b"1099 PRE-PRINTED FORMSApex 1099-DIV & 1099-R Packaged SetsAPEX 1099-DIV LASER PACKAGED SETAPEX LDA APEX LDB APEX LDC APEX L1096VOIDCORRECTED CORRECTED (if checked) Do Not StaplePAYERS 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. 1545-0110or foreign postal code, and telephone no.VOIDCORRECTED OMB No. 1545-0110Form1096 Annual Summary and Transmittal of OMB No. 1545-0108or foreign postal code, and telephone no.or foreign postal code, and telephone no.PAYERS name, street address, city or town, state or province, country, ZIP 1aTotal ordinary dividendsINKSRESISTANTUSING HEATBOND PAPERON OCR LASERMANUFACTURED DETACH BEFORE MAILING$1b Form1099-DIVDividends and$1b Form1099-DIV Dividends and$Form1099-DIVDividends andU.S. Information Returns 2024Department of the Treasury (Rev. January 2024) Distributions(Rev. January 2024) Distributions1b (Rev. January 2022) Distributions Internal Revenue ServiceFor calendar year For calendar year FILERS name$$$For calendar year$2aTotal capital gain distr. $2bUnrecap. Sec. 1250 gainCopy A RECIPIENTS TIN $2aTotal capital gain distr. $2bUnrecap. Sec. 1250 gainPAYERS TINCopy BRECIPIENTS TIN $2aTotal capital gain distr. $2bUnrecap. Sec. 1250 gainCopy CInternal Revenue For2cSection 1202 gain2dCollectibles (28%) gainFor Recipient2cSection 1202 gain2dCollectibles (28%) gainand/or StateStreet address (including room or suite number)PAYERS TIN RECIPIENTS TIN 2cSection 1202 gain2dCollectibles (28%) gain PAYERS TINFor Payer$$Service Center$$$$ Copy 1 or Copy 2$2eSection 897 ordinary dividends $2fSection 897 capital gainFile with Form 1096. $2eSection 897 ordinary dividends $2fSection 897 capital gainRECIPIENT'S name, stret adres, city or town, state or province, country, and ZIP or foreign postal code $2eSection 897 ordinary dividends $2fSection 897 capital gainCity or town, state or province, country, and ZIP or foreign postal code For Ofcial Use OnlyRECIPIENTS name3Nondividend distributions 4 Federal income tax withheldRECIPIENT'S name, stret adres, city or town, state or province, country, and ZIP or foreign postal code3Nondividend distributions 4Federal income tax withheldThis is important tax3Nondividend distributions 4Federal income tax withheld Name of person to contact Telephone number$$For Privacy Act$$information and is$$For Privacy ActFax number5Section 199A dividends 6Investment expensesand Paperwork5Section 199A dividends 6Investment expensesbeing furnished to5Section 199A dividends 6Investment expensesand Paperwork Email addressStreet address (including apt. no.)$$Reduction Act$$the IRS. If you are$$Reduction Act2 Social security number 3 Total number of forms 4 Federal income tax withheld5 Total amount reported with this Form 10967Foreign tax paid8Foreign country or U.S. possession Notice, see the7Foreign tax paid8Foreign country or U.S. possession return, a negligence7Foreign tax paid8Foreign country or U.S. possession Notice, see the 1 current Generalpenalty or othercurrent General$ $City or town, state or province, country, and ZIP or foreign postal code $9Cash liquidation distributions10 Noncash liquidation distributions Instructions for$9Cash liquidation distributions10 Noncash liquidation distributionssanction may be$9Cash liquidation distributions10 Noncash liquidation distributions6W-2G 1097-BTC10981098-C1098-E1098-F1098-Q1098-T1099-A1099-B1099-C1099-CAP1099-DIV1099-G1099-INT1099-KCertain this income is taxableInstructions for Certain imposed on you if 11 requirement 12Exempt-interest dividends13 bond interest dividends Information11 requirement 12Exempt-interest dividends13 bond interest dividends determines that it has11requirement $12Exempt-interest dividends $13bond interest dividends Information81 78 84 03 74 83 80 79 85 73 3921 91 86 92 10and the IRS32 50$$Returns.$$not been reported.Returns. Account number (see instructions)2nd TIN not.$14State 15 $16State tax withheld Account number (see instructions)$14State 15 $16State tax withheld Account number (see instructions)2nd TIN not.$14State 15 $16State tax withheld 1099-LS 1099-LTC1099-MISC1099-NEC 1099-OID1099-PATR1099-Q1099-QA 1099-R1099-S1099-SA 1099-SB25 392254985498-ESA5498-QA 16 93 95 71 96 97 31 1A 98 75 94 43 26 28 72 2A$$$ $$$5498-SA Form1099-DIV(Rev. 1-2022) 27Form1099-DIV(Rev. 1-2024) Department of the Treasury - Internal Revenue ServiceForm1099-DIV(Rev. 1-2024) (keep for your records)Department of the Treasury - Internal Revenue Service www.irs.gov/Form1099DIV Department of the Treasury - Internal Revenue ServiceReturn this entire page to the Internal Revenue Service. Photocopies are not acceptable. Send this form, with the copies of the form checked in box 6, to the IRS in a at mailer (not folded).VOIDCORRECTED CORRECTED (if checked) VOIDCORRECTED OMB No. 1545-0110Under penalties of perjury, I declare that I have examined this return and accompanying documents and, to the best of my knowledge and belief, they are true, correct, and complete.PAYERS name, street address, city or town, state or province, country, ZIP 1aTotal ordinary dividendsOMB No. 1545-0110PAYERS name, street address, city or town, state or province, country, ZIP 1aTotal ordinary dividendsOMB No. 1545-0110PAYERS name, street address, city or town, state or province, country, ZIP 1aTotal ordinary dividends or foreign postal code, and telephone no.$Formor foreign postal code, and telephone no.$Formor foreign postal code, and telephone no.$1b Form1099-DIVDividends andTitleDate1099-DIVDividends and1099-DIV Dividends and(Rev. January 2022) Signature When to le. If any date shown falls on a Saturday, Sunday, or legal 1b (Rev. January 2024) Distributions1b (Rev. January 2024) DistributionsFor calendar year Distributionsthe due date is the next business day. File Form 1096 in the calendar InstructionsFor calendar year For calendar year $related to Form 1096, such as legislation enacted after it was published, goyear following the year for which the information is being reported, as Future developments. For the latest information about developments $$2aTotal capital gain distr. 2bUnrecap. Sec. 1250 gainto www.irs.gov/Form1096. follows.Copy CPAYERS TIN RECIPIENTS TIN $2aTotal capital gain distr. $2bUnrecap. Sec. 1250 gainCopy AFor$2aTotal capital gain distr. $2bUnrecap. Sec. 1250 gainPAYERS TINCopy BRECIPIENTS TIN $2cSection 1202 gain$2dCollectibles (28%) gainand/or Statewww.irs.gov/inforeturn Reminder. For PayerInternal Revenuereturns. Go to 2cSection 1202 gain2dCollectibles (28%) gain PAYERS TINRECIPIENTS TIN 2cSection 1202 gain2dCollectibles (28%) gainFor Recipient$2eSection 897 ordinary dividends $2fSection 897 capital gainthe 2024 General Instructions for Certain Information Returns. *Leap years do not impact the due date. See Announcement 91-179,$$Service Center$$Copy 1 or Copy 2Purpose of form. Use this form to transmit paper Forms 1097, 1098, $2eSection 897 ordinary dividends $2fSection 897 capital gainFile with Form 1096. $2eSection 897 ordinary dividends $2fSection 897 capital gainRECIPIENT'S name, stre t adres, city or town, state or province, country, and ZIP or foreign postal code $3Nondividend distributions$4Federal income tax withheld 1099, 3921, 3922, 5498, and W-2G to the IRS.1991-49 I.R.B. 78, for more information.RECIPIENTS name$3Nondividend distributions$4Federal income tax withheldRECIPIENT'S name, stret adres, city or town, state or province, country, and ZIP or foreign postal code $3Nondividend distributions$4Federal income tax withheld This is important tax$5Section 199A dividends $6Investment expensesCaution: Where To File Use the following APEX DWMR or DWMRSnumber of returns.For Privacy Actinformation and isFor Privacy ActIf your principal business, ofce or Who must le. and Paperworkagency, or legal residence in the 5Section 199A dividends 6Investment expensesand Paperwork$5Section 199A dividends $6Investment expensesbeing furnished to$7Foreign tax paid$8Foreign country or U.S. possession Reduction Actcase of an individual, is located in: address:Caution: Street address (including apt. no.)$$Reduction Actthe IRS. If you areNotice, see theAlabama, Arizona, Arkansas, Delaware, 7Foreign tax paid8Foreign country or U.S. possession Notice, see the7Foreign tax paid8Foreign country or U.S. possession return, a negligencecurrent GeneralFlorida, Georgia, Kentucky, Maine,Internal Revenue Servicethe name and TIN used on your 94X series tax return(s) or you may be current Generalpenalty or othersubject to information return penalties. Do not use the name and/or TIN ofMassachusetts, Mississippi, NewP.O. Box 149213 City or town, state or province, country, and ZIP or foreign postal code $Instructions for$sanction may be$9Cash liquidation distributions10 Noncash liquidation distributionsInstructions for CertainHampshire, New Jersey, New Mexico,Austin, TX 78714-9213your paying agent or service bureau.9Cash liquidation distributions10 Noncash liquidation distributions Certain9Cash liquidation distributions10 Noncash liquidation distributionsimposed on you if$$InformationNew York, North Carolina, Ohio, Texas, number), and TIN in the spaces provided on the form. The name, address, $$Information$$ this income is taxable12Exempt-interest dividends13bond interest dividends Returns.Vermont, Virginia Internal Revenue Service Center and the IRS Returns.determines that it hasupper left area of Form 1097, 1098, 1099, 3921, 3922, 5498, or W-2G. Alaska, Colorado, Hawaii, Idaho, not been reported.11requirement Illinois, Indiana, Iowa, Kansas, 11 requirement 12Exempt-interest dividends13bond interest dividends 11 requirement 12Exempt-interest dividends13bond interest dividends $$Michigan, Minnesota, Missouri,P.O. Box 219256 Montana, Nebraska, Nevada, North Kansas City, MO 64121-9256Dakota, Oklahoma, Oregon, South Account number (see instructions)2nd TIN not.$14State 15 $16State tax withheld Account number (see instructions)$14State 15 $16State tax withheld Account number (see instructions)2nd TIN not.14State 15 $16State tax withheld Carolina, South Dakota, Tennessee,Utah, Washington, Wisconsin, Wyoming $$$ $$Form1099-DIV(Rev. 1-2022) LDC 5132 www.irs.gov/Form1099DIV Department of the Treasury - Internal Revenue Service Form1096(2024)For more information and the Privacy Act and Paperwork Reduction Act Notice, Form1099-DIV(Rev. 1-2024) Form1099-DIV(Rev. 1-2024) (keep for your records)Department of the Treasury - Internal Revenue Service see the 2024 General Instructions for Certain Information Returns.Department of the Treasury - Internal Revenue ServiceAPEX 1099-R LASER PACKAGED SETAPEX LRA APEX LRB APEX LRCLR2 APEX L1096Do Not Staple9898 VOID CORRECTED CORRECTED (if checked) CORRECTED (if checked) FormAnnual Summary and Transmittal of OMB No. 1545-0108PAYERS 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 Distributions From1Gross distribution OMB No. 1545-0119 1096 DETACH BEFORE MAILINGDETACH BEFORE MAILINGDETACH BEFORE MAILINGDistributions FromPAYERS name, street address, city or town, state or province,Distributions FromMANUFACTURED 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 INKScountry, ZIP or foreign postal code, and telephone no. $ Pensions, Annuities, $ Pensions, Annuities, $ Pensions, Annuities, U.S. Information Returns 2024country, ZIP or foreign postal code, and telephone no. country, ZIP or foreign postal code, and telephone no. Department of the Treasury Retirement orRetirement orRetirement or 2aTaxable amount 2024 Prot-Sharing Plans,2aTaxable amount 2024 Prot-Sharing Plans,2aTaxable amount 2024 Prot-Sharing Plans, Internal Revenue ServiceFILERS nameIRAs, InsuranceIRAs, InsuranceIRAs, Insurance $ Form 1099-R Contracts, etc. $ Form 1099-R Contracts, etc. $ Form 1099-R Contracts, etc.2bTaxable amountTotalCopy A2bTaxable amountTotalCopyB2bTaxable amountTotalCopy C Street address (including room or suite number)PAYERS TIN RECIPIENTS TIN not determined 4 distribution PAYERS TINForRECIPIENTS TIN not determined 4 distribution PAYERS TINReport thisRECIPIENTS TIN not determined 4 distribution For Recipient's 3Capital gain (included inFederal income tax Internal Revenue3Capital gain (included inFederal income tax income on your3Capital gain (included inFederal income tax Recordsbox 2a) withheld Service Centerbox 2a) withheld federal taxbox 2a) withheld City or town, state or province, country, and ZIP or foreign postal codereturn. If this $ contributions or$ employers securities File with Form 1096. $ insurance premiums $ appreciation in RECIPIENTS name, stre form shows$ 5Employee contributions/$ 6appreciation in Name of person to contact Telephone number For Ofcial Use OnlyRECIPIENTS name 5Employee contributions/ 6appreciation in RECIPIENTS name, stret adres, city or town, state or province, country and ZIP or foreign postal code 5Employee contributions/ 6Net unrealized federal incomecontributions orNet unrealized Email address Fax numbert adres, city or town, state or province, country and ZIP or foreign postal codeDesignated RothNet unrealized For Privacy Actcontributions oremployers securities tax withheld inDesignated Rothemployers securitiesDesignated Roth insurance premiums and Paperworkbox 4, attachinsurance premiumsReduction Act $ IRA/ $ 8Other Notice, see the $ 7DistributionIRA/ $ 8Other this copy to$ 7DistributionIRA/ $ 8Other 12 Social security number 3 Total number of forms $ 4 Federal income tax withheld $ 5 Total amount reported with this Form 1096Street address (including apt. no.) 7DistributionSEP/ 2024 Generalcode(s) SIMPLE your return.code(s) SIMPLE This information is code(s) SIMPLE $ % Instructions for CertainSEP/ $ % This information isSEP/ $ % 6W-2G 1097-BTC10981098-C1098-E1098-F1098-Q1098-T1099-A1099-B1099-C1099-CAP1099-DIV1099-G1099-INT1099-KCity 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 9aYour percentage of total 9bTotal employee contributions being furnished to the IRS. 81 78 84 03 74 83 80 79 85 73 91 86 92 10distribution %$ Returns. distribution %$ being furnished to the IRS. distribution %$ 32 5010Amount allocable to IRR111st year of desig. 12 requirement$ 14State tax withheld 15State/Payers state no.10Amount allocable to IRR111st year of desig. 12 requirement$ 14State tax withheld 15State/Payers state no.10Amount allocable to IRR111st year of desig. 12 requirement$ 14State tax withheld 15State/Payers state no. $ 16State distribution 1099-MISC 1099-NEC 1099-OID1099-PATR 1099-Q1099-QA 1099-R1099-S1099-SA 1099-SB 3921392254985498-ESA5498-QA 16State distribution 16State distributionwithin 5 years Roth contrib. within 5 years Roth contrib. within 5 years Roth contrib. 1099-LS 1099-LTC 95 71 96 97 31 1A 98 75 94 43 25 26 28 72 2A$ $$ $ $ $ $ $ $ $ $ 16 9319Local distribution 19Local distributionAccount number (see instructions) 13Date of17Local tax withheld 18Name of localityAccount number (see instructions) 13Date of17Local tax withheld 18Name of localityAccount number (see instructions) 13Date of17Local tax withheld 18Name of locality 19Local distributionpayment$ $ payment$ $ payment$ $$ $ $ $ $ $ 5498-SA Form 1099-R Form 1099-R (keep for your records) 27Form 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 ServiceDoNotCutorSeparateFormsonThisPage DoNotCutorSeparateFormsonThisPageReturn this entire page to the Internal Revenue Service. Photocopies are not acceptable. Send this form, with the copies of the form checked in box 6, to the IRS in a at mailer (not folded).9898 VOID CORRECTED CORRECTED (if checked) CORRECTED (if checked) 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.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. 1545-0119 Distributions From1Gross distribution OMB No. 1545-0119 Distributions From Distributions FromPAYERS name, street address, city or town, state or province, Pensions, Annuities, 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. Pensions, Annuities,Retirement or Retirement orRetirement orSignature TitleDate$ 2aTaxable amount 2024 Prot-Sharing Plans,$ 2aTaxable amount 2024 Prot-Sharing Plans,$ 2aTaxable amount 2024 Prot-Sharing Plans,When to le. If any date shown falls on a Saturday, Sunday, or legal InstructionsIRAs, InsuranceIRAs, InsuranceIRAs, Insurance Contracts, etc.$ Form 1099-R Contracts, etc. $ Form 1099-R Contracts, etc. $ Form 1099-R related to Form 1096, such as legislation enacted after it was published, goyear following the year for which the information is being reported, as Future developments. For the latest information about developmentsthe due date is the next business day. File Form 1096 in the calendar 2bTaxable amountTotalCopy A2bTaxable amountTotalCopyB2bTaxable amountTotalto www.irs.gov/Form1096. follows. PAYERS TIN RECIPIENTS TIN not determined 4 distribution PAYERS TINForRECIPIENTS TIN not determined 4 distribution PAYERS TINReport thisRECIPIENTS TIN not determined 4 distribution Copy CReminder.www.irs.gov/inforeturn For Recipient's returns. Go to Records3Capital gain (included inFederal income tax Internal Revenue3Capital gain (included inFederal income tax income on your3Capital gain (included inFederal income tax the 2024 General Instructions for Certain Information Returns.box 2a) withheld Service Centerbox 2a) withheld federal taxbox 2a) withheld Purpose of form. Use this form to transmit paper Forms 1097, 1098,*Leap years do not impact the due date. See Announcement 91-179,return. If this1099, 3921, 3922, 5498, and W-2G to the IRS.1991-49 I.R.B. 78, for more information.$ Designated Roth$ employers securities File with Form 1096. $ insurance premiums $ RECIPIENTS name, stre form shows$ 5Employee contributions/$ 6appreciation in Caution: Where To File Use the followingRECIPIENTS name 5Employee contributions/ 6appreciation inRECIPIENTS name, stret adres, city or town, state or province, country and ZIP or foreign postal code 5Employee contributions/ 6appreciation in federal incomeDesignated RothNet unrealized number of returns.t adres, city or town, state or province, country and ZIP or foreign postal codecontributions orNet unrealizedFor Privacy Actcontributions orNet unrealized tax withheld ininsurance premiums employers securities Who must le.If your principal business, ofce oraddress:Designated Roth insurance premiums and Paperworkemployers securities box 4, attachcontributions orCaution:case of an individual, is located in:Reduction Actagency, or legal residence in the $ IRA/ $ 8Other Notice, see the $ 7DistributionIRA/ $ 8Other this copy to$ 7DistributionIRA/ $ 8Other the name and TIN used on your 94X series tax return(s) or you may beAlabama, Arizona, Arkansas, Delaware, your return. Street address (including apt. no.) 7DistributionSEP/ 2024 Generalcode(s) SEP/ code(s) SIMPLE This information isFlorida, Georgia, Kentucky, Maine,Internal Revenue ServiceSEP/code(s) SIMPLE $ % Instructions for CertainSIMPLE $ % This information is$ % subject to information return penalties. Do not use the name and/or TIN ofMassachusetts, Mississippi, NewAustin, TX 78714-9213your paying agent or service bureau. Hampshire, New Jersey, New Mexico,P.O. Box 149213 City 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. New York, North Carolina, Ohio, Texas, distribution %$ Returns. distribution %$ distribution %$ number), and TIN in the spaces provided on the form. The name, address,Vermont, Virginia16State distribution 16State distribution upper left area of Form 1097, 1098, 1099, 3921, 3922, 5498, or W-2G. Illinois, Indiana, Iowa, Kansas, 10Amount allocable to IRR111st year of desig. 12 requirement$ 14State tax withheld 15State/Payers state no.10Amount allocable to IRR111st year of desig. 12 requirement$ 14State tax withheld 15State/Payers state no.10Amount allocable to IRR111st year of desig. 12 requirement$ 14State tax withheld 15State/Payers state no. $ 16State distribution Alaska, Colorado, Hawaii, Idaho,Internal Revenue Service Center within 5 years Roth contrib. within 5 years Roth contrib. within 5 years Roth contrib. Michigan, Minnesota, Missouri,P.O. Box 219256 $ $$ $ $ $ $ $ $ $ $ Montana, Nebraska, Nevada, North Kansas City, MO 64121-9256Account number (see instructions) 13Date of17Local tax withheld 18Name of localityAccount number (see instructions) 13Date of17Local tax withheld 18Name of localityAccount number (see instructions) 13Date of17Local tax withheld 18Name of locality 19Local distribution Dakota, Oklahoma, Oregon, South 19Local distribution 19Local distribution Carolina, South Dakota, Tennessee,payment$ $ payment$ $ payment$ $ Utah, Washington, Wisconsin, Wyoming $ $ $ $ $ $Form 1099-R LRA 41-0852411 5140 www.irs.gov/Form1099R Department of the Treasury - Internal Revenue Service 5141 www.irs.gov/Form1099R Department of the Treasury - Internal Revenue Service LRC www.irs.gov/Form1099R 5142 Department of the Treasury - Internal Revenue Service Form1096(2024)Form 1099-R LRB Form 1099-R (keep for your records) For more information and the Privacy Act and Paperwork Reduction Act Notice, see the 2024 General Instructions for Certain Information Returns.(3) Transmittal 1096 forms are included with each setAPEX 1099-DIV LASER PACKAGED SETAPEX 1099-R LASER PACKAGED SET STANDARD SETS (50 Sheets for 100 Recipients) STANDARD SETS w/ Envelopes (50 Sheets for 100 Recipients)959333-Part SET includes: (50 Sheets EACH) 1099-DIV Copy A, B, C 95944E4-Part SET includes: (50 Sheets EACH) 1099-R Copy A, B, C 959344-Part SET includes: (50 Sheets EACH) 1099-DIV Copy A, B, C, C + DWMR (100)VALUE SETS w/ Self-Seal Envelopes (10 Sheets for 20 Recipients) 95946E6-Part set includes: (50 Sheets EACH) 1099-R Copy A, B, C, 1, 2, 95910ES4-Part SET includes: (10 Sheets EACH) 1099-DIV Copy A, B, C, C,+ DWMR (100)+ DWMRS (20)21"