b"TABLE OF CONTENTSE-FILE | Page 5Convenient electronic solutions for customers| PAYERS name, street address, city or town, state or province, country, ZIPForm1099-NEC Compensation1099 Pages 6-27 or foreign postal code, and telephone no. VOID CORRECTED OMB No. 1545-0116 Nonemployee (Rev. January 2024)For calendar yearPAYERS TIN RECIPIENTS TIN 1 Nonemployee compensation Copy A$ For Internal Revenue Streamline your tax reporting with 1099 forms RECIPIENTS name $ 2 Payer made direct sales totaling $5,000 or more of3 $ 1 General Service Center $ Form 1099-R 1 CORRECTED (if checked) 12 OMB No. 1545-0119 2024consumer products to recipient for resale File with Form 1096.For Privacy Act and Grossdistribution 2aTaxableamount OMB No. 1545-0119 2024 Annuities, Retirement or Street address (including apt. no.) Form 1099-R CORRECTED (if checked)Paperwork Reduction ActGrossdistribution 2aTaxableamount Distributions From Pensions, City or town, state or province, country, and ZIP or foreign postal code 2bTaxableamount $distribution 12 requirementInstructions forcurrent2bTaxableamount $distribution Insurance Contracts, etc.Notice, see the 4 Federal income tax withheld Distributions From Pensions,Prot-Sharing Plans, IRAs, Annuities, Retirement or 2nd TIN not.$ Total $ Certain InformationReturns. notdetermined Total FATCA Filing13Date of paymentProt-Sharing Plans, IRAs, Insurance Contracts, etc.notdetermined FATCA Filing13Date of payment5 State tax withheld 6 State/Payers state no. 7 State income requirementAccount number (see instructions)$ PAYER'S name, street address, city or town, state or province, country, ZIP or foreign postal code, and phone no.PAYER'S name, street address, city or town, state or province, country, ZIP or foreign postal code, and phone no.$Form1099-NEC(Rev. 1-2024)Department of the Treasury - Internal Revenue ServiceDo Not Cut or Separate Forms on This PageDo Not Cut or Separate Forms on This Page RECIPIENT COPIESVOID CORRECTED PAYERS TIN RECIPIENTS TIN PAYERS TIN RECIPIENTS TINPAYERS name, street address, city or town, state or province, country, ZIPinbox gain FederalincomeRoth inbox gain Employeecontributionscontributions/Designatedoror foreign postal code, and telephone no. 3Capital 2a) (included OMB No. 1545-01164 taxwithheld5Employeecontributionscontributions/Designatedorinsurancepremiums 3Capital 2a) (included 4Federalincometaxwithheld5Roth insurancepremiums$ 6Net employesecurities Form$71099-NEC SIMPLE Nonemployee% $ 6Net employesecurities $7Distributioncode(s) SIMPLE $8Other %in unrealizedrs appreciation (Rev. January 2024) SEP/ $8Other in unrealizedrs appreciation SEP/Distributioncode(s) IRA/ IRA/$ Yourpercentageoftotaldistribution 9bTotal Compensation $ 9aYourpercentageoftotaldistribution 9bTotalemployee$ contributions9a For calendar year employee$ contributionsPAYERS TIN RECIPIENTS TIN 1 Nonemployee compensation Copy A| Copy BTo Be Filed With Employee's41-0852411 $ consumer products to recipient for resale %$ For Internal RevenueAccount number (see instructions) 15 %$ 10Amount allocable to IRR within 5 years W-2 Pages 28-40 b RECIPIENTS name a c 1 3 5 Wages, tips, other comp. 2 4 6 OMB No. 1545-0008 $ 3 b a c $ $ 14 RECIPIENT'S name, street address, city or town, state or province, country, and ZIP or foreign postal code 1 5 1 2 6 4 $ $ $ $ $ 14 RECIPIENT'S name, street address, city or town, state or province, country, and ZIP or foreign postal code 1 $ $ $2 Payer made direct sales totaling $5,000 or more ofService CenterFEDERAL Tax Return. Federal income tax withheld Copy 2To Be Filed With Employee's State, File with Form 1096.Employee's soc. sec. no. City, or Local Income Tax Return.41-0852411OMB No. 1545-0008Employer ID number (EIN) Social security wages Medicare tax withheld Account number (see instructions)3 15 1st year of desig. Roth contrib.10 For Privacy Act and currentState tax withheld State/Payers state no. 16State distributionEmployee's soc. sec. no. Wages, tips, other comp. Federal income tax withheldStreet address (including apt. no.) Social security tax withheld 4 Federal income tax withheld Social security wages Paperwork Reduction Act1st year of desig. Roth contrib.Notice, see the Amount allocable to IRR within 5 years Medicare wages and tips Employer ID number (EIN) Medicare wages and tips Social security tax withheldGeneral Instructions forMedicare tax withheldReturns.City or town, state or province, country, and ZIP or foreign postal code State tax withheld State/Payers state no. 16 Certain InformationState distributionEmployer's name, address, and ZIP code 5 State tax withheld 6 State/Payers state no. 7 State incomeEmployer's name, address, and ZIP codeAccount number (see instructions) 2nd TIN not.$ 17Local tax withheld 18Name of Locality $ 19Local distribution 17Local tax withheld 18Name of Locality 19Local distribution$ File this copy with your state, city, or $ Department of the Treasury File this copy with your state, city, or Department of the TreasuryForm1099-NEC(Rev. 1-2024)local income tax return, when required. Internal Revenue Service local income tax return, when required. Internal Revenue ServiceDepartment of the Treasury - Internal Revenue Service www.irs.gov/Form1099Rwww.irs.gov/Form1099RGet organized and IRS-compliant with W-2 forms Dod e Not Cut or Separate Forms on This PageDo Not Cut or S d e $ 1 1A 1 3 eparate Forms on This Page 4 2 $ Form 1099-R 1 1 3 CORRECTED (if checked) 4 2 12 S20 851 13 0 1 2743 2024Control number Control numberEmployee's name, address, and ZIP code Suff. Form 1099-R CORRECTED (if checked) OMB No. 1545-0119 2024 OMB No. 1545-0008distribution 2aTaxableamount OMB No. 1545-0119Employee's name, address, and ZIP code TaxableamountDepartment of the TreasuryInternal Suff. Gross Department of the TreasuryInternalRevenue ServiceVOID CORRECTED GrossOMB No. 1545-0008 Wages, tips, other compensation FederalAnnuities, Retirement or2bTaxable Social Total Federal Distributions From Pensions, Revenue Servicedistribution 2a Distributions From Pensions, PAYERS name, street address, city or town, state or province, country, ZIP2b A determined Social security wages 96 Social security income tax tax withheld withheld not 5 Wages, security tips, other wages compensation 6 Social security income tax tax withheld withheldAnnuities, Retirement or Prot-Sharing Plans, IRAs,Prot-Sharing Plans, IRAs, OMB No. 1545-0116 Insurance Contracts, etc. determined Insurance Contracts, etc.or foreign postal code, and telephone no. 7 Taxableamount Form $distribution 12FATCA Filing13Date of payment amount $distribution Medicare tax withheld FATCA Filing Date of paymentnot Total requirement Medicare wages and tips requirementMedicare wages and tips Medicare tax withheldEmployers name,51099-NEC Code Employers name, address, and ZIP code10 Social security tips 181 Allocated tips plans 192aCodeSee inst. for box 12 Social security tips c 181 Allocated tips plans 2a NonemployeecPAYER'S name, street address, city or town, state or province, country, ZIP or foreign postal code, and phone no.170PAYER'S name, street address, city or town, state or province, country, ZIP or foreign postal code, and phone no.13Statutory employee 14Other 12bCode 13Statutory employee 14Otheraddress, and ZIP code 1 Compensation(Rev. January 2024) 12bCodeFor calendar year1 158 Retirement plan 19 16State wages, tips, etc. 7 Code 3 158 $ PAYERS TIN 3 6 C o Social security tips b $7 4Federal C o Nonqualified tips plans 12 SEP/ Code 5122da Service Center % 13 PAYERS TIN 6 (included Nonqualified tips plans tax 12a SEP/ Employeecontributionscontributions/Designatedor %Third-party sick pay 122dc Retirement plan70Dependent care benefits RECIPIENTS TIN DependentPAYERS TIN RECIPIENTS TIN 1 Code $ 1 Nonemployee compensation 1 $ e d b 1 p 19 16 sick pay e d 8 1 Allocated 9b a Total 12dc 7 Code C C d e o o d e 1 9Roth Copy A premiumsC o d e 7 b 101 2b Social security care tips benefits $ $ 3 ey p of sick pay C e d o 8 12c 1 Allocated 4Federal a income RECIPIENTS TIN C C d d e e o o 9 $8 5Roth contributions insurancepremiumsThird-party sick pay For Internal RevenueMW285State Employer's state ID number 20 1Locality name consumer products to recipient for resale121cincome Employeecontributionscontributions/Designatedorinsurance inbox gain withheldRECIPIENTS name Local income tax State income tax 2 Payer made direct sales totaling $5,000 or more oftaxwithheld File with Form 1096. Capital 2a) 12d RECIPIENT COPIESLocal wages, tips, etc. Capital 2a) 12Employer identification number (EIN) Employees social security number Employer identification number (EIN) Employees social security numberinbox gain(included Local income tax 20 1Locality nameState Employer's state ID number State wages, tips, etc. State income taxForm W-2 Wage and Tax Statement 2023 Dept. of the Treasury IRS Local wages, tips, etc. 2023 IRA/ For Privacy Act andNet oe rye unrealizedrs appreciation 14 $7 Other code(s) IRA/ OtherThis information is being furnished to the Internal Revenue Service. www.irs.gov/ele$ 9a in Your 13Staptulotoyreye of Rlaentirement Distribution Other employee$ $8 Notice, see the current9a inemployesecurities distribution 9bTotalemployee$Street address (including apt. no.) Netunrealizedrs appreciation Third-party14 code(s) SIMPLE Paperwork Reduction ActSm taptulot Rlaetnirement Third-party Distribution SIMPLEemploye em securities OtherInstructions forCity or town, state or province, country, and ZIP or foreign postal code Form W-2 Wage and Tax Statement GeneralCertain Information Yourpercentagetotal4 Federal income tax withheld Dept. of the Treasury IRSpercentagetotaldistribution contributions Returns.5 State tax withheldeEmployees name, address, and ZIP code $ $ 7 State income eEmployees name, address, and ZIP code %$6 State/Payers state no.Account number (see instructions) 2nd TIN not.$ RECIPIENT'S name, street address, city or town, state or province, country, and ZIP or foreign postal code%| b d a e c Copy CFor EMPLOYEE'S RECORDS1 3 5 2 4 641-0852411 Suff. $ G O b d a e c $ $ 14 Copy 2To Be Filed With Employee's State, is 1 3 1 5 1 Service.2 2 4 6 4 $ $ $ $ 1641-0852411 Locality name __ $ $ RECIPIENT'S name, street address, city or town, state or province, country, and ZIP or foreign postal code If 1 3 1 4 $ $ $ G ONotice to Employee on the back of Copy B.)(See OMB No. 1545-0008 __ Department of the Treasury - Internal Revenue ServiceACA Pages 41-42 Form __ (Rev. 1-2024) Federal income tax withheld 17 City, or Local Income Tax Return. State income tax Federal income tax withheld W-2 15StateEmployers state ID number 16State wages, tips, etc.Employee's soc. sec. no. Wages, tips, other comp. Employee's soc. sec. no. Wages, tips, other comp. OMB No. 1545-00081099-NEC Employers state ID number State wages, tips, etc.Form 15State3Social security wages Social security tax withheld FormEmployer ID number (EIN) Social security wages Social security tax withheld W-2 Medicare wages and tips Medicare tax withheld Wage and Tax 17State income tax 1st year of desig. Roth contrib.10Amount allocable to IRR within 5 years__ Medicare wages and tips Medicare tax withheld Employer ID number (EIN) 17 1st year of desig. Roth contrib.10Amount allocable to IRR within 5 years Account number (see instructions)__ 18Local wages, tips, etc.Account number (see instructions) 18Local wages, tips, etc.Employer's name, address, and ZIP code Wage and Tax 15State/Payers state no. 16State distribution Statement 15 19 State/Payers state no. 20 16 Locality nameStatementEmployer's name, address, and ZIP code 14State tax withheld State distributionState tax withheldEmployer Name 2023 18 19Local income tax 19 20 2023 18 Local income tax 19Local distributionEmployer Address Line 1 Local tax withheld Name of Locality Local distribution 17Local tax withheld Name of LocalityCopy 2 - To Be Filed With Employees Copy 2 - To Be Filed With EmployeesEmployer Address Line 2 Copy C For Recipients Records Department of the Treasury State, City, or Local Income Tax Return. Department of the TreasuryInternalRevenue ServiceControl number This State, City, or Local Income Tax Return. Federal income tax withheld Internal Copy B Report this income on your federal tax return. Department of the TreasuryEmployer Address Line 3 Control number being Wages, tips, other compensation Department of the TreasuryInternalRevenue ServiceOMB No. 1545-0008 Wages, tips, other compensation Federalwithheldwww.irs.gov/Form1099R(5175)Employee's name, address, and ZIP code OMB No. 1545-0008 furnishedtotheInternalRevenue Internal Revenue Service This information is the If this form shows federal income tax withheld Internal Revenue Serviceinformation Medicare 6Medicare www.irs.gov/Form1099R Service. LR4 onother in box 4, attach this copy to your return.2 6tax withheldEmployee's name, address, and ZIP code being furnished you filearea to tax Social security income tax Revenuethe Internal Social security tax withheld tax withheldSuff. requiredornegligence MedicareHealth coverage reporting and IRS compliance 10 7Social security tips 8Allocated tipsplans 1 9 CodeSee inst. for box 12 7 c This information Social security wages and tips 192aCode penaltyc a to may be if this Social security wages and code tips Medicare tax withheld 600320 3Revenue Service. to is sanctionyoubeing furnished return,Employers name,5address, wages and ZIP code you failistotaxableaddress, wages and ZIPEmployers name,5imposed report it. andincomeSocial security tips 181 Allocated tips plans13Statutory employee 14Other1 12 2ba Code Form 1095-C (2021)1 103Statutory employee7 14Other 8Allocated Code9 7 8Allocated Page Policy Holder Name Code Part III Retirement plan10 b Social security care tips benefits 1Nonqualified tips plans a 12bcCode12a C C e o d o d See instructions for box 12 JanC e o d b 10 Social security care tips benefits b MayC o d e 1c Nonqualified tips plans a AugC C d o e d o e 1 1 92a d See instructions for box 12 DecCovered Individuals Retirement plan If Employer provided self-insured coverage, check the box and enter the information for each individual enrolled in coverage, including the employee.Third-party sick pay 122cd 12b Dependent 12c 12 Code (d) Covered Dependent (e) Months of coverage Policy Holder Address Line 1 1Code First name, middle initial, last nameC o d e C o d e (b) SSN or other TIN12(c) TIN is not available) d e all 12 months 12Employer Mar Apr 12(EIN) June July Sept Oct NovPolicy Holder Address Line 2 (a) Third-party sick pay DOB (if SSN or otherFebName of covered individual(s) Employees social12d security numberidentification numberEmployees social2security numberPolicy Holder Address Line 3 Employer identification number (EIN)Local wages, tips, etc. 16State wages, tips, etc. State income tax Local wages, tips, etc.13Sm taptulotoeyryepleantirement16Third-party State income tax Staptulotoreyey sick pay185 1 State Employer's state ID number 19Local income tax 20 1Locality name 7 18 158 1State Employer's state ID number e R 19Local income tax 14Other 20 1Locality name 7 13 em Rlaetnirement p Third-party14OtherState wages, tips, etc.sick payForm W-2 Wage and Tax Statement 2023 Dept. of the Treasury IRS Form W-2 Wage and Tax Statement e 2023 Dept. of the Treasury IRS eEmployees name, address, and ZIP code19 Employees name, address, and ZIP code 5205penalty or other sanction may be imposed on you if this income is taxable and you fail to report it. L4UP2021 Form 15StateEmployers state ID number 16State wages, tips, etc. 560115 15StateEmployers state ID number 16State wages, tips, etc.FormForm1095-BInformation about Form 1095-B and its separate instructions is at 22 W-2 17State income tax VOID 18 OMB No. 1545-2252 W-2 17State income tax 18Local wages, tips, etc.Health Coverage| Department of the Treasury . 23 Wage and Tax 19Local income tax Local wages, tips, etc. Wage and Tax 19Local income tax 20Locality nameStatement 2020 StatementSOFTWARE Page 43 Internal Revenue Service 24 2023 CORRECTED 20 2023www.irs.gov/form1095b.Part I Responsible Individual (Policy Holder) 2 Social security number (SSN)Locality name1Name of responsible individual, street address, city or town, state or province, country, and ZIP or foreign postal codeCopy B - ToFEDERALBe Filed With Tax Return. 3 Date of birth (If SSN is not available) CopyNotice Employee on the RECORDS back of Copy B.)Employees (See C - For to EMPLOYEES98 Enter letter identifying Origin of the Policy (see instructions for codes):25.Part IIEmployer Sponsored Coverage (If Line 8 is A or B, complete this part.) 1110Employer name, street address, city or town, state or province, country, and ZIP or foreign postal code26Tax software for small to large businesses Part IIIIssuer or Other Coverage Provider 27 1718Contact telephone number16Name, street address, city or town, state or province, country, and ZIP or foreign postal code28Part IVCovered Individuals (Enter the information for each covered individual(s).)(a) Name of covered individual(s) (b) SSN 29 available) Covered(e) Months of coverage(d) (c) DOB (If SSN is notall 12 months JanFebMarApr MayJunJulAugSepOctNovDec30 41-0852411 1095CIRSC Form 1095-C (2021)23 RAA #160724252627| code 28 1042-S Foreign Persons U.S. Source Income Subject to Withholding 13i 41-0852411 13f 1095B 13jLOB code MISCELLANEOUS Page 44 FormFor Privacy Act and Paperwork Reduction Act Notice, see separate instructions. . . 13h AMENDED s 2024 s OMB No. 1545-0096 Form 1095-B (2015)Department of the TreasuryGo to www.irs.gov/Form1042S for instructions and the latest information. AMENDMENT NO. Copy A Internal Revenue Service UNIQUE FORM IDENTIFIER Internal Revenue Servicefor1 Income 2Gross income 3 Chapter indicator.Enter 3 or 4 13eRecipients U.S. TIN, if any3a Exemption code 4a Exemption code Recipient GIINRecipient 13g Ch. 3 status codeCh. 4 status code3b Tax rate 4b Tax rate number, if any5Withholding allowance6Net income7aFederal tax withheld . 13kRecipients account number VOIDCORRECTED 2Date won OMB No. 1545-02387bCheck if federal tax withheld was not deposited with the IRS because . . . . . . . 3232 , country, $ 1Reportable winnings 4Federal income tax withheld Form W-2GReporting for non-resident alien income, gambling9escrow procedures were applied (see instructions). . . . . . . . . . . . 13lRecipientPAYERS name, street address, city or town, state or province s 3Type of wager $ 6Race Certain s date of birth (YYYYMMDD)and ZIP or foreign postal code7cCheck if withholding occurred in subsequent year with respect to a partnership interest 8Tax withheld by other agents14aPrimary Withholding Agent Name (if applicable) Gambling Overwithheld tax repaid to recipient pursuant to adjustment procedures (see instructions) 5Transaction Winnings(Rev. December 2023)winnings and new employee documentation () 14bPrimary Withholding Agents EIN 15Check if pro-rata basis reporting$ 7 9Winnings from identical wagers 8Cashier For calendar year10Total withholding credit (combine boxes 7a, 8, and 9) 2015aPAYERS TIN 15b Ch. 3 status codeCh. 4 status code11Tax paid by withholding agent (amounts not withheld) (see instructions) PAYERS telephone no.15c WINNERS TIN 10Window For Privacy Act 15d 12aWithholding agents EIN 12bCh. 3 status code12cCh. 4 status code and Paperwork 15e 11 12 Reduction Act 12dWithholding agents name 15fCountry codeWINNERS name15g current General Notice, see the Instructions for 12eWithholding agent 15hAddress (number and street) 1314State winnings Certain Information Returns.Street address (including apt. no.)12fCountry code 12g 15iCity or town, state or province, country, ZIP or foreign postal code $12hAddress (number and street) 16aPayerCity or town,state or province, country, and ZIP or foreign postal code 15State income tax withheld16Local winnings File with Form 1096s name16bPayers TIN12iCity or town, state or province, country, ZIP or foreign postal code 16cPayers GIIN 16d Ch. 3 status code16e Ch. 4 status code $ 17Local income tax withheld $ 18Name of locality Copy A 13aRecipients name 13bRecipients country code 17aState income tax withheld 17bPayers state tax no.17cName of state $ For Internal Revenue Service CenterUnder penalties of perjury, I declare that, to the best of my knowledge and belief, the name, address, and taxpayernumber that I have furnished 13cAddres (number and stret) correctly identify me as the recipient of this payment and any payments from identical wagers, and that no other person is entitled to any part of these payments.13dCity or town, state or province, country, ZIP or foreign postal code Signature: (Rev. 12-2023)Date: FormW-2G Department of the Treasury - Internal Revenue Service| For Privacy Act and Paperwork Reduction Act Notice, see instructions. and ZIP or foreign postal code Form1042-S(2024) 1Reportable winnings 4Federal income tax withheld Form W-2GENVELOPES & FOLDERSPages 45-51 3232 VOIDCORRECTED $ $ 2Date won OMB No. 1545-0238PAYERS name, street address, city or town, state or province, country,3Type of wager Certain Gambling 5Transaction 6Race Winnings(Rev. December 2023)7 Winnings from identical wagers8Cashier For calendar year20Youve done the work . now present it with pride! PAYERS TIN PAYERS telephone no. $ 11 9 WINNERS TIN 10Window For Privacy Act and Paperwork Reduction Act WINNERS name 12 Notice, see the current General Instructions for Street address (including apt. no.) 1314State winnings Certain Information Returns.$City or town,state or province, country, and ZIP or foreign postal code 15State income tax withheld16Local winningsFile with Form 1096$ $17Local income tax withheld18Name of locality Copy A For Internal Revenue $ Service Centercorrectly identify me as the recipient of this payment and a Iny payments from identical wagers, and that no other person is entitled to any part of these payments. I Under penalties of perjury, declare that, to the best of my knowledge and belief, the name, address, and taxpayernumber that have furnished Signature:Date: FormW-2G(Rev. 12-2023) Department of the Treasury - Internal Revenue ServiceBUSINESS GUIDE | Pages 52-63Explore this section for assistance in addressing numerous inquiries, key terms and conditions, and tools for precise tax reporting and compliance"