1fAccrued market discount 1g Wash sale loss disallowedBORROWERS name 3 5 If checked, the borrower was personally liable for repayment. . . . . . . . . . penalty or otherRECIPIENT'Sname,stretadres,cityortown,stateorprovince,country,andZIPorforeignpostalcode $ 2 Short-term gain or loss $ 3If checked, proceeds from: repayment of the debtInternal Revenuepenalty or other 4 Fair market value of property Service Center sanction may beService Center sanction may be Street address (including apt. no.) the debt . . . of the debt. . . . . . . .File with Form 1096.imposed on you if7979 VOID CORRECTED 4Federal income tax withheld Collectibles Broker andStreet address (including apt. no.) 5 Check here if the debtor was personally liable for. . . . . . . .File with Form 1096.imposed on you if $ taxable income resultsPAYERS name, street address, city or town, state or province, country, ZIPQOF This is important taxFor Privacy Act and from this transaction Account number (see instructions) 6 Description of property For Privacy Actfrom this transactionPAYERS name, street address, city or town, state or province, country, ZIP Applicablele checkbox o onLong-term gain or lossOrdinary F Form 8949 OMB No. 1545-0715 Proceeds FromAccount number (see instructions) repayment of the debt 6 7 Fair market value of property taxable income resultsDETACH BEFORE MAILING DETACH BEFORE MAILINGMANUFACTURED ON OCR LASER BOND PAPER USING HEAT RESISTANT INKSDETACH BEFORE MAILING5 Check if the borrower was personally liable for repayment ofand Paperworkor foreign postal code, and telephone no. Paperwork Reduction and the IRS determinesor foreign postal code, and telephone no. and the IRS determines City or town, state or province, country, and ZIP or foreign postal code 6 Description of property Reduction Actthat it has not been$ 202324 Barter ExchangeCity or town, state or province, country, and ZIP or foreign postal code $ Act Notice, see thethat it has not been reported.Notice, see thereported. 6Reported to IRS: Form5If checked, noncoveredinformation and isAccount number (see instructions)Form 1099-C(Rev. 1-2022) (keep for your records) 6 VOID CORRECTED current General securityForm1099-A(Rev. 1-2022) (keep for your records) www.irs.gov/Form1099A current General1099-B Transactionsbeing furnished toInstructions for Instructions for Certain checked, loss is not allowedthe IRS. If you areCertain Information Account number (see instructions) VOID CORRECTED Department of the Treasury - Internal Revenue Service PAYERS TIN or foreign postal code, and telephone no.1b VOID Gross proceeds 7Ifbased on amount in 1d return, a negligenceBroker andForm (Rev. 1-2022)ZIP or foreign postal code, and telephone no. 1 $ 7 Fair market value of propertyDepartment of the Treasury - Internal Revenue Service 1 of DebtForm(Rev. 1-2022) 41-0852411 InformationAcquisition or1a Description of property (Example: 100 sh. XYZ Co.) penalty or other1099-CCREDITORS name, street address, city or town, state or province, country,2 Amount of debt discharged OMB No. 1545-1424 Cancellation LENDERS name, street address, city or town, state or province, country, ZIP orOMB No. 1545-0877 PAYERS TIN RECIPIENTS TINDate acquired $ 8 CORRECTED $ open contracts12/31/2023 OMB No. 1545-0715 Proceeds FromZIP or foreign postal code, and telephone no. CORRECTED (if checked) OMB No. 1545-1424 Returns.Returns. Department of the Treasury - Internal Revenue Serviceforeign postal code, and telephone no.www.irs.gov/Form1099A Department of the Treasury - Internal Revenue Service PAYERS name, street address, city or town, state or province, country, ZIPDate acquired Net proceeds1cDate sold or disposedApplicable9 checkbox on Form 8949 sanction may beForm1099-C MANUFACTURED ON OCR LASER BOND PAPER USING HEAT RESISTANT INKSMANUFACTURED ON OCR LASER BOND PAPER USING HEAT RESISTANT INKSDo1099-A LENDERS name, street address, city or town, state or province, country, ZIP orOMB No. 1545-0877 Form1099-A Abandonment ofAccount number (see instructions)RECIPIENTS TIN $ 1d Proceeds 2024 on closed contracts 2024 Barter ExchangeCREDITORS name, street address, city or town, state or province, country,$ 3 Interest, if included in box 2 (Rev. January 2022)NotC utorSeparateFormsonThisPageDoNotCut orSeparateFormsonThisPageCORRECTED (if checked) (Rev. January 2022) 1d Proceeds 1eCost or other basis Copy A imposed on you if 1eCost or other basis this income is foreign postal code, and telephone no. CORRECTED Form1099-A For calendar yearCopy C RECIPIENTS name CUSIP number 15 requirement $ $ 1g Wash sale loss disallowed taxable and the IRS Transactions ZIP or foreign postal code, and telephone no. VOID CORRECTED 1 $ $ Form1099-C For calendar yearof Debt Copy C8080 VOID 1 Date of lenders acquisition or20 Acquisition or Secured Property 14State name $ 1f Accrued market discount10 open contracts12/31/2024 11on contracts For1099-B CREDITORS name, street address, city or town, state or province, country, CREDITORS TIN DEBTORS TIN 2 Amount of debt discharged (Rev. January 2022) CancellationFor CreditorForm determines that it foreign postal code, and telephone no. Form(Rev. January 2022) $ Abandonment ofor For Lender 16State tax withheld $ 1a Description of property (Example: 100 sh. XYZ Co.) Copy 2 DEBTOR'Sname,stret adres, cityortown,stateorprovince, country,andZIPorforeign OMB No. 1545-4 Debt description1424 For calendar year $ Internal Revenuehas not been LENDERS name, street address, city or town, state or province, country, ZIP orBORROWERS TIN OMB No. 1545-0877knowledge of abandonmentFor calendar year outstanding2 Balance of principal2 Short-term gain or loss 3Check if proceeds from: Service Centerreported. 3 Interest, if included in box 2LENDERS TIN t adres, city or town, state or province, country, and ZIP or foreign postal code3 20Acquisition or Secured Property StateCopy Street address (including apt. no.) 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Ifprovince,country, Check if loss is not allowedand Paperworkfurnished to the IRS. If based on amount in 1d and Paperwork based on amount in 1dcode 2 BORROWERS name 3 $ $ Internal Revenue return, a negligenceInstructions for Certainor foreign postal code, and telephone no. 8 CORRECTED (if checked)Short-term gain or loss Reduction ActBroker andDEBTORS name Account number (see instructions) 5 If checked, the debtor was personally liable for. . . . . . . .return, a negligenceReturns.of the debt . . 6 Description of property . . . . . . . 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Reduction ActAct Notice, see thereported.Returns.based on amount in 1dForm1099-A(Rev. 1-2022) (keep for your records) www.irs.gov/Form1099A current General$ IRS $ Net proceeds1cDate sold or disposed9 open contracts12/31/2023 Account number (see instructions)Form 1099-C(Rev. 1-2022) (keep for your records) 1 current General Form(Rev. 1-2022)LAA foreign postal code, and telephone no.5146 www.irs.gov/Form1099A Instructions for CertainAcquisition orLBA Account number (see instructions)RECIPIENTS TIN IRS $ $ $ $ 1eCost or other basis For Recipient Information 7 Fair market value of propertyDepartment of the Treasury - Internal Revenue ServiceAccount number (see instructions) 41-0852411 VOID CORRECTED Department of the Treasury - Internal Revenue Service Form1099-B PAYERS TIN 5153 $ 41-0852411 Check if basis reported to 1b Date acquired13Bartering8on closed contracts $ Copy B Instructions forCertainForm 1099-C(Rev. 1-2022) ZIP or foreign postal code, and telephone no. $ 2 Amount of debt discharged Instructions forCancellation LENDERS name, street address, city or town, state or province, country, ZIP orInformationwww.irs.gov/Form1099B1d ProceedsDepartment of the Treasury - Internal Revenue Service 2024 General CREDITORS name, street address, city or town, state or province, country,Certain Information Returns.OMB No. 1545-0877 OMB No. 1545-1424Returns.1099-ALENDERS name, street address, city or town, state or province, country, ZIP orDepartment of the Treasury - Internal Revenue ServiceForm1099-A Do Not Cut or Separate Forms on This PageDo Not Cut or Separate Forms on This Page Returns.ZIP or foreign postal code, and telephone no. CORRECTED (if checked) 1 OMB No. 1545-1424 Form1099-C of DebtDepartment of the Treasury - Internal Revenue Serviceforeign postal code, and telephone no. CORRECTED (if checked) OMB No. 1545-0877 (Rev. January 2022) Abandonment ofRECIPIENT'Sname,stretad 14State name , orprovince, 15 andZIPorforeignpostalcode requirement $ $ 1g Wash sale loss disallowedon contracts11 CREDITORS name, street address, city or town, state or province, country,$ 3 Interest, if included in box 2 (Rev. January 2022)CUSIP number 1fAccrued market discount10 open contracts12/31/1 Date of lenders acquisition orFor calendar yearCopy C rescity VOID state CORRECTED $ $ 2 Long-term gain or lossIRS 3IfCollectibles $ Department of the Treasury - Internal Revenue Service CREDITORS TIN DEBTORS TIN$ 2 Amount of debt discharged Form1099-C For calendar yearof Debt Copy CForm1099-A 20 Acquisition or Secured Property 7979 ortown, country, 16State tax withheld 12Check if basis reported tochecked, proceeds from:13Bartering $ 4 Debt description Cancellation Short-term gain or lossLENDERS TIN BORROWERS TIN (Rev. January 2022) Abandonment ofFor Lender PAYERS name, street address, city or town, state or province, country, ZIP Applicable checkbox onOrdinary Form 8949 OMB No. 1545-0715 Proceeds FromDEBTOR'Sname,stret adres, cityortown,stateorprovince, country,andZIP 3 Interest, if included in box 2 (Rev. January 2022) For Creditorknowledge of abandonment Secured Property or foreign postal code, and telephone no.Form1099-B $ QOF $ This is important taxorforeignpostalcode For calendar year For calendar year 2 Balance of principal outstanding Broker and knowledge of abandonment 20 $ Copy B orStateCopy $ 6Reported to IRS: 2023 Barter ExchangeCREDITORS TIN DEBTORS TIN $ 4 Debt description Copy B For Privacy Act 4Federal income tax withheldwww.irs.gov/Form1099B5If checked, noncoveredinformation and is security Transactionsbeing furnished to LENDERS TIN BORROWER'S name, stret adres, city or town, state or province, country, and ZIP or foreign postal code 2 Balance of principal 4 Fair market value of property For Privacy ActForm1099-B the IRS. If you are BORROWERS TIN 1 Date of lenders acquisition or 3 3 $ outstanding $ For Borrower and PaperworkVOID Gross proceeds 7Ifbased on amount in 1d return, a negligenceDEBTOR'Sname,stret adres, cityortown,stateorprovince, country,andZIPorforeignpostalcode 5 Check here if the debtor was personally liable for. . . . . . . For Debtor .and Paperworkchecked, loss is not allowed the debt . . . . . . . . . . This is important tax. Reduction ActAccount number (see instructions) 1a Description of property (Example: 100 sh. XYZ Co.) 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Ifcurrent General of the debt . . . . . $ . . . . .return, a negligenceInstructions forPAYERS TIN CUSIP number RECIPIENTS TIN $ 1d Proceeds $ $ 1eCost or other basis 2024 Barter ExchangeAccount number (see instructions) 5 If checked, the debtor was personally liable for. . . . . . . .return, a negligenceInstructions forimposed on you if Account number (see instructions) 6 Description of property penalty or otherCertainrequirement open contracts12/31/2024 $ Formthis income isTransactions repayment of the debt 6 $ 7 Fair market value of property Certain Information Returns.5 If checked, the borrower was personally liable for repaymentsanction may beInformation1f Accrued market discount10 1g Wash sale loss disallowed taxable and the IRSpenalty or other Account number (see instructions)Form1099-A(Rev. 1-2022) 6 Description of property imposed on you ifReturns. RECIPIENTS name14State name $ $ $ to IRS $ Collectibles 11on contracts For1099-B Copy 2 Form 1099-C(Rev. 1-2022) 6 sanction may be determines that it taxable income results1a Description of property (Example: 100 sh. XYZ Co.) taxable income results has not beenimposed on you if www.irs.gov/Form1099A from this transaction15 16State tax withheld $ Internal Revenuereported. Account number (see instructions) from this transaction and the IRS determines2 Short-term gain or loss 3Check if proceeds from: Service Centerand the IRS determines Department of the Treasury - Internal Revenue Service 1b Date acquired13Bartering 1cDate sold or disposed 7 Fair market value of propertyDepartment of the Treasury - Internal Revenue ServiceForm1099-A(Rev. 1-2022)LAB (keep for your records) 5147 www.irs.gov/Form1099A that it has not been reported. Street address (including apt. no.)Form1099-B PAYERS TIN $ Long-term gain or loss12If checked, basis reported$ File with Form 1096. To be Filed with Form 1099-C(Rev. 1-2022) (keep for your records) VOID CORRECTED $ that it has not been Department of the Treasury - Internal Revenue Service LBB 5154 Ordinary QOF $ 1d ProceedsDepartment of the Treasury - Internal Revenue ServiceLocal Income Tax reported.RECIPIENTS TIN 1eCost or other basis Recipients State or(Keep for your records) $Return, or Copy 1 Department of the Treasury - Internal Revenue Service4Federal income tax withheldwww.irs.gov/Form1099B5Check if noncovered foreign postal code, and telephone no. VOID CORRECTED FormAcquisition orCity or town, state or province, country, and ZIP or foreign postal codet , ortown, $ 6Reported to IRS: ZIPorforeignpostal security1fAccrued market discount $ 1g Wash sale loss disallowed For State Tax CREDITORS name, street address, city or town, state or province, country, 1 2 Amount of debt discharged OMB No. 1545-1424 Cancellation $LENDERS name, street address, city or town, state or province, country, ZIP orOMB No. 1545-0877 7Check if loss is not allowedFor Privacy ActDepartment ZIP or foreign postal code, and telephone no.province,country,and based on amount in 1d 3Check if proceeds from:1099-A RECIPIENT'Sname,streadrescity stateorGross proceeds code 2 Short-term gain or loss and PaperworkForm1099-C(Rev. January 2022) Abandonment of8 Net proceeds 9 Long-term gain or loss Reduction Act$ (Rev. January 2022) of DebtCollectiblesNotice, see the For calendar yearSecured Property Account number (see instructions) 2nd TIN not. 2024 on closed contracts Ordinary QOF 3 Interest, if included in box 2 For calendar year 20 open contracts12/31/2023 2024 General For Privacy ActCREDITORS TIN DEBTORS TIN $ 4 Debt description Copy C1 Date of lenders acquisition or 2 Balance of principalor Copy C CUSIP number 15 requirement $ open contracts12/31/2024 $ $ 4Federal income tax withheld5security and PaperworkDEBTOR'Sname,stret adres, cityortown,stateorprovince, country,andZIPorforeignpostalcode For CreditorCheck if noncovered LENDERS TIN BORROWERS TIN knowledge of abandonment outstanding For Lender 10 11on contracts6Reported to IRS: Instructions forCertainInformation7Check if loss is not allowed $ StateCopy 14State name 16State tax withheld $ $ Gross proceeds Returns. Reduction Act based on amount in 1dBORROWER'S name, stret adres, city or town, state or province, country, and ZIP or foreign postal code3 4 Fair market value of property For Privacy Act$ 12Check if basis reported to 13Bartering8 Net proceeds 9 open contracts12/31/2023 Notice, see the For Privacy Act $and PaperworkAccount number (see instructions) IRS requirement $on closed contracts 11on contracts 2024 General5 Check here if the debtor was personally liable for. . . . . . . .and Paperwork Reduction Act$ 41-0852411 www.irs.gov/Form1099B Department of the Treasury - Internal Revenue Service Instructions for repayment of the debtReduction Act 5 Check if the borrower was personally liable for repayment of. . . . . . . . . . . . Notice, see theForm1099-B LBA 5153 $ open contracts12/31/ $ Certain Notice, see the the debtcurrent GeneralCUSIP number 10 Information current General 6 Description of property Instructions for CertainReturns. Instructions for Account number (see instructions) Information14State name 15 16State tax withheld $ IRS $ Account number (see instructions) 6 $ 7 Fair market value of property Certain Information Returns.Returns. $ 12Check if basis reported to 13Bartering$ $Form1099-A(Rev. 1-2022) LAC www.irs.gov/Form1099A 5148 Department of the Treasury - Internal Revenue Service Form1099-B 5155 www.irs.gov/Form1099B Department of the Treasury - Internal Revenue Service Form 1099-C(Rev. 1-2022) Department of the Treasury - Internal Revenue ServiceRequired Envelope: Required Envelope: Required Envelope:APEX/TFP: DW19W or DW19WS APEX: DWMR or DWMRS APEX/TFP: DW19W or DW19WSTFP: 77771 or 77772(5) 1096 Transmittal forms are included with each Federal Copy A (Red) form orderAPEX - Sheets per packTFP - Forms per pack50s100sFORM DESCRIPTIONLAA51461099-A Federal Copy A1 Page Equals 3 FormsLAB51471099-A Borrower Copy B1 Page Equals 3 FormsLAC51481099-A Lender Copy C and/or State Copy1 Page Equals 3 FormsLBA51531099-B Federal Copy A1 Page Equals 2 FormsLBB51541099-B Recipient Copy B1 Page Equals 2 FormsN/A51551099-B State and/or File Copy1 Page Equals 2 FormsLCA51371099-C Federal Copy A1 Page Equals 3 FormsLCB51381099-C Debtor Copy B1 Page Equals 3 FormsLCC51391099-C Creditor Copy C1 Page Equals 3 Forms10"