b"1099 PRE-PRINTED FORMS 1099 PRE-PRINTED FORMS1-Wide Continuous 1-Wide Continuous1099-DIV COPY A 1099-MISC COPY A 1096 APEX NECTC-M3TFP NEC715439191 VOIDCORRECTED 9595 VOID CORRECTED Do Not Staple 6969 OMB No. 1545-0108PAYERS name, street address, city or town, state or province, country, ZIP 1aTotal ordinary dividendsOMB No. 1545-0110PAYERS name, street address, city or town, state or province, country, ZIP1 Rents OMB No. 1545-0115 Form1096 Annual Summary and Transmittal of __DETACH BEFORE MAILING7152-4 / TC-D4 4PT M 7154-3 3PT / TCM3MANUFACTURED ON OCR LASER BOND PAPER USING HEAT RESISTANT INKS FORMNEC7154-33PT/NECTCM3or foreign postal code, and telephone no.$Form1099-DIVDividends andor foreign postal code, and telephone no. $ Form1099-MISC MiscellaneousDepartment of the TreasuryU.S. Information Returns 2023 7171 VOID CORRECTED1b (Rev. January 2022) Distributions2 Royalties (Rev. January 2022) Information Internal Revenue Service PAYERS name, street address, city or town, state or province, country, ZIPOMB No. 1545-01161b 2bUnrecap. Sec. 1250 gain3 Other income 4CORRECTED (if checked) OMB No. 1545-0115 FILERS name or foreign postal code, and telephone no. Form1099-NEC Nonemployee For calendar year For calendar year $20 $ 20 1 RentsPAYERS name, street address, city or town, state or province, country, ZIP Copy A$2aTotal capital gain distr. $2dCollectibles (28%) gainCopy AForPAYERS TIN RECIPIENTS TIN or foreign postal code, and telephone no. $ Federal income tax withheld $ 2 Royalties ForForm1099-MISC MiscellaneousStreet address (including room or suite number) (Rev. January 2022) Compensation$ For calendar yearPAYERS TIN RECIPIENTS TIN $2cSection 1202 gain$Internal Revenue5 Fishing boat proceeds 6 Medical and health careInternal Revenue(Rev. January 2022) Information City or town, state or province, country, and ZIP or foreign postal code PAYERS TIN RECIPIENTS TIN 1 Nonemployee compensation 20 Copy AService Centerpayments Service Center For calendar year RECIPIENTS name$2eSection 897 ordinary dividends $2fSection 897 capital gainFile with Form 1096. RECIPIENTS name $ 7 Payer made direct sales$ 8 of dividends or interest $ 3 Other income $ 20 Copy B Name of person to contact Telephone number For Ofcial Use Only RECIPIENTS name $ 2 Payer made direct sales totaling $5,000 or more ofFor Internal Revenue File with Form 1096. 4 Federal income tax withheld For Recipient Email address Fax number consumer products to recipient for resale Service Center3Nondividend distributions 4Federal income tax withheldtotaling $5,000 or more ofSubstitute payments in lieu$For Privacy Act6 Medical and health careFile with Form 1096.$5Section 199A dividends $6Investment expensesFor Privacy ActPAYERS TINconsumer products toRECIPIENTS TIN and Paperworkpayments 12 Social security number 3 Total number of forms 4 Federal income tax withheld5 Total amount reported with this Form 1096 Street address (including apt. no.) 3 For Privacy Act and Street address (including apt. no.)$7Foreign tax paid$8Foreign country or U.S. possession and PaperworkStreet address (including apt. no.) recipient for resale $ attorney $ Reduction Act$ Substitute payments in lieuThis is important tax6W-2G 1097-BTC10981098-C1098-E1098-F1098-Q1098-T1099-A $ 1099-C1099-CAP$ 1099-DIV1099-G1099-INT1099-K City or town, state or province, country, and ZIP or foreign postal code $ 4 Federal income tax withheld Paperwork Reduction ActRequired Envelope:5 Fishing boat proceedsReduction Act9 Crop insurance proceeds 10 Gross proceeds paid to anNotice, see theNotice, see the Notice, see thecurrent General RECIPIENT'S name, stre , city or town, state or province, country, and ZIP or foreign postal code 7 Payer made direct sales Instructions forcurrent City or town, state or province, country, and ZIP or foreign postal code $current GeneralCity or town, state or province, country, and ZIP or foreign postal code $ t addres $ Instructions for8 of dividends or interest information and is32 50 81 78 84 03 74 83 80 1099-B 85 73 91 86 92 10 5 State tax withheld 6 State/Payers state no. 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If you are FOR11 12Exempt-interest dividends13 M 13 14 Excess golden parachute15$ 9 Crop insurance proceeds $ return, a negligence16 93 95 71 96 97 31 1A 98 75 94 43 25 26 28 72 2A Form1099-NEC(Rev. 1-2022) 41-0852411 $ $FORM FOR requirement bond interest dividends requirement payments compensation penalty or otherwww.irs.gov/Form1099NEC Department of the Treasury - Internal Revenue Service$$$ $ 11 Fish purchased for resale 12 Section 409A deferrals sanction may beDo Not Cut or Separate Forms on This PageDo Not Cut or Separate Forms on This PageAccount number (see instructions)2nd TIN not.14State 1516State tax withheld Account number (see instructions) 2nd TIN not.16 State tax withheld 17 State/Payers state no. 18 State income imposed on you if5498-SA this income is $$ $$ $ taxable and the IRS27determines that it Form1099-DIV(Rev. 1-2022) 41-0852411 www.irs.gov/Form1099DIV $Department of the Treasury - Internal Revenue Service Form1099-MISC(Rev. 1-2022)41-0852411 $ 13 requirement $14 Excess golden parachute15 compensation has not been7171 VOID CORRECTED OMB No. 1545-0116www.irs.gov/Form1099MISC payments reported. PAYERS name, street address, city or town, state or province, country, ZIP Department of the Treasury - Internal Revenue ServiceDoNotCutorSeparateFormsonThisPage DoNotCutorSeparateFormsonThisPage Do Not Cut or Separate Forms on This PageDo Not Cut or Separate Forms o$n This Page $ Return this entire page to the Internal Revenue Service. Photocopies are not acceptable.or foreign postal code, and telephone no.Account number (see instructions) 16 State tax withheld 17 State/Payers state no. 18 State income Send this form, with the copies of the form checked in box 6, to the IRS in a at mailer (not folded). Form1099-NEC Nonemployee $ $ 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. (Rev. January 2022) Compensation9191 VOIDCORRECTED OMB No. 1545-01101099-MISC COPY B VOID CORRECTED (Rev. 1-2022) (keep for your records) $ $ Signature Title Date PAYERS TIN RECIPIENTS TIN 1 Nonemployee compensation For calendar year Copy A9595 Form1099-MISCwww.irs.gov/Form1099MISC Department of the Treasury - Internal Revenue Service 20PAYERS name, street address, city or town, state or province, country, ZIP 1aTotal ordinary dividendsPAYERS name, street address, city or town, state or province, country, ZIP1 Rents OMB No. 1545-0115or foreign postal code, and telephone no.or foreign postal code, and telephone no. Instructions number), and TIN in the spaces provided on the form. The name, address, $1b Form1099-DIVDividends and$ 2 Royalties Form1099-MISC Miscellaneousrelated to Form 1096, such as legislation enacted after it was published, goupper left area of Form 1097, 1098, 1099, 3921, 3922, 5498, or W-2G. RECIPIENTS name $ 2 Payer made direct sales totaling $5,000 or more ofFor Internal Revenue Future developments. For the latest information about developments (Rev. January 2022) Distributions(Rev. January 2022) Information to www.irs.gov/Form1096. When to le. File Form 1096 as follows. consumer products to recipient for resale Service CenterFORMNEC7154-33PT/NECTCM320 20 Reminder. The only acceptable method of electronically through the FIRE For Privacy Act and $2aTotal capital gain distr. $For calendar year $ 3 Other income $ For calendar yearForreturns listed on this form in box 6 with the IRS isanyFebruary 28, 2024. Street address (including apt. no.) 3 File with Form 1096.System. See Pub. 1220. Copy A 1099, 3921, 3922, 5498, and W-2G to the IRS.Notice, see the $2bUnrecap. Sec. 1250 gainCopy AFor$ 4 Federal income tax withheld Purpose of form. Use this form to transmit paper Forms 1097, 1098,Where To File 4 Federal income tax withheld Paperwork Reduction Act current 2cSection 1202 gain2dCollectibles (28%) gain6 Medical and health careInternal RevenueGeneral Instructions forPAYERS TIN RECIPIENTS TIN Required Envelope: Internal RevenuePAYERS TIN RECIPIENTS TIN 5 Fishing boat proceeds Required Envelope: Caution: electronically but fail to do so, and you do not have anIf your principal business, ofce orUse the followingCity or town, state or province, country, and ZIP or foreign postal code $ 5 State tax withheld 6 State/Payers state no. Certain InformationReturns.$$Service Centerpayments Service Center approved waiver, you may be subject to a penalty. The Taxpayer First Actagency, or legal residence in theaddress Account number (see instructions) 2nd TIN not.$ $ 7 State incomeRECIPIENTS name$2eSection 897 ordinary dividends $2fSection 897 capital gainFile with Form 1096. RECIPIENTS name $ 7 Payer made direct sales$ 8 Substitute payments in lieuFile with Form 1096. of 2019, enacted July 1, 2019, authorized the Department of the Treasurycase of an individual, is located in Internal Revenue Service Form1099-NEC(Rev. 1-2022) 41-0852411 $ $ APEX NECTC-M4TFP NEC71544and the IRS to issue regulations that reduce the 250-return requirement for 2022 tax returns. If those regulations are issued and effective for 2023 tax IMOPCOURMTEANNTTETNACXL ROESTEUDRND APEX:DWMR or DWMRS Street address (including apt. no.) totaling $5,000 or more ofAPEX and TFP: DW19W or DW19WS Form1099 explaining the change. Until regulations are issued, however, www.irs.gov/ Alabama, Arizona, Arkansas, Delaware,P.O. Box 149213www.irs.gov/Form1099NEC Department of the Treasury - Internal Revenue Service3Nondividend distributions 4Federal income tax withheldof dividends or interest For Privacy ActFlorida, Georgia, Kentucky, Maine, Street address (including apt. no.)$5Section 199A dividends $6Investment expensesFor Privacy Actconsumer products to$ and Paperworkinformation, see part F in the 2023 General Instructions for CertainMassachusetts, Mississippi, NewAustin, TX 78714-9213 Do Not Cut or Separate Forms on This PageDo Not Cut or Separate Forms on This Page7152-4 / TC-D4 4PT M 7154-3 3 PT/ TCM3and Paperworkrecipient for resale Reduction ActInformation Returns. New York, North Carolina, Ohio, Texas, Hampshire, New Jersey, New Mexico, $$Reduction Act9 Crop insurance proceeds 10 Gross proceeds paid to anNotice, see thereturns. Vermont, Virginia7Foreign tax paid8Foreign country or U.S. possession Notice, see theattorney current GeneralAlaska, Colorado, Hawaii, Idaho,7171 VOID CORRECTEDCity or town, state or province, country, and ZIP or foreign postal code TFP: 77771 or 77772 current GeneralCity or town, state or province, country, and ZIP or foreign postal code $ For: 1099-A, 1099-C, 1099-G, Who must le.Illinois, Indiana, Iowa, Kansas,Internal Revenue Service Center7171 VOID CORRECTED OMB No. 1545-0116 PAYERS name, street address, city or town, state or province, country, ZIPOMB No. 1545-0116$9Cash liquidation distributions10 Noncash liquidation distributions Instructions for13 11 Fish purchased for resale $ Instructions forCaution:Montana, Nebraska, Nevada, North Kansas City, MO 64121-9256 PAYERS name, street address, city or town, state or province, country, ZIPForm Nonemployeeor foreign postal code, and telephone no. Form1099-NEC Nonemployee Certain12 Section 409A deferrals Certain the name and TIN used on your 94X series tax return(s) or you may beMichigan, Minnesota, Missouri,P.O. Box 219256or foreign postal code, and telephone no.$$Information$ $ Information subject to information return penalties. Do not use the name and/or TIN ofDakota, Oklahoma, Oregon, South 1099-NEC11 requirement 12Exempt-interest dividends13 bond interest dividends Returns.requirement 14 Excess golden parachute1099-PATR, 1099-S your paying agent or service bureau. Carolina, South Dakota, Tennessee, 5100 Form1096(2023) (Rev. January 2022) Compensation (Rev. January 2022) CompensationReturns.Utah, Washington, Wisconsin, Wyoming FORFor: 1099-B, 1099-DIV, 1099-INT,$ payments 15compensation For more information and the Privacy Act and Paperwork Reduction Act Notice,L1096 41-0852411 For calendar year For calendar year$$$Account number (see instructions)2nd TIN not.1099-K, 1099-MISC, 1099-R Account number (see instructions) 2nd TIN not.16 State tax withheld 17 State/Payers state no. 18 State income see the 2023 General Instructions for Certain Information Returns. PAYERS TIN RECIPIENTS TIN 1 Nonemployee compensation 20 Copy A PAYERS TIN RECIPIENTS TIN $ 1 Nonemployee compensation 20 Copy A14State 15 16State tax withheld$$ $ For Internal Revenue Form1099-DIV(Rev. 1-2022) 41-0852411 www.irs.gov/Form1099DIV $Department of the Treasury - Internal Revenue Service Form1099-MISC(Rev. 1-2022)41-0852411 $ $ RECIPIENTS name $ 2 Payer made direct sales totaling $5,000 or more ofFor Internal RevenueRECIPIENTS name 2 Payer made direct sales totaling $5,000 or more ofService Centerwww.irs.gov/Form1099MISC Department of the Treasury - Internal Revenue Service Service Center consumer products to recipient for resale File with Form 1096.FORMNEC7154-33PT/NECTCM3FORMNEC7154-44PT/NECTCM4 FORMNEC7154-44PT/NECTCM4consumer products to recipient for resale File with Form 1096. 3 For Privacy Act and 3 Paperwork Reduction ActStreet address (including apt. no.) Paperwork Reduction Act For Privacy Act and Notice, see the currentStreet address (including apt. no.) Notice, see the4 Federal income tax withheld General Instructions for City or town, state or province, country, and ZIP or foreign postal code 4 Federal income tax withheld General Instructions forcurrentCity or town, state or province, country, and ZIP or foreign postal code $ 5 State tax withheld 6 State/Payers state no. Certain InformationReturns.$ Certain InformationReturns. 7 State income5 State tax withheld 6 State/Payers state no. 7 State income Account number (see instructions) 2nd TIN not.$ $Account number (see instructions) 2nd TIN not.$ $ $ $$ $APEXTFP Form1099-NEC(Rev. 1-2022) 41-0852411 www.irs.gov/Form1099NEC Department of the Treasury - Internal Revenue Service Form1099-NEC(Rev. 1-2022) 41-0852411 www.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 PageFORM DESCRIPTION 7171 VOID CORRECTED OMB No. 1545-0116PAYERS name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.Form1099-NEC Nonemployee TC-D4715241099-DIV 4-Part Carbonless Copy A, B, C (Rev. January 2022) CompensationFor calendar year20TC-I4715041099-INT 4-Part Carbonless Copy A, B, C PAYERS TIN RECIPIENTS TIN $ 1 Nonemployee compensation Copy AFor Internal Revenue RECIPIENTS name 2 Payer made direct sales totaling $5,000 or more ofService Center APEX NECTC-M5TFP NEC71545consumer products to recipient for resale File with Form 1096.TC-M3715431099-MISC 3-Part Carbonless Copy A, B, C* Street address (including apt. no.) 3 Paperwork Reduction Act For Privacy Act and Notice, see the current4 Federal income tax withheld General Instructions for City or town, state or province, country, and ZIP or foreign postal code $ Certain InformationReturns.TC-M4715441099-MISC 4-Part Carbonless Copy A, State, B, C*Account number (see instructions) 2nd TIN not.$ 5 State tax withheld 6 State/Payers state no. $ 7 State income 7171 VOID CORRECTED OMB No. 1545-0116PAYERS name, street address, city or town, state or province, country, ZIP Form1099-NEC(Rev. 1-2022) 41-0852411 $ $ or foreign postal code, and telephone no. Form1099-NEC Nonemployee TC-M5715451099-MISC 5-Part Carbonless Copy A, State, B, 2, C*Do Not Cut or Separate Forms on This PageDo Not Cut or Separate Forms on This Page (Rev. January 2022) Compensationwww.irs.gov/Form1099NEC Department of the Treasury - Internal Revenue ServiceFor calendar year20PAYERS TIN RECIPIENTS TIN 1 Nonemployee compensation Copy ATC-R4715941099-R 4-Part Carbonless Copy A, B, C, D 7171 VOID CORRECTED OMB No. 1545-0116 NonemployeeRECIPIENTS name $ 2 Payer made direct sales totaling $5,000 or more ofFor Internal Revenue PAYERS name, street address, city or town, state or province, country, ZIPService Centeror foreign postal code, and telephone no.Form1099-NEC consumer products to recipient for resale File with Form 1096.FORMNEC7154-55PT/NECTCM5 FORMNEC7154-55PT/NECTCM5TC-S4716041099-S 4-Part Carbonless Copy A, State, B, C (Rev. January 2022) Compensation Street address (including apt. no.) $ 3 For Privacy Act and Paperwork Reduction Act For calendar year 4 Federal income tax withheld Notice, see the current Instructions for 20 GeneralCertain InformationPAYERS TIN RECIPIENTS TIN 1 Nonemployee compensation Copy A City or town, state or province, country, and ZIP or foreign postal code Returns.TC18-3716831098 3-Part Carbonless Copy A, B, C RECIPIENTS name $ 2 Payer made direct sales totaling $5,000 or more ofFor Internal RevenueAccount number (see instructions) 2nd TIN not.$ 5 State tax withheld 6 State/Payers state no. $ 7 State incomeService CenterFORMNEC7154-44PT/NECTCM4consumer products to recipient for resale File with Form 1096. $ $3 For Privacy Act andForm1099-NEC(Rev. 1-2022) 41-0852411 www.irs.gov/Form1099NEC Department of the Treasury - Internal Revenue Service1096109621096 2-Part Carbonless Annual Summary & Transmittal Of U.S. Information Returns* Street address (including apt. no.) $ 4 Federal income tax withheld Paperwork Reduction ActDo Not Cut or Separate Forms on This PageDo Not Cut or Separate Forms on This PageGeneral Instructions forcurrent Notice, see the City or town, state or province, country, and ZIP or foreign postal code Certain InformationReturns.5 State tax withheld 6 State/Payers state no. 7 State income 7171 VOID CORRECTEDAccount number (see instructions) 2nd TIN not.$ $ PAYERS name, street address, city or town, state or province, country, ZIPOMB No. 1545-0116Form1099-NEC(Rev. 1-2022) 41-0852411 $ $ or foreign postal code, and telephone no. Form1099-NEC Nonemployee www.irs.gov/Form1099NEC Department of the Treasury - Internal Revenue Service (Rev. January 2022) CompensationFor calendar year20PAYERS TIN RECIPIENTS TIN 1 Nonemployee compensation Copy A$ For Internal Revenue Service Center(5) 1096 Transmittal forms are included with each Federal Copy A (Red) form order RECIPIENTS name 2 Payer made direct sales totaling $5,000 or more ofFile with Form 1096.consumer products to recipient for resale3 Paperwork Reduction Act For Privacy Act and Street address (including apt. no.)Notice, see the current4 Federal income tax withheld General Instructions for City or town, state or province, country, and ZIP or foreign postal code $ Certain InformationReturns.5 State tax withheld 6 State/Payers state no. 7 State income2nd TIN not.$ $PARTS DESCRIPTION FOR 1099 & 1098 FORMSAccount number (see instructions) 41-0852411 $ $Form1099-NEC(Rev. 1-2022) www.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 Page7171 VOID CORRECTEDPAYERS name, street address, city or town, state or province, country, ZIPOMB No. 1545-01161099-R 1099 or foreign postal code, and telephone no. Form1099-NEC Nonemployee (Rev. January 2022) CompensationFor calendar yearPAYERS COPIES PAYERS COPIES PAYERS TIN RECIPIENTS TIN $ 1 Nonemployee compensation 20 Copy AFor Internal Revenue RECIPIENTS name 2 Payer made direct sales totaling $5,000 or more ofService CenterFORMNEC7154-55PT/NECTCM5Copy AFor Internal Revenue Service Copy AFor Internal Revenue Service Street address (including apt. no.) 3 consumer products to recipient for resale File with Form 1096.For Privacy Act and Paperwork Reduction ActInstructions forcurrent Notice, see the Copy 1For State, City or Local Tax Dept. StateFor State Copy City or town, state or province, country, and ZIP or foreign postal code $ 4 Federal income tax withheld GeneralCertain InformationReturns.5 State tax withheld 6 State/Payers state no. 7 State incomeCopy DFile Copy Recipients Copies Copy CFiler, Payer, Creditor, Lender or File CopyAccount number (see instructions) 41-0852411 2nd TIN not.$ $Form1099-NEC(Rev. 1-2022) $ $www.irs.gov/Form1099NEC Department of the Treasury - Internal Revenue ServiceCopy BFor Recipient to file with IRSCopy CFor Recipients Records RECIPIENTS COPIESCopy BTransferor, Debtor, Recipient or Borrower APEXTFPCopy 2For Recipient to file with State, City or Local Tax Dept.Copy 2For Recipient to file with State FORM DESCRIPTION 1098 NECTC-M3NEC715431099-NEC 3-Part Carbonless Copy A, B, CNECTC-M4NEC715441099-NEC 4-Part Carbonless Copy A, B, C, CPAYERS COPIES NECTC-M5NEC715451099-NEC 5-Part Carbonless Copy A, B, C, C, CCopy AFor Internal Revenue ServiceStateFor State CopyCopy CFor Recipient/Lender/Filer/Donors RecordsRECIPIENTS COPYCopy BFor Payer/Borrower/Student/DonorCopy DFor Donee54 55"