b"TABLE OF CONTENTS| or foreign postal code, and telephone no. $ 1 Nonemployee compensation Form1099-NEC Compensation1099 Pages 4-22 PAYERS TIN 7171 VOID CORRECTED OMB No. 1545-0116 NonemployeeDETACH BEFORE MAILING MANUFACTURED ON OCR LASER BOND PAPER USING HEAT RESISTANT INKSPAYERS name, street address, city or town, state or province, country, ZIP (Rev. April 2025)For calendar yearRECIPIENTS TIN Copy ARECIPIENTS name 2 Payer made direct sales totaling $5,000 or more ofFor Internal Revenue consumer products to recipient for resale Service CenterPrivacy Act, and Streamline your tax reporting with 1099 forms Street address (including apt. no.) 2nd TIN not. $ 3 Excess golden parachute payments $ 1 e 2aTaxableamount $ Paperwork Reduction Act2025 $ Form 1099-R 1 CORRECTED (if checked) 12 OMB No. 1545-0119 2025Notice, see the General Form 1099-R CORRECTED (if checked) OMB No. 1545-0119 Grossdistribution 2aTaxableamount Distributions From Pensions, 4 Federal income tax withheld Instructions for CertainAnnuities, Retirement or Distributions From Pensions, City or town, state or province, country, and ZIP or foreign postal code Grossdistribution Information Returns. Prot-Sharing Plans, IRAs, Account number (see instructions) $ 5 State tax withheld Taxabl 6 State/Payers state no. 7 State income Annuities, Retirement or2bTaxableamount $distribution Insurance Contracts, etc.Prot-Sharing Plans, IRAs, www.irs.gov/Form1099amount Total Insurance Contracts, etc.$ 2b notdetermined $distribution 12 requirement 13Date of payment notdetermined Total requirement 13Date of payment(Rev. 4-2025) 41-0852411 $ 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-NECwww.irs.gov/Form1099NEC Department of the Treasury - Internal Revenue ServiceDo Not Cut or Separate Forms on This PageDo Not Cut or Separate Forms on This Page RECIPIENT COPIES7171 VOID CORRECTED PAYERS TIN RECIPIENTS TIN PAYERS TIN RECIPIENTS TINPAYERS name, street address, city or town, state or province, country, ZIPOMB No. 1545-0116 Employecontributions/Designated box gainRothcontributionsorinsurancepremiumsor foreign postal code, and telephone no. $ 3 6 Capital in in t gain(included1099-NEC $7 4 incometaxwitheld $5Rothcontribution e sorinsurancepremiums $ 3 6 Capita in in t l 2a) (included $4 7 Federalincometaxwitheld $5Employeecontributions/Designatedbox2a) Form Federal code(s) NonemployeeNe employ Distributioncode(s) SIMPLE OtherNeemploy (Rev. April 2025) Compensation unrealizeersdsecuritiesappreciation SEP/unrealizeersdsecuritiesappreciation Distribution SIMPLE Other IRA/IRA/$ Yourpercentage For calendar year of 9bTotalemployee$8 contributions %$ 9aYourpercentageoftotaldistribution 9bTotalSEP/ employee$8 contributions %9a totaldistributionPAYERS TIN RECIPIENTS TIN 1 Nonemployee compensation %$ Copy A %$RECIPIENTS name $ 2 Payer made direct sales totaling $5,000 or more ofFor Internal RevenueRECIPIENT'S name, street address, city or town, state or province, country, and ZIP or foreign postal codeRECIPIENT'S name, street address, city or town, state or province, country, and ZIP or foreign postal codeconsumer products to recipient for resale Service CenterPrivacy Act, and b Street address (including apt. no.) 3 5 41-0852411 4 6 2nd TIN not. $ 3 Excess golden parachute payments b c $ 5 3Social security wages 1 $ Paperwork Reduction Act4 6 $ $ . $ Account number (see instructions) 15 11st year of desig. Roth contrib. $ 10 $ $ Amount allocable to IRR within 5 years Notice, see the General City or town, state or province, country, and ZIP or foreign postal code Copy 2To Be Filed With Employee's State, Instructions for Certain Copy BTo Be Filed With Employee's41-0852411 4 Federal income tax withheld 1st year of desig. Roth contrib.10Amount allocable to IRR within 5 years Account number (see instructions) Information Returns 41-0852411| d a e c FEDERAL Tax Return. 1Wages, tips, other comp. VOID 2 OMB No. 1545-0008$ d a e City, or Local Income Tax Return. 1A $ $ 1 e 1State/Payers state no.2Federal income tax withheld $ $ $ 1 14State tax withheld e 18 State/Payers state no. 12 16State distribution 8510 1 2743OMB No. 1545-0008Employee's soc. sec. no. s state no. www.irs.gov/Form1099W-2 Pages 23-32 Employee's soc. sec. no. Social security wages Federal income tax withheld $ 5 State tax withheld State tax withheld Wages, tips, other comp. $ 7 State income Department of the Treasury 17Local tax withheld 2a Name of Locality 19Local distribution14 6 State/Payer 15 16State distributionAccount number (see instructions) Employer ID number (EIN) Medicare wages and tips 19Local distribution Internal Revenue ServiceEmployer ID number (EIN) Medicare wages and tips Social security tax withheld $ 17Local tax withheld 18Name of Locality Social security tax withheld Copy 2 File this copy with your state, city, Department of the TreasuryForm1099-NEC(Rev. 4-2025) Medicare tax withheld Copy 2 File this copy with your state, city,Medicare tax withheld or local income tax return, when required. www.irs.gov/Form1099RInternal Revenue ServiceEmployer's name, address, and ZIP code www.irs.gov/Form1099NEC Department of the Treasury - Internal Revenue ServiceDo Not Cut or Separate Forms on This PageDo No or local income tax return, when required. www.irs.gov/Form1099REmployer's name, address, and ZIP code aget Cut or Separate Forms on This PForm 1099-R CORRECTED (if checked) OMB No. 1545-0119 2025 Form 1099-R CORRECTED (if checked) OMB No. 1545-0119 20257171 CORRECTED Grossdistribution 2aTaxableamount Distributions From Pensions,Grossdistribution Taxableamount Distributions From Pensions, Annuities, Retirement orAnnuities, Retirement or PAYERS name, street address, city or town, state or province, country, ZIPSuff. Control number determined OMB No. 1545-0116 12 Prot-Sharing Plans, IRAs,2bTaxablamount $distribution Prot-Sharing Plans, IRAs, Total Insurance Contracts, etc. Insurance Contracts, etc.Control number 2bTaxablamount $distribution requirement 13Date of payment notdetermined Total requirement 13Date of paymentS20or foreign postal code, and telephone no. not Form1099-NEC NonemployeeSuff. OMB No. 1545-0008 1 Department of the TreasuryInternal 2 Revenue ServiceEmployee's name, address, and ZIP code Employee's name, address, and ZIP code Department of the TreasuryInternal 2 Revenue ServicePAYER'S name, street address, city or town, state or province, country, ZIP or foreign postal code, and phone no.OMB No. 1545-0008 (Rev. April 2025) CompensationA Social security wages Social security income tax tax withheld withheld Wages, security tips, other wages compensation FederalPAYER'S name, street address, city or town, state or province, country, ZIP or foreign postal code, and phone no.1 Social security income tax tax withheld withheldWages, tips, other compensation FederalGet organized and IRS-compliant with W-2 forms 10 7Social security tips 14Other 181 Allocated tips plans RECIPIENTS TIN $ 1 Nonemployee compensation 3 in c l 14 For calendar year 3 4 incometaxwith1 12b 9 6 4 eld Medicare tax withheld h e insurancepremiums PAYERS TIN 3 in c l 3 5 Social 4Federalincometaxwith 6 4 eld Medicare tax withheld h e insurancepremiumsPAYERS TIN Social security tips Medicare wages and tips Copy A Medicare wages and tipsEmployers name,5address, and ZIP code 2aService CenterRECIPIENTS name 192aCodeSee inst. for box 12 170 PAYERS TIN 181 Allocated tips plans RECIPIENTS TIN Employers name, address, and ZIP code2 Payer made direct sales totaling $5,000 or more ofFor Internal Revenue 13Statutory employee 12bCode consumer products to recipient for resale Federal CodeRotcontributionsor Capita 2a) (included RECIPIENTS TIN5Rotcontributionsor RECIPIENT COPIESThird-party sick pay 16State wages, tips, etc. Code $ 158 Third-party sick payin box Dependent care benefits Nonqualified tips plans 12 SEP/ Code$5 Other GeneralSocial totaldistribution12c Allocated 9b SEP/ contributions13Statutory employee gain(included CodeEmployecontributions/Designated gain Employecontributions/DesignatedCapita 2a) Other Privacy Act, and 158 1 Retirement plan 19Local income tax 1 7 Code 2nd TIN not. $ 3 Excess golden parachute payments 1 $ $ 6 C e d o b 1 oftotaldistribution1 $7 C o d e 8Distribution % code(s) $ a $ Paperwork Reduction Act7 8 C C d d o e o e e 9 %$ $ 6 9a Ne in C e o d b 7 1 box tsecurity care tips benefits of $ 7 C d e o 8Distribution 1 % code(s) $ a Total IRA/ $ C C e o o d e d 9Other %Retirement plan Notice, see the Street address (including apt. no.) 122dc $ 9a Ne70tSocial security tips Allocated 9b Instructions for Certain . Your unrealizeersdsecuritiesappreciation Nonqualified tips plans SIMPLECity or town, state or province, country, and ZIP or foreign postal code 5 State tax withheld Your b unrealizeersdsecuritiesappreciation 16 121c Total 12dc IRA/ Code1 122da contributions 10 employ employee$812a12demploy SIMPLE4 Federal income tax withheld Information Returns DependentMW285employe$percentage www.irs.gov/Form1099 percentage6 State/Payers state no. 7 State incomeAccount number (see instructions) 20 1Locality name $ 12Employer identification number (EIN) $Employees social security number 2b Employer identification number (EIN) Employees social security numberState Employer's state ID number State income tax State Employer's state ID number 19Local income tax 20 1Locality name RECIPIENT'S name, street address, city or town, state or province, country, and ZIP or foreign postal codeLocal wages, tips, etc. Local wages, tips, etc. State wages, tips, etc. State income taxRECIPIENT'S name, street address, city or town, state or province, country, and ZIP or foreign postal codeForm1099-NEC(Rev. 4-2025) 41-0852411 NEC5110www.irs.gov/Form1099NEC em p Department of the Treasury - Internal Revenue Service 13Sme taptulotoeyrye Rlaetnirement p Third-party14Other13 sick pay 14OtherForm W-2 Wage and Tax Statement 2023 Dept. of the Treasury IRS Staptulotoyreye Rlaentirement Third-party 2023 Dept. of the Treasury IRS sick payThis information is being furnished to the Internal Revenue Service. www.irs.gov/ele Form W-2 Wage and Tax StatementEmployees name, address, and ZIP code1 Employees name, address, and ZIP code1Notice to Employee on the back of Copy B.)(See 1 2Federal income tax withheld a $ Account number (see instructions)e 1 15 1st year of desig. Roth contrib. 2 $ 10 $ $ Amount allocable to IRR within 5 years$ $ Account number (see instructions)e 15 1st year of desig. Roth contrib. $ 10 $ $ Amount allocable to IRR within 5 years Copy CFor EMPLOYEE'S RECORDS 41-0852411 Copy 2To Be Filed With Employee's State,$ 1641-0852411 14State tax withheld 18 State/Payers state no. 16State distribution14State tax withheld State/Payers state no. State distributionaEmployee's soc. sec. no. Wages, tips, other comp. OMB No. 1545-0008 City, or Local Income Tax Return. Name of Locality Federal income tax withheld 17Local tax withheld Name of Locality 19Local distributionEmployee's soc. sec. no. Wages, tips, other comp. OMB No. 1545-000817Local tax withheld 18 19Local distributionbEmployer ID number (EIN) 3 5 Social security wages 4 6 Social security tax withheld bEmployer ID number (EIN)is 15State 3 5 Employers state ID number to Service. 4 6 16State wages, tips, etc. Form 15StateEmployers state ID number 16State wages, tips, etc.Copy C For Recipients Records Department of the Treasury Copy B Report this income on your federal tax return. Department of the TreasuryForm Social security wages Revenue(keep for your records)Internal Revenue Service If this form shows federal income tax withheld Internal Revenue Serviceinformation Social security tax withheldc Medicare wages and tips Medicare tax withheld c This W-2 beingfurnished 17 theInternal 18 www.irs.gov/Form1099R W-2 in box 4, attach this copy to your return. 18 www.irs.gov/Form1099R(5175)Medicare wages and tips Medicare tax withheld 17State income tax Local wages, tips, etc.Employer's name, address, and ZIP code State income tax Local wages, tips, etc.560118Wage and Tax| d e 7 Employer's name, address, and ZIP code 8 9 Health Coverage . O G d e 7 Wage and Tax 1address, wages and ZIP code 19Local income tax 6 4 2 20 OMB No. 1545-2252 c Statementto If on 1 3Social security wages and code tips 19Local income tax 6 4 2 20Locality name Page 3 G OACA Pages 33-34 Form1095-B Allocated tips Go to www.irs.gov/Form1095B Form 1095-C (2024)c 2023 VOID Medicare Locality name 2023 Department of the TreasuryInternalRevenue ServiceStatementFoldHereDepartment of the Treasury Do not attach to your tax return. Keep for your records CORRECTED 2024 Copy 2 - To Be Filed With EmployeesInternal Revenue Servicefor instructions and the latest information Department of the TreasuryInternalRevenue Service State, City, or Local Income Tax Return. FederalwithheldCopy 2 - To Be Filed With EmployeesControl number Responsible Individual State, City, or Local Income Tax Return. Federal income tax withheld OMB No. 1545-0008 Wages, tips, other compensationPart I Control number 2 Social security number (SSN) or other TIN This information is the1Name of responsible individualFirst name, middle name, last name OMB No. 1545-0008 Wages, tips, other compensation3 Date of birth (if SSN or other TIN is not available) InternalRevenuebeing furnished requireda Social security income taxEmployee's name, address, and ZIP code 5City or townSuff. Employee's name, address, and ZIP code 7Country and ZIP or foreign postal code being furnished you filearea to taxtax withheld4 Street address (including apartment no.) This 6information Medicare Social security tax withheld tax withheldSuff. Service. negligence Medicare Medicare tax withheld 600320the InternalService. to is Social security wages and tips return, mayyoube if thisState or province3 penalty 8 Enter letter identifying Origin of the Health Coverage (see instructions for codes):9Reserved imposed or otheraddress, wages and ZIPRevenue sanctionyou failisto report it. andPart II Information About Certain Employer-Sponsored Coverage Part III(see instructions) 181 11 192aCodeDOB (if SSN or otherall 12 monthsJan Employers name,5 Mar Apr MayJune ncluding the employee. Oct Nov DecEmployers name,5 incometaxableCovered Individuals Social security tips Social security tips13 12 Street address (including room or suite no.) plans 12 2ba Code 13City or town 1031 (a) Name of covered individual(s)7 Allocated tips plans 8 (c) TIN is not available) 9 (d) Covered7Social Feb 8 (e) Months of coverage 10 10Employer name 1CodeSee inst. for box 12 If Employer provided self-insured coverage, check the box and enter the information for each individual enrolled in coverage, i July Aug SeptOther1 14Other (b) SSN or other TIN15Country and ZIP or foreign postal codeHealth coverage reporting and IRS compliance Statutory employee 14 1 122cd Code 20City or town 18 First name, middle initial, last name C e o d b C o e d 12c 1 Allocated a 12bc Code C C o e e o d d C e d o b 10 bsecurity care tips benefits C d o e 1 Allocated c a C C e o d e d o 1 1 92a d See instructions for box 12Statutory employee14State or provinceRetirement plan Issuer or Other Coverage Provider (see instructions) Social security care tips benefits Nonqualified tips plans18Contact telephone number Dependent Nonqualified tips plansPart III Retirement plan1017 Dependent 12Code12aSee instructions for box 1216Name Code 19 Third-party sick pay12b Employer identification number (EIN) 12dCode 12Employer identification number12(EIN) Employees social2security numberThird-party sick pay 21State or province 22Country and ZIP or foreign postal code19 Street address (including room or suite no.) Employees social12d security numberPart IVCovered Individuals (Enter the information for each covered individual.) 1 13Sme taptulotoeyryepleantirementR Local income tax 14Other 20 1Locality name 7 13 em Rlaetnirement p Third-party14Other16 Jan Feb Mar Apr MayJunJul Aug Sep Oct Nov Dec185 1 State Employer's state ID number 19Local income tax State income taxDOB (if SSN or other158 all 12 months 19 16Third-party(e) Months of coverageState income tax Staptulotoreyey sick pay State wages, tips, etc.(b) SSN or other TIN20 1Locality name7 Covered (a) Name of covered individual(s)(c)State Employer's state ID number State wages, tips, etc.Local wages, tips, etc.First name, middle initial, last nameTIN is not available) 20 (d)Local wages, tips, etc. sick payForm W-2 Wage and Tax Statement 2023 Dept. of the Treasury IRS 21Form W-2 Wage and Tax Statement e 2023 Dept. of the Treasury IRS eEmployees name, address, and ZIP codepenalty or other sanction may be imposed on you if this income is taxable and you fail to report it. L4UP Employees name, address, and ZIP code 520523222423 Form 15StateEmployers state ID number 16State wages, tips, etc. Form 15StateEmployers state ID number 16State wages, tips, etc.25 24 W-2 17State income tax 18Local wages, tips, etc. W-2 17State income tax 18Local wages, tips, etc.Wage and Tax Wage and Tax26 25 Statement 19Local income tax 20Locality name Statement 19Local income tax 20Locality name27 2023 202326 Copy B - ToFEDERALBe Filed With Tax Return. CopyNotice Employee on the RECORDS back of Copy B.)Employees (See C - For to EMPLOYEES| 28 27 41-0852411SOFTWARE Page 35 RAA #1607For Privacy Act and Paperwork Reduction Act Notice, see separate instructions. 41-0852411 1095B Form 1095-B (2024) 1095CIRSC Form 1095-C (2024)DDoowwnnloloaadd y yoouurrsoftware now2829Ready to file in 3 easy steps30RAA #1607Download yoursoftware nowTax software for small to large businesses Ready to file in 3 easy steps1:DOWNLOAD Download tDhowe snolfotawd tare fhe sroom wftwawrwe f.cromom oplyurr wighettbasxisteo.ftware.comWhen prompted, enter access code below:8X74X2XDXLX2X5XX3X5X9X1 X1:DOWNLOAD Download the software from our website.When prompted, enter access code below:| Department of the TreasuryGo to www.irs.gov/Form1042S for instructions and the latest information. AMENDMENT NO. XXMISCELLANEOUS Page 36 Form1042-S Foreign Persons U.S. Source Income Subject to Withholding . . 2025 OMB No. 1545-0096 XX XXXX XXXXInternal Revenue Service UNIQUE FORM IDENTIFIER AMENDED Copy AforInternal Revenue Service1 Income 2Gross income 3 Chapter indicator.Enter 3 or 4 2:ENTER DATA code 3a Exemption code 4aExemption code 13dCity or town, state or province, country, ZIP or foreign postal codeEnter dr data by following on-screen instructions and guides. 3b Tax rate 4b Tax rate 13eRecipients U.S. TIN, if any 13fCh. 3 status code6Net income Recipients13g Ch. 4 status code5Withholding allowance 13hRecipients GIIN13i number, if any 13jLOB code 7aFederal tax withheld7b Check if federal tax withheld was not deposited with the IRS because 3232 VOIDCORRECTED 2Date won OMB No. 1545-0238escrow procedures were applied (see instructions)13kRecipients account numberPAYERS name, street address, city or town, state or province, country, 1Reportable winnings DETACH BEFORE MAILING12034IMANUFACTURED ON OCR LASER BOND PAPER USING HEAT RESISTANT INKSReporting for non-resident alien income, gambling winnings8 7c Check if withholding occurred in subsequent year with respect to a 14aT and ZIP or foreign postal code 2:E $ N 7 TER DATA $ 4Federal income tax withheld Form W-2Gpartnership interest13lRecipients date of birth (YYYYMMDD) 3Type of wager uctions and guide Certain 7d partnership, or withholding foreign trust revising its reporting on FormEnter data by following on-screen instr 6Race Gambling s. Winnings3:PRIN Primary withholding agents name (if applicable) 5Transaction (Rev. December 2023)14bor EFILE15Check if pro-rata basis reporting$ 9Winnings from identical wagers 8Cashier For calendar year9Tax withheld by other agentsns available for an additional fee.and new employee documentation Overwithheld tax repaid to recipient pursuant to adjustment procedures (see instructions) tio Primary withholding agents EIN 15b Ch. 3 status code15c Ch. 4 status code 11 WINNERS TIN 10Window 20Print or efile your data. Efile op 15aPAYERS TIN PAYERS telephone no.()10Total withholding credit (combine boxes 7a, 8, and 9)For Privacy Act 12aWithholding agents EIN 12bCh. 3 status code12cQuestions? 12 Reduction Act 11Tax paid by withholding agent (amounts not withheld) (see instructions) 15d and Paperwork 15eWINNERS name Notice, see theCh. 4 status code current General Email our suppEm 15fCountry code 15g mcustsupp.com 3:PRINT or EFILEInstructions forau spuoprpt oter Returns.12dWithholding agents name orati lt eoaumr stp ta@ 13 14State winnings Certain Information Street address (including apt. no.)12e Print or efile your data. Efile options available for an additiona $ l fee.15hAddress (number and street)equirem City or town,state or province, country, and ZIP or foreign postal code12fCountry code 12g1 System R 15iCity or town, state or province, country, ZIP or foreign postal code $ 15State income tax withheld $ 16Local winnings File with Form 1096ents:Win dfdfoorw es-ufition or higher, in z processor orpor l gher, im4mGizBe dR f e116bPayers TIN Questions? 18Name of locality Copy A A12hAddress (number and street) liin0g a),n 6d0 0u0p M, 2BGofH tdeirsnk e es16aPayers name hiyg p 16dAoMr-fior2 h 0igx1h10er8r8 017Local income tax withheld For Internal Revenue sc(r8eGenB resolpccee, sdsi sf la u odpattes andf I o 9 to16e Ch. 4 status code and$ belief, the name, address, and taxpayernumber that IService Centert aac r y e ling process.16cPayers GIIN Ch. 3 status codeWorks with most Windows compatible printers (laser printers are recommended).12iCity or town, state or province, country, ZIP or foreign postal code 17a Under. 17bperjury, declare that, 17cbest ofEmail our support team have furnished 13aRecipients name Admin rights required of Payers state tax no. the Name of stateknowledgeDate: State income tax withheldpenaltiesmy 13bRecipients country code 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.Signature:13cAddress (number and street) FormW-2G(Rev. 12-2023)10 and u 41-0852411 sH www.irs.gov/FormW2G er, 4GB RAM or higher Windows p, 2S Gpr Roeceqsusiorre more hnigtshNo more CD-ROM, our tax software is fully downloadadbley. tezm : Department of the Treasury - Internal Revenue Service| Do Not Cut or Separate Forms on This PageDo Not Cut or Separate Forms on This Page able. ENVELOPES & FOLDERSPages 37-43 For Privacy Act and Paperwork Reduction Act Notice, see instructions. (8GB for elu-fitliiong )o(2025) f tdeirsnke stp aacccee, sdsi sfporla uy podpatitmesiz aendd f oer-fi 1l9in2g0 px1ro0c8e0s s. $ $5320 Form1042-S Mscreen reso n , r6 0h0igheBr,oinWorks with most Windows compatible printers (laser printers are recommended).3232 VOIDCORRECTED 2Date won OMB No. 1545-0238and ZIP or foreign postal code Admin rights required. Form W-2GPAYERS name, street address, city or town, state or province, country, 1Reportable winningsCertain No more CD-ROM, our tax software is fully downlo Gambling 3Type of wager 4Federal income tax withheld ad5Transaction 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 WINNERS name 12 Reduction Act 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 withheld $ 16Local winningsFile with Form 1096$ 17Local income tax withheld $ 18Name of locality Copy A For Internal Revenue Under penalties of perjury, I declare that, to the best of my knowledge and$ belief, the name, address, and taxpayernumber that IService Centerhave furnished 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.Signature:Date: FormW-2G(Rev. 12-2023) 5230 LW2GA 41-0852411 www.irs.gov/FormW2G Department of the Treasury - Internal Revenue ServiceBUSINESS GUIDE | Pages 44-46State Filling requirements, customer service and other general information.E-FILE | Pages 47-48Convenient electronic solutions for customers"