b"1099 PRE-PRINTED & BLANK FORMSIndividual Laser Packs1099-MISC9595 VOID CORRECTED OMB No. 1545-0115 APEX LMA PAYER'S name, stretadres,city CORRECTED(ifchecked) postal code$ 31Rents $ 4 2 Royalties OMB 1099-MISCPAYERS name, street address, city or town, state or province, country, ZIP 1 Rents Form1099-MISC Miscellaneousor town, state or province,country, and ZIP or foreign Other income Federal income tax withheldFormNo.1545-0115 APEX LM3or foreign postal code, and telephone no. (Rev. January 2022) DETACH BEFORE MAILING ON OCR LASER BOND PAPER USING HEAT RESISTANT INKSMANUFACTURED$ 2 Royalties (Rev. January 2024) Information TFP 5110 $ 57 Fishingboatproceeds $ $ 6 Medical and health careFor calendar year PAYERS TIN RECIPIENTS TIN $ 3 Other income $ For calendar year Copy A PAYERS TIN RECIPIENTS TIN $ 9Payer made direct sales $ payments Miscellaneoussis . 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DepartmentoftheTreasuryInternalRevenueServiceCORRECTED (if checked) Information1 Rents OMB No. 1545-0115Account number (see instructions) or foreign postal code, and telephone no.$ 14 Excess golden parachute 15 compensation FormReturns. MiscellaneousVOID tadres,city CORRECTED(ifchecked) postal code$ 31Rents $ 4 2 Royalties OMBNo.1545-011513 requirement $ payments $ $ 2 Royalties 1099-MISC Information PAYER'S name, stre or town, state or province,country, and ZIP or foreign Other income Federal income tax withheldForm1099-MISC2nd TIN not. $ 16 State tax withheld 17 State/Payers state no. $ (Rev. January 2024) Copy B TFP 5111 $ 5 Fishingboatproceeds $ 6 Medical and health care(Rev. 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Formrecipient for resale the IRS. If you arepayments InstructionCrop insurance proceeds Informationfor$ 2 Royalties $ 1099-MISC Miscellaneousreturn, a negligence16 Statetaxwithheld 17 State/Payers state number State income$ 3 Other income (Rev. 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January 2024) $ Information APEX LMBL Form (Rev. 1-2022) LM3 $ $ Statetax 5114 DepartmentoftheTreasury $ $ -InternalRevenueServiceFor calendar year18 State income 12 Section 409A deferrals11 Fish purchased for resale$ $ 3 Other income $ 4 Federal income tax withheld Copy BForm1099-MISC(Rev. 1-2024) $ $ 5 Fishing boat proceeds13 requirement $ 14 payments For RecipientRECIPIENTS TIN Department of the Treasury - Internal Revenue Service 15 compensationExcess golden parachute RECIPIENT'S name, stret adres Account number (see instructions) $ 7 totaling $5,000 or more of$ 6 Medical and health care$ 17 State/Payers state no. $ 18 State income TFP 5108payments$ 16 State tax withheld, city or town, state or province, country, and ZIP or foreign postal code Payer made direct sales$ This is important tax$Form1099-MISC(Rev. 1-2024) consumer products to$ 8 of dividends or interest being furnished to Substitute payments in lieu $recipient for resalewww.irs.gov/Form1099MISC information and is Department of the Treasury - Internal Revenue Service9 Crop insurance proceeds 10 Gross proceeds paid to anFront Blankattorney the IRS. If you are $ 11 Fish purchased for resale $ 12 Section 409A deferrals return, a negligence penalty or other VOID CORRECTED (if checked) sanction may be PAYERS name, street address, city or town, state or province, country, ZIP 1 Rents with W-2 Instructions imposed on you if OMB No. 1545-0115this income is or foreign postal code, and telephone no.$ 14 Excess golden parachute$ 15 compensation taxable and the IRSMiscellaneousLM3BL 5173Form1099-MISC13 requirement payments $ 2 Royalties determines that itInformationAccount number (see instructions) $ 16 State tax withheld $ 17 State/Payers state no. $ has not beenCopy 2 TFP 5159$ $ 3 Other income on back side.(Rev. January 2024)reported.For calendar year18 State income4 Federal income tax withheldForm1099-MISC(Rev. 1-2024)PAYERS TIN $ $ 5 Fishing boat proceeds $ $ 6 Medical and health careRecipients State or Required Envelope:(keep for your records) RECIPIENTS TIN Department of the Treasury - Internal Revenue Service To be Filed withLocal Income TaxpaymentsReturn, or Copy 1For State TaxRECIPIENT'S name, stret adres, city or town, state or province, country, and ZIP or foreign postal code $ 7 Payer made direct sales$ 8 Substitute payments in lieuDepartmenttotaling $5,000 or more of$ of dividends or interest Front Blank APEX: DWM3consumer products to recipient for resale9 Crop insurance proceeds 10 Gross proceeds paid to an attorney13 requirement $ 11 Fish purchased for resale $ 12 Section 409A deferrals TFP: 52521$ 14 Excess golden parachute$ 15 compensation with W-2 Instructions paymentsAccount number (see instructions) $ 16 State tax withheld $ 17 State/Payers state no. on back side.Form1099-MISC(Rev. 1-2024) $ 5112 $ 18 State income or foreign postal code, and telephone no. CORRECTED (if checked) OMB No. 1545-0115 MiscellaneousAPEX LMB2$ $ DETACH BEFORE MAILINGMANUFACTURED ON OCR LASER BOND PAPER USING HEAT RESISTANT INKSwww.irs.gov/Form1099MISC Department of the Treasury - Internal Revenue Service PAYERS name, street address, city or town, state or province, country, ZIP1 Rents$ 2 Royalties Form1099-MISC Information(Rev. January 2022)THIS PANEL CONTAINS $ 3 Other income For calendar yearCopy B204 Federal income tax withheld$ $ For Recipient1099MISC COPY B BACKER INFORMATION PAYERS TIN RECIPIENTS TIN 5 Fishing boat proceeds 6 Medical and health care paymentsRECIPIENT'S name, stret adres, city or town, state or province, country, and ZIP or foreign postal code $ 7 totaling $5,000 or more of$ 8 Substitute payments in lieu ofThis is important tax Payer made direct salesdividends or interest information and is consumer products to$ 10 Gross proceeds paid to anbeing furnished to 9 recipient for resale attorney the IRS. If you are Crop insurance proceeds$ 11 Fish purchased for resale $ 12 Section 409A deferrals return, a negligence penalty or other sanction may be imposed on you if this income is 13 requirement $ 14 Excess golden parachute$ 15 compensation taxable and the IRS payments determines that it has not been THIS PANEL CONTAINS Account number (see instructions) $ 16 State tax withheld 17 State/Payers state no. $ 18 State income Do Not Staple OMB No. 1545-0108 APEX L1096$ $ reported.Form1099-MISC(Rev. 1-2022) (keep for your records) $ www.irs.gov/Form1099MISC $ Form1096 Annual Summary and Transmittal ofDepartment of the Treasury - Internal Revenue Service Internal Revenue Service 2024COPY B BACKER INFORMATION Department of the TreasuryU.S. Information Returns TFP 5100FILERS nameCORRECTED (if checked) OMB No. 1545-0115 Street address (including room or suite number)PAYERS name, street address, city or town, state or province, country, ZIP1 Rentsor foreign postal code, and telephone no. Form1099-MISC MiscellaneousCity or town, state or province, country, and ZIP or foreign postal code$ 2 Royalties (Rev. January 2022) InformationFor calendar year $ 3 Other income 20 Name of person to contact Telephone number For Ofcial Use Only4 Federal income tax withheldPAYERS TIN RECIPIENTS TIN $ 5 Fishing boat proceeds $ 6 Medical and health care payments Copy 2 Email address Fax numberTo be led with recipients state12 Social security number 3 Total number of forms 4 Federal income tax withheld5 Total amount reported with this Form 1096income tax return,$ $RECIPIENT'S name, stret adres, city or town, state or province, country, and ZIP or foreign postal code $ 7 totaling $5,000 or more of$ 8 Substitute payments in lieu ofwhen required. 6W-2G 1097-BTC10981098-C1098-E1098-F1098-Q1098-T1099-A1099-B1099-C1099-CAP1099-DIV1099-G1099-INT1099-KPayer made direct salesdividends or interest 32 50 81 78 84 03 74 83 80 79 85 73 91 86 92 10consumer products to$ 10 Gross proceeds paid to an1099-LS 1099-LTC1099-MISC 1099-NEC 1099-OID1099-PATR 1099-Q1099-QA 1099-R1099-S1099-SA 1099-SB 3921392254985498-ESA5498-QA recipient for resaleRequired Envelope: $ 9 Crop insurance proceeds $ attorney 16 93 95 71 96 97 31 1A 98 75 94 43 25 26 28 72 2A11 Fish purchased for resale 12 Section 409A deferrals5498-SA $ Excess golden parachute$APEX: DWMR or DWMRS Account number (see instructions) 13 requirement $ 14 payments $ 15 compensation 18 State income 2716 State tax withheld 17 State/Payers state no. Return 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).$ $ 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.TFP: 77771 or 77772 Form1099-MISC(Rev. 1-2022) LMB2 $ $ Signature When to le. TitleIf any date shown falls on a Saturday, Sunday, or legal Datewww.irs.gov/Form1099MISC Department of the Treasury - Internal Revenue ServiceInstructionsFuture developments. For the latest information about developmentsthe due date is the next business day. File Form 1096 in the calendar related to Form 1096, such as legislation enacted after it was published, goyear following the year for which the information is being reported, as to www.irs.gov/Form1096. follows.Reminder. returns. Go to www.irs.gov/inforeturn the 2024 General Instructions for Certain Information Returns.Purpose of form. Use this form to transmit paper Forms 1097, 1098,1991-49 I.R.B. 78, for more information. *1099, 3921, 3922, 5498, and W-2G to the IRS.Leap years do not impact the due date. See Announcement 91-179,Caution:number of returns. Where To FileWho must le.If your principal business, ofce orUse the followingCaution:agency, or legal residence in theaddress:case of an individual, is located in:the name and TIN used on your 94X series tax return(s) or you may beFlorida, Georgia, Kentucky, Maine, subject to information return penalties. Do not use the name and/or TIN ofAlabama, Arizona, Arkansas, Delaware,Internal Revenue Serviceyour paying agent or service bureau. Massachusetts, Mississippi, NewP.O. Box 149213 Hampshire, New Jersey, New Mexico, number), and TIN in the spaces provided on the form. The name, address,New York, North Carolina, Ohio, Texas,Austin, TX 78714-9213upper left area of Form 1097, 1098, 1099, 3921, 3922, 5498, or W-2G. Vermont, VirginiaAlaska, Colorado, Hawaii, Idaho, Illinois, Indiana, Iowa, Kansas,Internal Revenue Service Center Michigan, Minnesota, Missouri,P.O. Box 219256 Montana, Nebraska, Nevada, North Kansas City, MO 64121-9256Dakota, Oklahoma, Oregon, South Utah, Washington, Wisconsin, Wyoming Carolina, South Dakota, Tennessee,For more information and the Privacy Act and Paperwork Reduction Act Notice,Form1096(2024)see the 2024 General Instructions for Certain Information Returns.(5) 1096 Transmittal forms are included with each Federal Copy A (Red) form orderAPEX - Sheets per packTFP - Forms per pack50s500s100s1000sFORM DESCRIPTION(5 00 formsL1096L1096500510010 or 510025 5100Bper package) 1096 Annual Transmittal For U.S. Information ReturnsLMALMA50051105110B1099-MISC Federal Copy A1 Page Equals 2 FormsLMBLMB50051115111B1099-MISC Recipient Copy B1 Page Equals 2 FormsLM2LM250051125112B1099-MISC State and/or File Copy1 Page Equals 2 FormsLMBLLMBL50051085108B1099-MISC Blank With Backer Instructions Copy B1 Page Equals 2 FormsN/AN/A51595159B1099-MISC Blank With Copy B Backer With Stub1 Page Equals 2 Forms50s500s100s500sLM3LM350051145114B1099-MISC 3-Up Recipient Copy B and State or File Copy1 Page Equals 1 FormLM3BLLM3BL50051735173B1099-MISC Blank Copy B Backer1 Page Equals 1 Form8"