b'1099 PRE-PRINTED & BLANK FORMSPressure Seal 1099|1098|5498 Forms1A S2020 APEX PS351 1A This proof is submitted for your review and approval. It is supplied for content, layout, and version review and does not reflect paper or ink match. Please review your proof carefully. APEX PS28419238 8510VOID CORRECTED (if checked) OMB No. 1545-0112 S201PAYERS name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no. 1 $ Payers RTN (optional) Form1099-INT IInntceoremset TFP 5115 A $ Form 1099-R CORRECTED (if checked) $ OMB No. 1545-0119 24 $ Form 1099-R CORRECTED (if checked) $ OMB No. 1545-0119 24 TFP 5177Interest income (Rev. January 2022) 1 Gross distribution 2a Taxable amount Distributions1 Gross distribution 2a Taxable amount Distributions 1099-INT MW284For calendar year Annuities, From Retirement Pensions,or Annuities, From Retirement Plans, Pensions,IRAs,or20 Profit-SharingProfit-Sharing Insurance Contracts, Plans, IRAs,etc. Insurance Contracts, etc.2 $ Early withdrawal penalty Copy 2 2b TaxableTiosttarilbutiond 12FATCA13 Date of payment2b TaxableTiosttarilbutiond 12FATCA13 Date of paymentMW351 not determinedamount requiremfilingent not determinedamount requiremfilingentPAYERS TIN RECIPIENTS TIN 3 $ Interest on U.S. Savings Bonds and Treas. obligations PAYERS name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.PAYERS name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.RECIPIENTS name, Street address (including apt. no.), City or town, state or province, country, and ZIP or foreign postal code 4 $ Federal income tax withheld 5 $ 7 Investment expenses esion To be filedwith This proof is submitted for your review and approval. It is supplied for content, layout, and version review and does not reflect paper or ink match. Please review your proof carefully. 8510274recipients tax stateA 6 $ Foreign tax paid Foreign country or U.S. pos income return, PAYERS TIN 1A RECIPIENTS TIN PAYERS TIN RECIPIENTS TIN S2001O G Form 1099-INT $ 8Tax-exempt interest 1 13 9 $ $ $ 1 Specified private activity bond interest 1 $ $ 7 whenrequired. 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Roth contrib. $ 10 Amount allocable to IRR within 5 yearsFor calendar year202 $ Early withdrawal penalty Copy B 14 State tax withheld 15 State/Payers state no. $ 16 State distribution $14 State tax withheld 15 State/Payers state no. $ 16 State distributionPAYERS TIN RECIPIENTS TIN 3 $ Interest on U.S. Savings Bonds and Treas. obligations For Recipient O G $17 Local tax withheld $ 18 Name of locality R $ 19 Local distribution $ 17 Local tax withheld 18 Name of locality R $ 19 Local distribution O GRECIPIENTS name, Street address (including apt. no.), City or town, state or province, country, and ZIP or foreign postal code 4 $ Federal income tax withheld5 $ Investment expenses Thisinformation the Copy 2 www.irs.gov/Form109 DepartmentCopy 2 www.irs.gov/Form109 Departmentis important and tax isbeing furnished you toare File this copy with your state, city, or Internal Revenue of the ServiceTreasury local income tax return,Internal Revenue of the ServiceTreasuryFile this copy with your state, when required.city, or6 $ Foreign tax paid 7Foreign country or U.S. posesion required IRS.to file penalty local income tax return, when required. OMB No. 1545-0119 24 Form 1099-R Department of the Treasury - Internal Revenue Service From24a negligenceIf a return, or Form 1099-R CORRECTED (if checked) Distributions1 Gross distribution CORRECTED (if checked)OMB No. 1545-0119 Retirement requirem filingent 1 10 $ 8Tax-exempt interest 11 1 9 $ $ $ 3 Specified private activity bond interest 1 $ 7 imposed sanction may be $ 1 Gross distribution $ 2a Taxable amount 12FATCAProfit-Sharing$ 2b Taxable amount $ 2a Taxable amount 12 DistributionsPensions,orother this Profit-Sharing Plans, IRAs,etc.Market discount Bond premium income is on taxable you ifand 2b Taxabledo requiremfilingent Annuities, From Retirement Plans, Pensions,IRAs,etc.or not determined distribution requiremfilingent Annuities, Contracts, the IRS determines that Insurance Contracts,Insurance FATCA 1 $2Bond premium on Treasury obligations 15 Bond premium on tax-exempt bond it has not been reported. not determinedamount Tisttarilbution 13 Date of payment Total FATCA13 Date of paymentAccount number (see instructions) $4 bond CUSIP and no. tax credit State16State identification no. State tax withheld PAYERS name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.PAYERS name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.Form 1099-INT (keep for your records) www.irs.gov/Form1099INT Department of the Treasury - Internal$Revenue Service PRINTED IN USA O G O GTax-exemptPAYERS TIN RECIPIENTS TIN PAYERS TIN RECIPIENTS TIN3 Capital4 Federal income tax withheld 5 Employee3 Capital4 Federal income tax withheld5 Employee in box 2a)gain (included $ /Designated$ in box 2a)gain (included $ $ or insurance contributionsRoth premiumscontributionsor insurance contributionsRoth premiumscontributions /Designated First-Class Mail $6 Net unrealized appreciation $7 Distribution code(s) SS IIRA/8 Other % in employers7 Distribution code(s) SISIRA/ $ 8 Other %SEE REVERSE SIDE FOR OPENING INSTRUCTIONS PRINTED IN U.S.A.Important Tax Return in employers securities MEPPL/E $6 Net unrealized securitiesappreciation MEPPL/EDocument Enclosed $9a Your percentage of total distribution $9b Total employee $ contributions 9a Your percentage of total distribution %$9b Total employee contributions% RECIPIENTS name, street address (including apt. no.), city or town, state or province, country, and ZIP or foreign postal codeRECIPIENTS name, street address (including apt. no.), city or town, state or province, country, and ZIP or foreign postal codePROOF 1 8510027759Account number (see instruc.) 11 1st year of desig. Roth contrib. $ 10 Amount allocable to IRR within 5 yearsAccount number (see instruc.) 11 1st year of desig. Roth contrib. $ 10 Amount allocable to IRR within 5 years14 State tax withheld 15 State/Payers state no. $ 16 State distribution $14 State tax withheld 15 State/Payers state no. $ 16 State distribution$17 Local tax withheld 18 Name of locality 19 Local distribution $17 Local tax withheld 18 Name of locality $ 19 Local distribution$ $Copy C For Recipients Records R Internal Revenue of the ServiceTreasury w Copy B R Report this tax withheld income on in your box 4, federal attach tax this return. copy If to this your form return.shows federal(keep for your records) www.irs.gov/Form109 Departmentincome This information is being furnished to the IRS. w.irs.gov/Form109This information is being furnished to the IRS.FACE; PERFS AS SHOWN; SCREEN 20%PROOF 1 8510027744 1099 R - Copy B1099 R - Copy CAPEX PS1159TFP 5178 FACE; PERFS AS SHOWNZFoldVFold1A This proof is submitted for your review and approval. It is supplied for content, layout, and version review and does not reflect paper or ink match. Please review your proof carefully. 851019247 S2020 APEX PS361A PAYERS name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.Payers(if checked) \x1f 8 OMB1545-0112 Interest Income TFP 5502VOID CORRECTEDRTN (optional) (Rev. 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