b'1099 PRE-PRINTED & BLANK FORMS 1099 PRE-PRINTED & BLANK FORMSPressure Seal 1099|1098|5498 Forms Pressure Seal 1099|1098|5498 Forms1A VOID CORRECTED (if checked) 1 OMB No. 1545-0112 S2020 APEX PS351 1A PAYERS name, stret adres VOID CORRECTED $ OMB No. 1545-0110S2020 APEX PS352 1A Form 1099-R CORRECTED (if checked)OMB Distributions 23 Form 1099-R CORRECTED (if checked)OMB Distributions S201 APEX PS284 1A Form 1099-R CORRECTED (if checked) $ 1 Gross distribution OMB No. 1545-0119 Distributions Annuities, From 9406363 APEX PS1304 A 1A 8102591 APEX PS814RB19238 8510 19239 8510For calendar year Copy 2 TFP 5115 2aTotal capital gain distr. For calendar year Copy 2 not determined amount disttarilbution require lingment Annuities, Contracts, not determined amount disttarilbution require lingment Annuities, Contracts, MW1304 not determined amount Profit-Sharing S2032B S2032BPAYERS name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.Payers RTN (optional)PAYERS TIN RECIPIENTS TIN 1 $ 3 $ Interest income 13 $ Form1099-INT 17 $ To beO O PAYERS TIN , city or town, state or province, country, ZIP or foreign postal code, and telephone no. $ 5 3 7 $ 1a $ $ $ 9 $ $ Total ordinary dividends $ $ $ $ 6 4 $ 2f $ 8 $ 2 $ Formd 1099-DIVDividends and O $ 1 Gross distribution $ 2a Taxable amount SISIRA/ 12 $ 5No. 1545-0119 From Pensions, 1 Gross distribution $ $ 2a Taxable amount SS IIRA/ 12 $ $ 5No. 1545-0119 From Pensions, S2001 8510274 copy federalPAYERS name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no. totax thisyour boxIf this onyourto $ $ $ $ $ 2a Taxable amount doT Forml $ 23 IRA/ Pensions, $ $ $ Insu rIRAs,a etc.nce2 $ Early withdrawal penalty (Rev. January 2022) IInntceoremset $ 1bQualified dividends $ 2b (Rev. January 2022) Distributions A 2b Taxable To FATCA Profit-SharingRetirement 2b Taxable To FATCA Profit-Sharing 23 TFP 5177 A 2b Taxable isttaribution 1099-R Retirement or TFP 5503 TFP 5225R1099-INT 1099-DIV 20Plans, IRAs, etc. or MW28420 Unrecap. Sec. 1250 gain InsurancePlans, IRAs, etc. or InsuranceRetirement Plans,Interest on U.S. Savings Bonds and Treas. obligations RECIPIENTS TIN 2cSection 1202 gain Collectibles (28%) gain recipientsstate 13 Date of payment 13 Date of payment PAYERS TIN RECIPIENTS TIN 3Capital 4 Federal income tax withheld 5Contracts,MW351 MW352 2eSection 897 ordinary dividends Section 897 capital gain To be filed with 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. in box 2a) gain (included Employee/Designated contributions Roth contributions or4Federal income tax withheld 5Investment expenses income tax return, insurance premiumsRECIPIENTS name, Street address (including apt. no.), City or town, state or province, country, and ZIP or foreign postal code $ 6 $ Foreign tax paid 7 $ Foreign country or U.S. posesion income filedstatewith RECIPIENTS name, Street address (including apt. no.), City or town, state or province, country, and ZIP or foreign postal code Nondividend distributions Federal income tax withheld when required. PAYERS TIN 1A RECIPIENTS TIN PAYERS TIN RECIPIENTS TIN RECIPIENTS name, street address (incl. apt. no.), city or town, state or province, country, and ZIP or foreign postal code6Net unrealized securities appreciation $7 Distribution code(s) SEP/ $8 Other % LRPSBin employersA recipients return, Section 199A dividends Investment expenses $9a Your percentage of total distribution SIMPLEwhen tax Foreign tax paid Foreign country or U.S. possession % 9b Total employee contributions$ 8Tax-exempt interest $ 9Specified private activity bond interest required. /Designated in box 2a) gain (included /Designated 15 State/Payers state no. $16 State distributionPRINTED IN USA PRINTED IN USAO Account number (see instructions) 10Market discount 11 $ Bond premium $ G G Account number (see instructions) 11FATCA filing requirement $ 12 Cash liquidation distributions 10Noncash liquidation distributions G 3 Capital 4 Federal income tax withheld Employee % 3 Capital 4 Federal income tax withheld MEPPL/E Employee % showsAccount number (see instructions) filing requirement 11 1st year of desig. Roth contrib. $14 State tax withheld 18 Name of locality $19 Local distribution$2Bond premium on Treasury obligations Bond premium on tax-exempt bond Exempt-interest dividends 13Specified private activity bond interest dividends in box 2a) gain (included or insurance contributionsRothpremiums contributions or insurance contributionsRothpremiums contributions Copy B 13 Date of payment12FATCA10 Amount allocable to IRR within 5 years $17 Local tax withheldFATCA 1 $4Tax-exempt and tax credit 15State16State identification no. State tax withheld 13State 15State identification no. 16State tax withheld $6 Net unrealized appreciation $7 Distribution code(s) MEPPL/E 8 Other $6 Net unrealized appreciation $7 Distribution code(s) 8 Other A Report inreturn. income income www.irs.gov/Form1099R Department of the Treasury - Internal Revenue Servicerequirem filingent bond CUSIP no. in employers securities in employers securities information federal 4,return. attach formThisthistaxA MW1159 withheldis being furnishedPRINTED IN USAG Form 1099-INT www.irs.gov/Form1099INT Department of the Treasury - Internal Revenue Service Form1099-DIV www.irs.gov/Form1099DIV Department of the Treasury - Internal Revenue Service $9a Your percentage of total distribution $9b Total employee$contributions $9a Your percentage of total distribution %$9b Total employee contributions the IRS. CORRECTED (if checked) 1 Gross distribution OMB No. 1545-0119 Distributions Annuities, FromPRINTED IN USA% RECIPIENTS name, street address (including apt. no.), city or town, state or province, country, and ZIP or foreign postal code Form 1099-R Pensions,CORRECTED (if checked) OMB No. 1545-0112 PAYERS name, stret adres CORRECTED (if checked) OMB No. 1545-0110RECIPIENTS name, street address (including apt. no.), city or town, state or province, country, and ZIP or foreign postal code PAYERS name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no. $2a Taxable amount Retirement orPAYERS name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.Payers RTN (optional) Form1099-INT , city or town, state or province, country, ZIP or foreign postal code, and telephone no.1a $ 1 $ b Total ordinary dividends Form1099-DIVDividends and 1st year of desig. Roth contrib. $ 10 Amount allocable to IRR within 5 years Account number (see instruc.) 11 1st year of desig. Roth contrib. $ 10 Amount allocable to IRR within 5 years PAYERS TIN RECIPIENTS TIN $2b Taxable amount Total Form23 5Profit-SharingFor calendar year Plans, IRAs,PAYERS TIN RECIPIENTS TIN 14 3 $ 1 2 4 $ $ $ Interest income 15 1 $ $ 5 3 (Rev. January 2022) 1 $ 7 IInntceoremset PAYERS TIN RECIPIENTS TIN 11FATCA filing requirement $ $ 5 7 3 2a $ $ $ $ 9 $ 2e Qualified dividends $ $ $ $ 4 6 2 $ 8 2b $ $ $ $ f (Rev. January 2022) Distributions O $ $ Account number (see instruc.) $ Tiosttarilbutiond 1112 $ $ 16 State distribution $ $ 14 State tax withheld $ 15 State/Payers state no. 12 $ $ 16 State distribution G O G File RECIPIENTS name, street address (incl. apt. no.), city or town, state or province, country, and ZIP or foreign postal code $ $ $ $ $not determined $ 7distribution 1099-R $ IR $ $ $ $ 8 Other Insurance O G O G G OEarly withdrawal penalty For calendar year Copy B 2c Total capital gain distr. 2d 20 Copy B 14 State tax withheld 15 State/Payers state no. 3Capital 4 Federal income tax withheld Contracts, etc.20 Unrecap. Sec. 1250 gain in box 2a) gain (included Employee contributions/Designated Roth contributions orSection 1202 gain Collectibles (28%) gain For Recipient insurance premiumsInterest on U.S. Savings Bonds and Treas. obligations For Recipient RECIPIENTS name, Street address (including apt. no.), City or town, state or province, country, and ZIP or foreign postal code Section 897 ordinary dividends Section 897 capital gain Thisinformation G $17 Local tax withheld 18 Name of locality 19 Local distribution $17 Local tax withheld 18 Name of locality 19 Local distribution O Net unrealized appreciation Distribution code(s) SS IMEAPPL//E % is important and tax is being furnished $6in employers securitiesFederal income tax withheld Investment expenses Thisinformation the Nondividend distributions Federal income tax withheldis important and tax is Copy 2 www.irs.gov/Form1099R Department Copy 2 www.irs.gov/Form1099R Department 9a Your percentage of total distribution 9b Total employee contributionsrequiredto file are to aRECIPIENTS name, Street address (including apt. no.), City or town, state or province, country, and ZIP or foreign postal code $ 6Foreign tax paid $ 7Foreign country or U.S. posesion being furnished you toare $ Section 199A dividends Investment expenses the IRS. Ifyou File this income copy tax with return, yourstate,whenrequired.city, or Internal Revenue of the Service Treasury File this income copy tax with return, yourstate,whenrequired.city, or Internal Revenue of the Service Treasury Account number (see instructions) 11 1st year of desig. Roth contrib. 14 State tax withheld % $16 State distributionrequired IRS.to file penalty penalty or other$ a negligenceIf a return, or Foreign tax paid Foreign country or U.S. possessiona negligence local CORRECTED (if checked)OMB No. 1545-0119 local Department of the Treasury - Internal Revenue Service 15 State/Payers state no.8Tax-exempt interest 9 $ Specified private activity bond interest other sanction may be Cash liquidation distributions 10Noncash liquidation distributions return,sanction is onmaytaxable you be if Form 1099-R 2a Taxable amount Profit-Sharing 23 Form 1099-R CORRECTED (if checked)OMB No. 1545-0119 23 Copy 213 Date of payment12FATCA10 Amount allocable to IRR within 5 years $17 Local tax withheld 18 Name of locality $19 Local distributionimposed1 1 $0Market discount 11Bond premium imposed this 12Exempt-interest dividends 13Specified private activity bond interest dividends this incomeand that reported. the itIRShas 1 Gross distribution Distributions From Pensions, 1 Gross distribution 2a Taxable amount Distributions From Pensions, your thisstate,income when copy city, tax with or filing requirement www.irs.gov/Form1099R Department of the Treasury - Internal Revenue Serviceincome is on taxable you ifand determines 2b Taxable require lingment Annuities, Contracts, 2b Taxable distribution require lingment Annuities, Retirement or localthe IRS determines that not been FATCA InsurancePlans, IRAs, etc. or not determined amount Total FATCA Profit-Sharing Contracts, required. RetirementInsurancePlans, IRAs, etc.it has not been reported. 13 Date of payment 13 Date of paymentForm 1099-INT FATCA filing $2Bond premium on Treasury obligations Bond premium on tax-exempt bond State tax withheld Account number (see instructions) 14State 15State identification no. 16State tax withheld not determined amount O PAYERS name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no. O return, CORRECTED (if checked) $ 1 Gross distribution OMB No. 1545-0119 Distributions Annuities, Fromrequirement Tax-exempt State16State identification no. PAYERS name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no. Form 1099-RPRINTED IN USAAccount number (see instructions) bond CUSIP and no. tax credit Form1099-DIV (keep for your records) www.irs.gov/Form1099DIV Department of the Treasury - Internal Revenue Service PAYERS name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no. Pensions,(keep for your records) www.irs.gov/Form1099INT Department of the Treasury - Internal$Revenue Service Retirement orG G 2a Taxable amount 23 Profit-SharingPAYERS TIN RECIPIENTS TIN Employee PAYERS TIN RECIPIENTS TIN Employee PAYERS TIN RECIPIENTS TIN $ Taxable d Forml 1099-R 5 Employee Plans,5/Designated 3 Capital 4 Federal income tax withheld5or insurance contributionsRothpremiums contributions $ 2bnot determined amount $4 Federal iontax withheld R Insu rIRAs,anceSEE REVERSE SIDE FOR OPENING INSTRUCTIONS PRINTED IN U.S.A.First-Class Mail 3 Capital 4 Federal income tax withheld or insurance contributionsRothpremiums contributions in box 2a) gain (included $ /Designated 3in box 2a) Tiosttaribu tincome Contracts, etc.First-Class Mail Important Tax Return $ in box 2a) gain (included $ Capital gain (included /Designated contributions Roth contributions orinsurance premiumsImportant Document Enclosed 6 Net employers securities $7 Distribution code(s) SS IIRA/8 Other % $6 Netin employers $7 Distribution code(s) SISIRA/8 Other % RECIPIENTS name, street address (incl. apt. no.), city or town, state or province, country, and ZIP or foreign postal code6Net unrealized securities appreciation 7 Distribution code(s) SS IIMEAPPL//E $8 Other $ %SEE REVERSE SIDE FOR OPENING INSTRUCTIONS 8510019239DocumentTaxEnclosed Return inunrealized appreciation MEPPL/Eunrealized securities appreciation MEPPL/E $ in employers 9b Total employee contributions$9a Your percentage of total distribution $9b Total employee$contributions $9a Your percentage of total distribution %$9b Total employee contributions $9a Your percentage of total distribution %$ $ 16 State distribution% RECIPIENTS name, street address (including apt. no.), city or town, state or province, country, and ZIP or foreign postal code Account number (see instructions) 11 1st year of desig. Roth contrib. $14 State tax withheld 15 State/Payers state no.RECIPIENTS name, street address (including apt. no.), city or town, state or province, country, and ZIP or foreign postal codeCopy C 13 Date of payment12FATCA10 Amount allocable to IRR within 5 years $17 Local tax withheld $ $ 18 Name of locality $19 Local distribution $ $Account number (see instruc.) 11 1st year of desig. Roth contrib. $ 10 Amount allocable to IRR within 5 years Account number (see instruc.) 11 1st year of desig. Roth contrib. $ 10 Amount allocable to IRR within 5 years For ordsis being furnished filing requirement $ www.irs.gov/Form1099R (keep for your records) Department of the Treasury - Internal Revenue ServiceRec Recipientsto the informationThisIRS.$14 State tax withheld 15 State/Payers state no. $ 16 State distribution $17 Local tax withheld 15 State/Payers state no. $ 16 State distribution FROM: FROM:14 State tax withheld$17 Local tax withheld 18 Name of locality $ 19 Local distribution $ 18 Name of locality $ 19 Local distribution1099 R - Copy C SEE REVERSE SIDE FOR OPENING INSTRUCTIONSCopy C For Recipients Records Internal Revenue of the Service Treasury Copy BReportThis information is being furnished to the IRS. incomethistaxwithheldincome isbeingon inyourbox furnished4,federal attach to this thecopyIRS. to your return. tax return. If this form shows federal(keep for your records) www.irs.gov/Form1099R Department www.irs.gov/Form1099RThis informationImportant Tax Document Enclosed First-Class Mail First-Class MailSEE REVERSE INSTRUCTIONS SIDE FOR OPENINGAPEX PS1159 1099 R - Copy B Important Tax Document EnclosedTFP 5178ZFold ZFoldVFold EccentricEccentric ZFold ZFold1A VOID CORRECTED (if checked) OMB No. 1545-0112 851019247 S2020 APEX PS361PAYERS name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.Payers RTN (optional)A 1Interest income Form1099-INT(Rev. January 2022) IInntceoremset2 $ Early withdrawal penalty For calendar year Copy 2 TFP 5502 1A 851019243 S2020 1A 85101924620O 1099-INT PAYERS TIN RECIPIENTS TIN requirement 1 14 3 8 $ 6 $ 4 $ Interest on U.S. Savings Bonds and Treas. obligations 9 7 $ $ 5 esion 17 $ $ incometax return, O o a o Instructions for Payer/Borrower h A B a e e r o s r o ilu e on B 9 B m B p B S ox 6. o 7 ow eilp th incqiupnairdela dor n ty heteha erl,omsahno orintwg sat hgtehe e ca amleonrdtgaarg yee parr,in schipos of January 1 ofa wtlhs ae st hc oeaf l methnoedr atgdraa ytgeee a orf.a u APEX PS356 8 s c n Y s a f o d Instructions for Student u Yra r I p r ec e e a A f g B b e B e B e (including those not reported by the institution) may reduce the amount of thite a enddu ccearttioanin 0 o l u - x t a 9 in o e le is fr e e y S2020 APEX PS359Federal income tax withheld Investment expensesMW361$0 Tax-exempt interest 11 Speci\x1fed private activity bond interest whenrequired. ancaul e eduction. Each borow e rm thaaythraepvere tsoe innt celuadcehibno irnrocowmeres as hsaharereBooxx34DSoho nwosttdheed duacttetohfi sth aem moourntgta. gIte i so ari greinfaueondudnu tc( ootiron c ntsrhe eidni tOt)h fteohr e yorevianerc(rsop)ma yyeomuel innpeta(sido)fto hyfeo in uinrt etcerearelsetsn ty,do ayuor uyear TFP 5116 or parelpioffyur ntf noadrnaythccelr aeIindms iedn ad tun fo iteiro dnhu ecalapnt idion n re cclaarlcteedudilat edins, e otsrhibtso y s yatoantu e.im nTsehunirstersf otwra thyeoom umer anretk icesso r redreqsi.mu iTrbeou drs steeoem ief nytous cd reud:c iaYt tyoioounu ma cla laaysim sbei sf otaar bnthlceee toy(ie nianccrlu.rediansgePtheelc TFP 5117RECIPIENTS name, Street address (including apt. no.), City or town, state or province, country, and ZIP or foreign postal code $ Foreign tax paid $ Foreign country or U.S. pos To be ledwith b A prspienorersaostni,onro)rtga whdoin isfnront financiainl tdleaaar itaudtieo no, r a bosutfsfmuinorenrstishnta,n s inta nite, t a c(nionduc rlasued c ionoogf p sceuercrahtati tivnreapdhoeoi nuostsri)n g Ifr ohx2am. tiooSrhntgsao fthe outstanding practicaolen. tion. erdoeuudc,i at otorion tn hFaeloripnmesr ts1ito0un4ti o0wn hoo1c0a4n0 -cSlaRim.Tyhoisuastsa tae mdeepnet nhdaesn bt,e mena yfu bren isahbeledttoocyloauim b ya na ne deulicgaibtiloen Pluoigbxi.b5l9e.7Se0d htuoowc raset ipotohnretatla oi ntraselt diotuufc tatioioln ns. c iThnh oeyloa arusmr hoeipudsnu cot aro tfgi osrnac hnctorsel adaridst mhoiripn tsui soitterio rgner daa nantnds d ffe operr osthc deee scdsauelcdeti nobdyna. trh yeearrecipientsstate cu oy one m e c ceivgee idg ea mh gea ygoed an ins tt ry ste a$6r 0m0ugoverngsma aegtnhedi s tu e rttehesment to you. oriitngceinipal a.Ifgst htehorere igdciiapntiaeet enotdf / laeinnc qdthueeirsi(inluAMW356 1098 offmtahone uyn aat mmeoaoucunhnt t b aorlelrorpwoartebdleina sb ao xd 4. 1098-T , uac ua owGormanbtisn )iet i fr at hrneets cs eftiouvrde dae. np tF rinoiorcrlduyeedtaearsi.lsTs, ohsmiesee aIf you received this statement as the payer of rec oowrrirdto hwo nien rfao i rsmm eoanrttitogitlaneg dae bt ooou ndt e wthdheuicc hpt r otohnpeleyre rt haere in which you are enrolMarket discount Bond premium other borowers, fuouwrnnetissrhpr eeapaidoc rahten oddf opthnoe itn hotsisthpefaor irbdm ob.r Eryo awthceeh r ssbeel mcaahdye ehd aiunvl eea1 pto (r iFionorc rylmued a1er0po4ra0 r)yt.eoNar oras .al l Idof jyuf osthutme i etbenomtx ti zo4eyadmo dur prior year(s) tax return(s) is necesary. For q8 u63, a ds of quailtt iffortions for Form 1040 Relso TIPG PRINTED IN USA Form 1099-INT www.irs.gov/Form1099INT Department of the Treasury - Internal Revenue Service G Paaasyy ere sla tsat xfopaury edrig iidtse ontf iyfiocuart ioTInNn(uSmSNb,e IrT (ITNIN, A).T FINor,yoro uEr INpr).o tHecotwioenv,e thr, isthfor the poisuin roctfs hy aaorseuerf oruefl lsyyio ddueern dcpuercin. ticOb can deduct. MW359 fig stitution mr mouvasidtyeditceontlfaoirm e. 1e xi nX2 a02m4o. uSnet einPbuobx.19 7in0c efeorrce ahprootoggaet poer orthoaennsee a- hcaaamdlfoe tumhneitc sn .poermrioadlAccount number (see instructions) FATCA \x1fling 1 $ Bond premium on Treasury obligations13 $ Bond premium on tax-exempt bond State tax withheld 1 distribution of amo form Sachtioend fo rismsuer i m noerr 5e altl h points are reportable to you. Box 6 shows points you or the sel 5c.tible mortgage on let r t chiorsnoo u tstha te intt setehmreve infcielt.e also iney bl uto tixnpget tanh, lieffio ear dmm-Eoodur-neEtixnopffoe yrnomsuearts ic.orne, dgito,steoe Pub. 970, Form ad n.) in Sfoghr oJ tawhnesuwparrhiyoe-rtMh yeaerra ctrhh.to d value of an education credmoPruo baul.ln9ot 7fm 0tha.$2 Tax-exempt 15State16State identi\x1fcation no. a0 b4 leI0ft)y oof odurerhdmoucowtr t ttgoha egr eeapm opraoty uthmnet e onmft sto hrwetg easrguee bss iuindbtyse.ri deSiszetee. dA t hblseyo,ain f osgtror umvceotirornemn sine fontr agency,u,sleyeo eAu , Pm Cua,b yo.9rn 3Eo6t (bFaeondrm Btox e si.t.INo atmioeon u,c nsaetl eeisndPreauprb oy 9ert3ae6rd Saincn dhth eIditseu mbleoiz xAe,di(tFmDoreamdyuq1c0utiao4l0nif) y Ri nteosc tobruevce ttrireioeansst ei nadnPadus P bd.u e5bd2. e y9r3o p6uai dG ethnise ryaelay,r www.irs.gov/Credits-Deduicntciolundse/I nitds ivniadmuaels, /Qaacdntd sirnwefeosrsrm ,c aaetnritdoa ninin f ofqoru rema sastiteoiornvnsi c ceao bnpotruaoctv tit hdteeelr e.s ptAahltotehnmoeue gnnhut,mtdhboeer Bfofexcc 6t tt.h oSeh aaolmw ass usainsdtt juaonsf tcamene yinn at isnl co amsbcehi onlta uthritsieoh inyp easa nordirl e gfe aensadmedeuncdteiodninocr oemdeu ctaatxio rne tcurrend (iFt tohramt youbond CUSIP and no. tax credit Pub. 535.r shpsoo/Bwrto eordnr lyoywo tuehr complete TIN to the IRS. th nf of Srametn ea ea eli nrretphsoeidi neytsen acnreoptt ahraeidtp , oabrrutee td rye oiqnuu b irmoexuds6ttosm ubaeby t rraaelpcsoto rs tbeeeldledrto-epdauidc tpibolein.t Ss efreo mPub. ioure) ancyeducation crert or thers m thravayitc opu dra oebmvlaidyerc xplanations of the requirements for (and how to claimed for the prior year. You may have to fm thees bea sp figure the amount you Bo4gx07A dicsoxtcino 1gu.u nSits hhn ouywomsu brt eharec.cmMoouarynt gts.ahgoew in atenr easctc oreucnet ivoer do tbhye rt huen irqeuceip nieunmt/lbeenrd ethr ed lernindge rt hhea sy eaasrs.i gTnheisd to B3o6x to me as mtahgpeele.ted. Students taxpayer identification number (TIN). For your protection, this foirtshmsisu m ebrao hxy ,as syhoouwr uo im ludes rwayrtiinn untls aft sttion. 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Iof roen tlhy aonn eo npero ppreorptye rstye csuerceusr ethse t hloea lno,a tnh,i ssi vhbeoo wxyo sm uta hoeyt h bneeur m binlbafeonrrkm o. f tpioronp, esurtciehsasse rceuarilng the AisctcinoguuniSts hhn ouywomsub rt ehaerc.cto May show an acount or other unique number the filer as Braduate degree, graduate-level certificate, or other recognized graduate-level educationalInterest income (Rev. January 2022) ciIlfrle cyru ompuas pytarmenpecanetsids.oinnt earesbt uiyn dtohwe ncalmenodrtagra ygeea. rShcath a acmcrouuendt si na frueldbeyd uJacntiubaler yb 1y 5y,Booxrxt 10. The interest recipient may use this box to g Bnoyxs1o.uotu tulaititoen t oa nthdo rseel apteady meexnpetsn sreecse lievesdadnuyr inrge im20b2u3rs.ements or refunds credential. acyro nts or refunndteo rfeudin1099-INT re apmaido uinntt einre sthte m caayle bned ainrc yleuadre dp ainid b eovxe 1n.thHoouwgehv ietr ,Bsotaxt e1 1t.a Ixfe tsh,e o rre incispuierantn/lceen dpeari da cfroqmuir eedsc trhoew m. ortgage in calendar year, shows the date of acquisition. rce for qualifiaetd r anl tp. ayments received by an eligible educational institution in 2023 from tuoitixo n1 0a.n Sdh roewlaste tdhe e txopteanl sa emrseod muuncatde oe tf h breey ai mamnb ouinurnsseut mroefer .ath naeyb yo am deve s cr$ $ For calendar year For Recipient 8 If you hold a mortga cedr tiinfi cbaotex1a.nd can claim the mortgage interest credit, see Form o F Bo o velopments. For the latest information about developments related to Form 1098 and r q Booxx23RReesseerrvveeddffo a n you p Ffooerrm f yeuature developmTh eeeut aur cooafut tiohlnopments related to FormIInntceoremset mayg beecirnecdluitditsu itnusrteru dcetiovn/Fs,o srmu1ch0 9a8s. legislation enacted after they were published, go to made during 2023 othrrffuuttuurreeuusseee for trh (em caayle rnedsuarl t sinter uanncts se,r a stsuhecehiln aa ttesas xltelgiinaifsboliarlimttiyoa nfoti ore nnacted after they were published, go to1098-T and its in year m tiion. n2Early withdrawal penalty 20 Copy B quu9a l6imf.ie aIdfyt rhbeeesiisnduetenbrecjeesct,t ywtoo uaas cpdaaenidd ounln wrwewe .iFrisl.eg.Box 4. Shows any adjustmewnxtp ameblnaesd eeesdbutyhc aaatti now nee lricgerie brdeleiptoethdrtaeutcd otinoncaa lalp iirmniosertid tyu efocartiaornthtue" pariio1n0rt9hy8eea- Trin . 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See "rePAYERS TIN RECIPIENTS TIN 3 $ 4 Interest on U.S. Savings Bonds and Treas. obligations 5 Thisinformation RECIPIENTS/LENDERS name, stret adres CORRECTED (if checked) OMB No. 1545-1380MortgageRECIPIENTS name, Street address (including apt. no.), City or town, state or province, country, and ZIP or foreign postal code $ Federal income tax withheld $ 7 Investment expenses esionis important and tax is , city or town, state or province, country, ZIP or foreign postal code, and telephone number*amount Form1098 Interest FILERS name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone number 1Payments received for qualified OMB No. 1545-1574being furnishedyou toaretheCaution:andThe by the you. amount cost Limits and shownbasedvalue mayofon thenotthe securedbeloan fully (Rev. January 2022)deductiblerequired IRS.to \x1fle penalty interest 206 $ Foreign tax paid Foreign country or U.S. pos a negligenceIfa return, or propertytopaid may the by apply. extent you, Also,andit wasnotyou incurred reimbursed may only by you, deduct by For calendar year Statement tuition and related expenses CORRECTED (if checked)actuallyFATCA \x1fling 14 1 $ Market discount 15 1 1 $ $ $ 1 3 Bond premium 17 $ other sanction may be O RECIPIENTS/LENDERS TIN res PAYERS/BORROWERS TIN $ $ 1 another person. $ 3 Mortgage origination date negligencefurnishedor Copy B O FILERS employer identification no. STUDENTS TIN $ $ $ 4 6 2 3 Adjustments made for a $ 5 7 Form 23 Tuition8Tax-exempt interest 9Speci\x1fed private activity bond interest Mortgage interest received from payer(s)/borrower(s)*$0 imposed on you ifandthis $ 2 Outstanding mortgage principal For Payer/Borrower 1098-T Statementincome is taxablethe IRS determines thatit has not been reported.requirement 1 $2Bond premium on Treasury obligations Bond premium on tax-exempt bond State tax withheld G PAYERS/BOROWERS name, stret ad , (including apt. no.), city or town, state or province, country, and ZIP or foreign postal code4 Refund of overpaid interest 5 Mortgage insurance premiums The information in boxes tax to information the 1 through IRS. If G STUDENTS name, street address (including apt. no.), city or town, state or province, country, and ZIP or foreign postal code prior year Scholarships or grants Copy BAccount number (see instructions) Tax-exempt and tax credit State16State identi\x1fcation no. $ $ 6 Points paid on purchase of principal residence 9 and 11 is important ontoother fileyou a ifsanctionreturn, the IRS a Adjustments in box 1 includes if the amount For Studentbond CUSIP no. andyou is are being requiredpenaltythat an underpayment Checked This is importantForm 1099-INT (keep for your records) www.irs.gov/Form1099INT Department of the Treasury - Internal Revenue Service 7If address of property address, securing the mortgage box is checked, is the same as may be imposedthis mortgage you overstated interest or a of scholarships academic period Form taxand IRdeterminesinformationPAYERS/BORROWERS deductionbecausereported in boxes the 1 for a prior yeartoor grants amounts for an furnished istobeing theS.tax results becauseor the address or description is entered in box 8. andfor these for points,(box didnt O 8 hh ae lfc -tikmeedisf taudt leenatst $ 9Checked$ 10 beginning This form must O2018, All rights reserved.8 Address or description of property securing mortgage refundof interest a younondeductible Service Provider/Acct. No. (see instructions) C graduate if astudent Ins. contract reimb./refund be educationit to it thetoor G 6; orclaimed4); or report because item. March 2024January - used 8863 to completetocredits. claimyoutaxGive preparer9 Number of properties securing the mortgage10 Other 11 Mortgage acquisition date G Form 1098-T (keep for your records) www.irs.gov/Form1098T Department of the Treasury - Internal Revenue Service useAccount number (see instructions) prepare the taxreturn.SEE REVERSE SIDE FOR OPENING INSTRUCTIONSFirst-Class MailImportantReturn Form 1098 (Keep for your records) www.irs.gov/Form1098 Department of the Treasury - Internal Revenue ServiceDocumentTaxEnclosedSEE REVERSE SIDE FOR OPENING INSTRUCTIONS SEE REVERSE SIDE FOR OPENING INSTRUCTIONSFirst-Class Mail First-Class MailImportant Tax Return Important Tax ReturnDocument Enclosed Document EnclosedZFoldZFoldAPEX - Sheets per packTFP - Forms per pack APEX -Sheets per packTFP Forms per pack500s500sFORM DESCRIPTION 500s500sFORM DESCRIPTIONPS351511511" 1099-INT Copy BZ-Fold Simplex1 Page Equals 1 Form* PS1304550314" Printed 1099-R 3-Up Horizontal Copy B, C, 2EZ-Fold Simplex1 Page Equals 1 Form PS361550211" 1099-INT Multiple Account Copy BZ-Fold Simplex1 Page Equals 1 Form PS814RB5225R14" Blank 1099-R 4-Up Box w/ Instructions1 Page Equals 1 Form PS352N/A11" 1099-DIV Copy BZ-Fold Simplex1 Page Equals 1 Form* PS356511611" Printed 1098 Copy BZ-Fold Simplex1 Page Equals 1 Form* PS284517711" 1099-R 4-Up Box Copy B, C, 2, 2V-Fold Duplex1 Page Equals 1 Form PS354N/A11" Printed 1098-E Copy BZ-Fold Simplex1 Page Equals 1 FormPS1159517811" 1099-R 4-Up Box Blank w/ InstructionsV-Fold Duplex1 Page Equals 1 Form PS359511711" Printed 1098-T Copy BZ-Fold Simplex1 Page Equals 1 FormPS379N/A11" Blank 1098-TZ-Fold Simplex1 Page Equals 1 Form52 53'