b"1099 PRE-PRINTED & BLANK FORMS 1099 PRE-PRINTED & BLANK FORMSIndividual Laser Packs Individual Laser Packs1099-NEC 1099-MISCCORRECTED (if checked) OMB No. 1545-0116 9595 VOID CORRECTED OMB No. 1545-0115 MiscellaneousAPEX LMA PAYER'S name, stretadres,city CORRECTED(ifchecked) postal code$ 31Rents $ 4 2 Royalties OMBNo.1545-01157171 VOID CORRECTED OMB No. 1545-0116 APEX NECLMA or foreign postal code, and telephone no. Form NonemployeeAPEX NECLM3 PAYERS name, street address, city or town, state or province, country, ZIP$ 1 Rents Form1099-MISC Information or town, state or province,country, and ZIP or foreign $ 5Other income proceeds $ 6Federal income tax withheldForm1099-MISC APEX LM3 DETACH BEFORE MAILINGDETACH BEFORE MAILINGON OCR LASER BOND PAPER USING HEAT RESISTANT INKSPAYERS name, street address, city or town, state or province, country, ZIPor foreign postal code, and telephone no. (Rev. January 2022) ON OCR LASER BOND PAPER USING HEAT RESISTANT INKSMANUFACTUREDDETACH BEFORE MAILINGor foreign postal code, and telephone no. Form1099-NEC Nonemployee 1099-NEC Compensation $ 2 Royalties (Rev. January 2022) TFP 5110 $ 7 Fishingboat $ 8Medical and health care payments For calendar year PAYERS name, street address, city or town, state or province, country, ZIP20(Rev. January 2022) Compensation TFP NEC5110 PAYERS TIN RECIPIENTS TIN 1 Nonemployee compensation (Rev. January 2022) Copy B TFP NEC5114 PAYERS TIN RECIPIENTS TIN $ 3 Other income $ For calendar yearCopy A PAYERS TIN RECIPIENTS TIN 9Payer made direct sales $ Substitute payments in lieu of Miscellaneousis is TFP 5114InformationRECIPIENTS name 3 For calendar year Service Center RECIPIENT'S name, stret adres, city or town, state or province, country, and ZIP or foreign postal code For calendar year information and is beingRECIPIENTS name $ 5 Fishing boat proceeds $ 4 Federal income tax withheld ForAccount number (see instructions) t , stateorprovince, 13requirement postal code $ 14consumer products to $ 12dividends or interest a has Thisimportant if taxof $5,000 or more of6 Medical and health careInternal Revenuerecipient for resale10 Gross proceeds paid to aninformation toPAYERS TIN RECIPIENTS TIN 1 Nonemployee compensation Copy A $ 2 Payer made direct sales totaling $5,000 or more ofFor Recipient payments Service Center RECIPIENT'S name,streadrescityor town, country,andZIP or foreign Crop insurance proceeds attorney other beingfurnishedandareor$ 2 Payer made direct sales totaling $5,000 or more ofFor Internal Revenue3 consumer products to recipient for resale This is important tax7 Payer made direct sales8 of dividends or interest File with Form 1096. $ 11 Fish purchased for resale $ 15Section 409A deferrals requiredthe IRS.Ifayoureturn, APEX LM3BLconsumer products to recipient for resale File with Form 1096. furnished to the IRS. If you aretotaling $5,000 or more ofSubstitute payments in lieuFor Privacy ActExcess golden parachute compensation negligenceto penalty thatIRS sanction youmayandthisbeimposed isontaxableStreet address (including apt. no.) $ 4 Federal income tax withheld For Privacy Act and$ 4 Federal income tax withheld negligence penalty or otherAPEX NECLM3BL Street address (including apt. no.) $ consumer products to$ 10 Gross proceeds paid to anand PaperworkForm (Rev. 1-2022) (Keep $ $ $ 16payments withheld $ 17 State/Payers state number $ $ - income beenreported.Paperwork Reduction Actsanction may be imposed onrecipient for resale Statetax 18 ittheState incomenotdeterminesCity or town, state or province, country, and ZIP or foreign postal code Notice, see the5 State tax withheld 6 State/Payers state no. you if this income is taxableCity or town, state or province, country, and ZIP or foreign postal code 9 Crop insurance proceeds $ attorney Reduction Act Instructions forcurrenthas not been reported. current General Account number (see instructions) 2nd TIN not.$ 5 State tax withheld 6 State/Payers state no. $ GeneralCertain InformationReturns. Account number (see instructions) $ $ and the IRS determines that it11 Fish purchased for resale 12 Section 409A deferrals Notice, see the foryourrecords.) DepartmentoftheTreasuryInternalRevenueService TFP 5173 DETACH BEFORE MAILINGMANUFACTURED ON OCR LASER BOND PAPER USING HEAT RESISTANT INKSMANUFACTUREDForm1099-NEC(Rev. 1-2022) 41-0852411 $ $ 7 State income Form1099-NEC(Rev. 1-2022) (keep for your records) $ $ 7 State income or foreign postal code, and telephone no. $ payments CORRECTED (if checked) Instructions forCertainMiscellaneousAPEX LMB VOID tadres,city CORRECTED(ifchecked) postal code$ 31Rents $ 4 2 Royalties OMBNo.1545-0115Do Not Cut or Separate Forms on This PageDo Not Cut CORRECTED (if checked) TFP NEC5173 13 requirement 14 Excess golden parachute$ 15 compensation InformationReturns. www.irs.gov/Form1099NEC Department of the Treasury - Internal Revenue Service APEX NECLMB www.irs.gov/Form1099NEC Department of the Treasury - Internal Revenue Service Account number (see instructions) PAYERS name, street address, city or town, state or province, country, ZIP$ 1 Rents OMB No. 1545-0115 Information PAYER'S name, stre or town, state or province,country, and ZIP or foreign Other income Federal income tax withheldForm1099-MISC DETACH BEFORE MAILINGMANUFACTURED ON OCR LASER BOND PAPER USING HEAT RESISTANT INKS or Separate Forms on This Page Form1099-MISC7171 PAYERS name, street address, city or town, state or province, country, ZIPOMB No. 1545-0116 NonemployeeVOID CORRECTED OMB No. 1545-0116 2nd TIN not. $ 16 State tax withheld $ $ 2 Royalties $ (Rev. January 2022) Copy B TFP 5111 $ 5 Fishingboatproceeds $ 6 Medical and health care payments (Rev. January 2022) MANUFACTURED ON OCR LASER BOND PAPER USING HEAT RESISTANT INKSDETACH BEFORE MAILINGor foreign postal code, and telephone no. OMB No. 1545-0116 Form1099-NEC Compensation or foreign postal code, and telephone no. Form1099-MISC(Rev. 1-2022)41-0852411 $ 17 State/Payers state no. $ 18 State income For Recipient $ 7Payer made direct sales $ 8 Substitute payments in lieu of For calendar year For calendar year or foreign postal code, and telephone no. VOID CORRECTED Form1099-NEC (Rev. January 2022) TFP NEC5111 PAYERS name, street address, city or town, state or province, country, ZIPForm1099-NEC NonemployeePAYERS TIN $ $ 3 Other income $ 4 Federal income tax withheld PAYERS TIN RECIPIENTS TIN of $5,000 or more of dividends or interest 20PAYERS name, street address, city or town, state or province, country, ZIPMiscellaneous For calendar year www.irs.gov/Form1099MISC Department of the Treasury - Internal Revenue Service InformationNonemployeeDo Not Cut or Separate Forms on This PageDo Not Cut or Separate Forms on This Page consumer products toRECIPIENTS TIN 5 Fishing boat proceeds 6 Medical and health care PAYERS TIN t adres RECIPIENTS TIN (Rev. January 2022) Compensation Copy B PAYERS TIN RECIPIENTS TIN 1 Nonemployee compensation (Rev. January 2022) Compensation 9595 RECIPIENT'S name, stret adres, city or town, state or province, country, and ZIP or foreign postal code7totaling $5,000 or more ofpayments This is important taxAccount number (see instructions) t , stateorprovince, 13requirement 2nd TIN not. $ 9recipient for resale$ 10 Gross proceeds paid to anFor PaperworkAct1 Nonemployee compensationRECIPIENT'S name, stre 1 Nonemployee compensation For calendar year Copy A For Recipient RECIPIENT'Sname,stretadres,cityortown,stateorprovince,country,andZIPorforeignpostalcode For calendar year Copy C or foreign postal code, and telephone no. VOID CORRECTED Form$ Payer made direct sales$ 8 Substitute payments in lieuinformation and isRECIPIENT'S name,streadrescityor town, country,andZIP or foreignpostal code $ 14Crop insurance proceeds $ 12attorney andPrivacy Act$ This is important tax PAYERS TIN RECIPIENTS TIN , city or town, state or province, country, and ZIP or foreign postal code 2 Payer made direct sales totaling $5,000 or more ofinformation and is being2 Payer made direct sales totaling $5,000 or more ofor State Copy PAYERS name, street address, city or town, state or province, country, ZIP$ 1 Rents OMB No. 1545-0115 $ of dividends or interest being furnished to$ 11 Fish purchased for resale $ Section 409A deferrals 18Notice,Generalconsumer products to recipient for resale ReductionseetheRECIPIENTS name $ 2 consumer products to recipient for resale For Internal Revenuefurnished to the IRS. If you are$ consumer products to recipient for resale For Payer 2 Royalties consumer products toMiscellaneousthe IRS. If you are16Excess golden parachute $ 15 compensation current forStreet address (including apt. no.) $ Payer made direct sales totaling $5,000 or more of 3 5 State tax withheld $ General Service Center $ sanction may be imposed onAccount number (see instructions) 2nd TIN not. $ 4 Federal income tax withheld $ or Copy 2 PAYERS TIN RECIPIENTS TIN $ 3 Other income 13 $ $ recipient for resale $ 10 Gross proceeds paid to anreturn, a negligenceMiscellaneousForm VOID tadres, (Rev. 1-2022) (ifchecked) postal code $ $ $ 31 payments withheld $ 17 State/Payers state number 4 $ $ -Internal InstructionsFile with Form 1096. negligence penalty or other3 For Privacy Act and1099-MISC Information penalty or otherStatetax CertainInformation9 Crop insurance proceeds attorney State income Returns.City or town, state or province, country, and ZIP or foreign postal codeAccount number (see instructions) 3 4 Federal income tax withheld $ 4 Federal income tax withheld Returns. $ you if this income is taxablePaperwork Reduction$ 5 Fishing boat proceeds requirement (Rev. January 2022) $ 12 Section 409A deferrals sanction may beAPEX LMCLM2For Privacy Act and currenthas not been reported. Act Notice, see the or foreign postal code, and telephone no. 11 Fish purchased for resale Copy A imposed on you ifDepartmentoftheTreasury RevenueServicePaperwork Reduction Actand the IRS determines that itFor calendar year Notice, see the7 State income current GeneralVOID CORRECTED OMB No. 1545-0115Form1099-NEC(Rev. 1-2022) Form1099-NEC(Rev. 1-2022)$$ 5 State tax withheld 6 State/Payers state no. $ 6 State/Payer OMB No. 1545-0116 Form1099-NEC(Rev. 1-2022) $ 5 State tax withheld 6 State/Payers state no. $ 7 State income RECIPIENTS name Account number (see instructions) $ 7 Payer made direct sales$ 4 Federal income tax withheld $ $ 1 Rents For$ taxable and the IRSInformation PAYER'S name, stre city CORRECTED country, and ZIP or foreign Rents Contains 1099 MISC 1545-0115 Instructions fors state no.$ Certain Information Instructions for Certain PAYERS name, street address, city or town, state or province, country, ZIPthis income is www.irs.gov/Form1099NEC Information Returns.$ 14 Excess golden parachuteService Center Form has not beenThis panel DETACH BEFORE MAILINGMANUFACTURED ON OCR LASER BOND PAPER USING HEAT RESISTANT INKSAccount number (see instructions) 41-0852411 2nd TIN not. PAYER (keep for your records) $ VOID 7 State incomeDepartment of the Treasury - Internal Revenue Service APEX NECLMCLM2 $ Department of the Treasury - Internal Revenue Service Street address (including apt. no.) totaling $5,000 or more of$ 6 Medical and health care15 compensation $ determines that itor or Copy C 2 TFP 5112 or town, state or province, $ 57 Other income proceeds $ 2 Royalties OMBNo. 20payments Internal Revenue1099-MISCwww.irs.gov/Form1099NEC CORRECTED (if checked) CORRECTED Form1099-NEC Nonemployeewww.irs.gov/Form1099NEC Form1099-MISC(Rev. 1-2022) (keep for your records) $ payments $ 2 Royalties $ 20 reported. For Payer Fishingboat 6Copy C Backer 1099-MISC(Rev. January 2022)S name, street address, city or town, state or province, country, ZIPSubstitute payments in lieu17 State/Payers state no. For calendar year(Rev. January 2022)Department of the Treasury - Internal Revenue Service $ 16 State tax withheld File with Form 1096. 18 State income Federal income tax withheldFormFor calendar yearMANUFACTURED ON OCR LASER BOND PAPER USING HEAT RESISTANT INKSDo Not Cut or Separate Forms on This PageDo Not Cut or Separate Forms on This Page consumer products to8 of dividends or interest For Privacy Act4 Federal income tax withheld7171 VOID or foreign postal code, and telephone no. Form1099-NEC (Rev. January 2022) VOID CORRECTED City or town, state or province, country, and ZIP or foreign postal code $ recipient for resale $ $ www.irs.gov/Form1099MISC and Paperwork$ 6 Medical and health careStateCopy PAYERS TIN RECIPIENTS TIN $ Payer made direct sales $ 8Information Miscellaneous 3 Other incomePAYERS name, street address, city or town, state or province, country, ZIPt , or or1099-NEC andZIPorforeignpostalcode OMB No. 1545-0116 NonemployeeCompensation TFP NEC5112 PAYERS name, street address, city or town, state or province, country, ZIPOMB No. 1545-0116 Compensation 13 requirement PAYERS TIN t adres $ 10 Gross proceeds paid to anReduction Act$ payments Copy Account number (see instructions) t , stateorprovince, 13requirement 2nd TIN not. $ 9of $5,000 or more of $ 12Medical and health care payments InformationRECIPIENTS TIN $ 5 Fishing boat proceedsDepartment of the Treasury - Internal Revenue Serviceor foreign postal code, and telephone no. OMB No. 1545-0116 (Rev. January 2022) For calendar year Copy 1 or Copy 2 or foreign postal code, and telephone no. For calendar year or foreign postal code, and telephone no. $ 9 Crop insurance proceeds attorney Notice, see the Substitute payments in lieu For Privacy ActRECIPIENT'S name,streadrescityor town, country,andZIP or foreignpostal code consumer products to $ Substitute payments in lieu ofCORRECTED current GeneralPAYERS name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no. PAYERS TIN streadrescitytown, FormRECIPIENTS TIN NonemployeeCompensation Copy C Form1099-NEC Nonemployee11 Fish purchased for resale 12 Section 409A deferrals Instructions forCertain8 of dividends or interest and Paperworkrecipient for resaledividends or interest1 Nonemployee compensation PAYERS name, street address, city or town, state or province, country, ZIP1 Rents $ 7totaling $5,000 or more ofattorneyRECIPIENT'Sname, S TIN (Rev. January 2022) For calendar year Copy B For Payer (Rev. January 2022) RECIPIENT'S name, stre , city or town, state or province, country, and ZIP or foreign postal code Information 10 Gross proceeds paid to anReduction ActCrop insurance proceeds 10 Gross proceeds paid to an PAYERS TIN RECIPIENT stateprovince,country, Compensation and/or State CORRECTED (if checked) Returns. $ Payer made direct sales PAYERS TIN RECIPIENTS TINt adres $ 1 Nonemployee compensation For calendar year $ 2 Payer made direct sales totaling $5,000 or more ofPaperwork Reduction PAYERS TIN stretadres,cityortown,stateor RECIPIENTS TIN ZIPorforeignpostalcode $ 1 Nonemployee compensationState Copy Account number (see instructions) 2nd TIN not. $ 14 Excess golden parachute$ 15 compensation 13 $ OMB No. 1545-0115 MiscellaneousNotice, see theLM3 $ $ $ 11 Fish purchased for resale $ 15Section 409A deferrals $ $ 18- State income ServiceRECIPIENT'S name, stre , city or town, state or province, country, and ZIP or foreign postal code 1 Nonemployee compensation consumer products to recipient for resale For Privacy Act andpayments $ 2 Royalties Form$ 9consumer products toInformation current General 14 Excess golden parachute compensationrecipient for resale$ 2 Payer made direct sales totaling $5,000 or more of 3 Copy A For Recipient current General $ 16 State tax withheld 17 State/Payers state no. 1099-MISC $ attorney Instructions for $ 16payments withheld $ 17 State/Payers state numberCrop insurance proceedsRECIPIENTS name 2 Payer made direct sales totaling $5,000 or more of 3 consumer products to recipient for resale information and is beingAct Notice, see the RECIPIENT'Sname, province,country,and 2 Payer made direct sales totaling $5,000 or more ofForm(Rev. 1-2022)LMA 41-0852411 5110 $ $ 3 Other income $ $ (Rev. January 2022) $ 12 Section 409A deferrals Certain APEX LMBL StatetaxThis is important tax For Internal Revenuefurnished to the IRS. If you are18 State incomeAccount number (see instructions) $ $ 4 Federal income tax withheld negligence penalty or other$ Instructions for Certain 3 consumer products to recipient for resaleor Extra 1099-MISCPAYERS TIN www.irs.gov/Form1099MISC $ 5 Fishing boat proceeds requirement For calendar yearCopy B Information Form (Rev. 1-2022)Service Center Information Returns. 11 Fish purchased for resale Returns.Street address (including apt. no.) 3 consumer products to recipient for resale4 Federal income tax withheld2nd TIN not. 5 State tax withheld sanction may be imposed on7 State incomeFile Copy RECIPIENTS TIN 4 Federal income tax withheld For Recipient 5114 DepartmentoftheTreasuryInternalRevenueFile with Form 1096. 6 State/Payers state no. Department of the Treasury - Internal Revenue ServiceAccount number (see instructions) Form1099-NEC(Rev. 1-2022) $ (keep for your records) www.irs.gov/Form1099NEC For Privacy Act andyou if this income is taxable$ 4 Federal income tax withheld 7 State income RECIPIENT'S name, stret adres Account number (see instructions) $ 2nd TIN not. $ 14 Excess golden parachute$ 15 compensation $ 18 State incomePaperwork Reduction Actand the IRS determines that it6 Medical and health care City or town, state or province, country, and ZIP or foreign postal codeAccount number (see instructions)Form41099-NEC6 State/Payer $ 5 State tax withheldwww.irs.gov/Form1099NEC7 State income s state no. $ has not been reported. $ , city or town, state or province, country, and ZIP or foreign postal code7 totaling $5,000 or more of$ $ payments 17 State/Payers state no. $ TFP 5108Notice, see the currentDepartment of the Treasury - Internal Revenue Service payments2nd TIN not. $ Federal income tax withheld(Rev. 1-2022) $s state no. $ GeneralCertain Information $ 7 State income APEX NECLMBL 5 State tax withheld 6 State/Payers state no. Payer made direct sales$ 16 State tax withheld This is important tax $ Instructions for6 State/PayerReturns.5 State tax withheld Substitute payments in lieu Department of the Treasury - Internal Revenue Service 8 of dividends or interest information and is $Form1099-NEC(Rev. 1-2022)NECLMA41-0852411NEC5110 $ VOID $ CORRECTED OMB No. 1545-0116 NonemployeeAccount number (see instructions) NECLM3 2nd TIN not.$ NEC5114 $ Form1099-MISC(Rev. 1-2022) $ consumer products to$ 10 Gross proceeds paid to anbeing furnished to www.irs.gov/Form1099MISC Department of the Treasury - Internal Revenue Servicewww.irs.gov/Form1099NEC Department of the Treasury - Internal Revenue Service Form Form1099-NEC(Rev. 1-2022) $ $ 9 recipient for resale $ attorney Front BlankPAYERS name, street address, city or town, state or province, country, ZIPOMB No. 1545-01161099-NEC TFP NEC5108 www.irs.gov/Form1099NEC Department of the Treasury - Internal Revenue Service Crop insurance proceeds 12 Section 409A deferrals the IRS. If you are or foreign postal code, and telephone no. return, a negligence CORRECTED (if checked) 11 Fish purchased for resale penalty or other PAYERS name, street address, city or town, state or province, country, ZIP(Rev. January 2022) Compensation VOID CORRECTED sanction may be or foreign postal code, and telephone no. Form1099-NEC NonemployeePAYERS name, street address, city or town, state or province, country, ZIP1 Rents with W-2 Instructions imposed on you if PAYERS TIN RECIPIENTS TIN For calendar year For calendar year Copy C or foreign postal code, and telephone no. $ 14 Excess golden parachute$ 15compensation this income isMiscellaneousLM3BL 5173OMB No. 1545-0115taxable and the IRS (Rev. January 2022) Compensation 13 requirement payments $ 2 Royalties determines that itInformation1 Nonemployee compensation Account number (see instructions) $ 16 State tax withheld $ 17 State/Payers state no. Form1099-MISChas not been PAYERS TIN RECIPIENT'Sname,stretadres,cityortown,stateorprovince,country,andZIPorforeignpostalcode 2 Payer made direct sales totaling $5,000 or more ofand/or State $ $ 3 Other income $ 20 reported. Copy C TFP 5159(Rev. January 2022)RECIPIENT'S name, stret adres RECIPIENTS TIN $ 1 Nonemployee compensation $ consumer products to recipient for resale For Payer Form1099-MISC(Rev. 1-2022)LMB(keep for your records)5111 $ www.irs.gov/Form1099MISC $ 5 Fishing boat proceeds $ on back side. or For PayerFor calendar year 18 State incomeCopy B Copy 1 or Copy 2 4 Federal income tax withheld, city or town, state or province, country, and ZIP or foreign postal code 2 Payer made direct sales totaling $5,000 or more ofFor Recipient Paperwork ReductionPAYERS TIN RECIPIENTS TIN $ 6 Medical and health careStateCopy23 consumer products to recipient for resale3 4 Federal income tax withheld information and is beingFor Privacy Act andNEC5144M Department of the Treasury - Internal Revenue Service orCopy Required Envelope:This is important tax furnished to the IRS. If you areAct Notice, see thepaymentscurrent General$ sanction may be imposed onInstructions for CertainRECIPIENT'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 For Privacy Act negligence penalty or otherInformation Returns.Account number (see instructions) $ 4 Federal income tax withheld $ 5 State tax withheld 6 State/Payers state no. $ 7 State income TFP NEC5159 Payer made direct sales$ of dividends or interest and Paperwork you if this income is taxable Account number (see instructions)Form1099-NEC(Rev. 1-2022) $ 5 State tax withheld 2nd TIN not. $ s state no. $ and the IRS determines that it$ consumer products to10 Gross proceeds paid to anFront Blank APEX: DWM3has not been reported.6 State/Payer 7 State income recipient for resale Reduction Act www.irs.gov/Form1099NEC Department of the Treasury - Internal Revenue Service 9 Crop insurance proceeds attorney Notice, see the Form1099-NEC(Rev. 1-2022)NECLMB(keep for your records) $ www.irs.gov/Form1099NEC $ Required Envelope: $ 11 Fish purchased for resale $ 12 Section 409A deferrals current GeneralDETACH BEFORE MAILINGMANUFACTURED ON OCR LASER BOND PAPER USING HEAT RESISTANT INKSNEC5111 Department of the Treasury - Internal Revenue Service Instructions forCertainVOID CORRECTED OMB No. 1545-0116 13 requirement $ 14 Excess golden parachute$ 15 compensation with W-2 InstructionsTFP: 52521InformationPAYERS name, street address, city or town, state or province, country, ZIPReturns. or foreign postal code, and telephone no. Form1099-NEC NonemployeeAPEX: DWM3 Account number (see instructions) 2nd TIN not. $ payments $ 17 State/Payers state no. on back side.(Rev. January 2022) CompensationFront Blank $ 16 State tax withheld $ 18 State incomePAYERS TIN stretadres,cityortown,stateor RECIPIENTS TIN ZIPorforeignpostalcode $ 1 Nonemployee compensation For calendar year Copy C Form1099-MISC(Rev. 1-2022) LMC/LM2 $ 5112 $ or foreign postal code, and telephone no. CORRECTED (if checked) OMB No. 1545-0115 MiscellaneousAPEX LMB2RECIPIENT'Sname, province,country,and 2 Payer made direct sales totaling $5,000 or more ofFor Payer TFP: 52521 www.irs.gov/Form1099MISC Department of the Treasury - Internal Revenue Service PAYERS name, street address, city or town, state or province, country, ZIP$ 1 Rents Form1099-MISC DETACH BEFORE MAILINGMANUFACTURED ON OCR LASER BOND PAPER USING HEAT RESISTANT INKSwith W-2 Instructions and/or State 2 Royalties (Rev. January 2022) Informationconsumer products to recipient for resale Copy 1 or Copy 23 For Privacy Act andFor calendar year 4 Federal income tax withheld Paperwork ReductionTHIS PANEL CONTAINS $ 3 Other income 20 Copy BAct Notice, see the current General $ 5 State tax withheld on back side. Instructions for Certain PAYERS TIN RECIPIENTS TIN $ 5 Fishing boat proceeds $ 4 Federal income tax withheld For RecipientInformation Returns. Account number (see instructions) 2nd TIN not.$ 6 State/Payers state no. $ 7 State income 1099MISC COPY B BACKER INFORMATION 6 Medical and health care payments$ $1099-NECForm1099-NEC(Rev. 1-2022)NECLMC NEC5112www.irs.gov/Form1099NEC Department of the Treasury - Internal Revenue Service 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 ofThis is important tax Payer made direct salesdividends or interest information and is consumer products to$ 10 Gross proceeds paid to anbeing furnished to recipient for resale attorney the IRS. If you are 9 Crop insurance proceedsCORRECTED (if checked) OMB No. 1545-0116 APEX NECLMB2 $ 11 Fish purchased for resale $ 12 Section 409A deferrals return, a negligence penalty or other sanction may be imposed on you if PAYERS name, street address, city or town, state or province, country, ZIPthis income isDETACH BEFORE MAILINGMANUFACTURED ON OCR LASER BOND PAPER USING HEAT RESISTANT INKSor foreign postal code, and telephone no. Form1099-NEC Nonemployee13 requirement $ 14 Excess golden parachute$ 15compensation taxable and the IRS payments determines that it has not been (Rev. January 2022) Compensation THIS PANEL CONTAINS Account number (see instructions) $ 16 State tax withheld $ 17 State/Payers state no. $ reported. Do Not Staple 6969 OMB No. 1545-0108 APEX L1096For calendar year $ 18 State incomePAYERS TIN t adres RECIPIENTS TIN $ 1 Nonemployee compensation Copy B Form1099-MISC(Rev. 1-2022) (keep for your records) $ www.irs.gov/Form1099MISC $ Form1096 Annual Summary and Transmittal of 2023 DETACH BEFORE MAILING MANUFACTURED ON OCR LASER BOND PAPER USING HEAT RESISTANT INKSRECIPIENT'S name, stre , city or town, state or province, country, and ZIP or foreign postal code 2 Payer made direct sales totaling $5,000 or more of3 For Recipient COPY B BACKER INFORMATION Department of the Treasury - Internal Revenue Service Department of the TreasuryU.S. Information Returns TFP 5100This is important taxInternal Revenue Serviceconsumer products to recipient for resale information and is beingFILERS namefurnished to the IRS. If you are negligence penalty or other NECLMBL NEC5108 4 Federal income tax withheld sanction may be imposed onor foreign postal code, and telephone no. CORRECTED (if checked) OMB No. 1545-0115 MiscellaneousStreet address (including room or suite number)you if this income is taxablePAYERS name, street address, city or town, state or province, country, ZIP1 Rents$ and the IRS determines that it$ 2 Royalties Form1099-MISC Information City or town, state or province, country, and ZIP or foreign postal codehas not been reported.5 State tax withheld 6 State/Payers state no. 7 State income (Rev. January 2022)Account number (see instructions) $ $ For calendar yearFor Ofcial Use OnlyForm1099-NEC(Rev. 1-2022) (keep for your records) $ $ $ 3 Other income 20 Name of person to contact Telephone numberwww.irs.gov/Form1099NEC Department of the Treasury - Internal Revenue Service 4 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 1096VOID CORRECTED income tax return,$ $or foreign postal code, and telephone no. OMB No. 1545-0116 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-KPAYERS name, street address, city or town, state or province, country, ZIP Payer made direct sales Form1099-NEC Nonemployeeconsumer products to$ dividends or interest 32 50 81 78 84 03 74 83 80 79 85 73 91 86 92 10(Rev. January 2022) Compensation 9 recipient for resale 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 PAYERS TIN stretadres,cityortown,stateor RECIPIENTS TIN ZIPorforeignpostalcode $ 1 Nonemployee compensation For calendar year Copy 2 Required Envelope: $ 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 deferralsRECIPIENT'Sname, province,country,and 2 Payer made direct sales totaling $5,000 or more of3 To be led with s state13 requirement $ 14 Excess golden parachute$ 15compensation 5498-SA 27NEC5159 consumer products to recipient for resale recipientincome taxAPEX: DWMR or DWMRS Account number (see instructions) $ payments $ 17 State/Payers state no. 18 State income Return this entire page to the Internal Revenue Service. Photocopies are not acceptable. return, when required.4 Federal income tax withheld 16 State tax withheld 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.Account number (see instructions) 2nd TIN not.$ 5 State tax withheld 6 State/Payers state no. $ 7 State income TFP: 77771 or 77772 Form1099-MISC(Rev. 1-2022) LMB2 $ $ Signature TitleDateRequired Envelope: Form1099-NEC(Rev. 1-2022) $ $ www.irs.gov/Form1099MISC Department of the Treasury - Internal Revenue Service Instructions number), and TIN in the spaces provided on the form. The name, address, www.irs.gov/Form1099NEC Department of the Treasury - Internal Revenue Service Future developments. For the latest information about developmentsupper left area of Form 1097, 1098, 1099, 3921, 3922, 5498, or W-2G.related to Form 1096, such as legislation enacted after it was published, go to www.irs.gov/Form1096. When to le. File Form 1096 as follows.Reminder. The only acceptable method of electronically through the FIREAPEX and TFP: DW19W or DW19WS or foreign postal code, and telephone no. VOID CORRECTED OMB No. 1545-0116 Nonemployeereturns listed on this form in box 6 with the IRS isanyFebruary 28, 2024.System. See Pub. 1220. PAYERS name, street address, city or town, state or province, country, ZIPPurpose of form. Use this form to transmit paper Forms 1097, 1098, 1099, 3921, 3922, 5498, and W-2G to the IRS. Form1099-NEC Caution: electronically but fail to do so, and you do not have anWhere To File(Rev. January 2022) Compensation approved waiver, you may be subject to a penalty. The Taxpayer First ActIf your principal business, ofce orUse the following For calendar year of 2019, enacted July 1, 2019, authorized the Department of the Treasuryagency, or legal residence in theaddressPAYERS TIN RECIPIENTS TIN 1 Nonemployee compensation Copy 2 and the IRS to issue regulations that reduce the 250-return requirement for www.irs.gov/ case of an individual, is located in Internal Revenue Service2022 tax returns. If those regulations are issued and effective for 2023 tax Form1099 explaining the change. Until regulations are issued, however,Alabama, Arizona, Arkansas, Delaware, Florida, Georgia, Kentucky, Maine, RECIPIENT'Sname,stretadres,cityortown,stateorprovince,country,andZIPorforeignpostalcode $ 2 Payer made direct sales totaling $5,000 or more ofTo be led with s stateinformation, see part F in the 2023 General Instructions for CertainMassachusetts, Mississippi, NewAustin, TX 78714-9213Information Returns. Hampshire, New Jersey, New Mexico,P.O. Box 149213 3 consumer products to recipient for resale recipientincome taxreturns. New York, North Carolina, Ohio, Texas, Vermont, Virginiareturn, whenWho must le.Alaska, Colorado, Hawaii, Idaho, required. Caution:Illinois, Indiana, Iowa, Kansas,Internal Revenue Service Center Michigan, Minnesota, Missouri, 4 Federal income tax withheld the name and TIN used on your 94X series tax return(s) or you may beMontana, Nebraska, Nevada, NorthP.O. Box 219256 Dakota, Oklahoma, Oregon, South Kansas City, MO 64121-9256$ subject to information return penalties. Do not use the name and/or TIN ofCarolina, South Dakota, Tennessee,5 State tax withheld 6 State/Payers state no. 7 State income your paying agent or service bureau. Utah, Washington, Wisconsin, Wyoming Account number (see instructions) 2nd TIN not.$ $ For more information and the Privacy Act and Paperwork Reduction Act Notice,L1096 41-0852411 5100 Form1096(2023)Form1099-NEC(Rev. 1-2022)NECLMB2 $ $ see the 2023 General Instructions for Certain Information Returns.1099-NEC www.irs.gov/Form1099NEC Department of the Treasury - Internal Revenue Service(5) 1096 Transmittal forms are included with each Federal Copy A (Red) form order (5) 1096 Transmittal forms are included with each Federal Copy A (Red) form orderAPEX - Sheets per packTFP - Forms per pack APEX - Sheets per packTFP - Forms per pack50s500s100s1500sFORM DESCRIPTION 50s500s100s1000sFORM DESCRIPTIONNECLMANECLMA500NEC5110NEC5110B1099-NEC Federal Copy A1 Page Equals 3 Forms (5 00 formsL1096L1096500510010 or 510025 5100Bper package) 1096 Annual Transmittal For U.S. Information ReturnsNECLMBNECLMB500NEC5111NEC5111B1099-NEC Recipient Copy B1 Page Equals 3 Forms LMALMA50051105110B1099-MISC Federal Copy A1 Page Equals 2 FormsNECLMCLM2NECLMCLM2500NEC5112NEC5112B1099-NEC Payer Copy C and/or State Copy1 Page Equals 3 Forms LMBLMB50051115111B1099-MISC Recipient Copy B1 Page Equals 2 FormsNECLMBLNECLMBL500NEC5108NEC5108B1099-NEC Blank with Backer Instructions Copy B1 Page Equals 3 Forms LMCLM2LMCLM250051125112B1099-MISC Payer Copy C and/or State Copy1 Page Equals 2 FormsN/AN/ANEC5159NEC5159B1099-NEC Blank with Copy B Backer with Stub1 Page Equals 3 Forms LMBLLMBL50051085108B1099-MISC Blank With Backer Instructions Copy B1 Page Equals 2 Forms50s500s100s500s N/AN/A51595159B1099-MISC Blank With Copy B Backer With Stub1 Page Equals 2 FormsNECLM3NECLM3500NEC5114NEC5114B1099-NEC 3-Up Recipient Copy B and Payer Copy C and State Or File Copy1 Page Equals 1 Form 50s500s100s500sNECLM3BLNECLM3BL500NEC5173NEC5173B1099-NEC Blank Copy B, C Backer1 Page Equals 1 Form LM3LM350051145114B1099-MISC 3-Up Recipient Copy B and Payer Copy C and State or File Copy1 Page Equals 1 FormNECLMB2NECLMB2500N/AN/A1099-NEC Recipient Copy B, 21 Page Equals 1 Form LM3BLLM3BL50051735173B1099-MISC Blank Copy B, C Backer1 Page Equals 1 FormLMB2LMB2500N/AN/A1099-MISC Recipient Copy B, 21 Page Equals 1 Form36 37"