b'YOU CAN ORDERPREPRINTED FORMSBLANK FORMSSETS & KITSVOID CORRECTED OMB No. 1545-0115 9292 VOID CORRECTED OMB No. 1545-0112 DETACH BEFORE MAILING DETACH BEFORE MAILINGMANUFACTURED ON OCR LASER BOND PAPER USING HEAT RESISTANT INKSDETACH BEFORE MAILINGPAYERS name, street address, city or town, state or province, country, ZIP 1 Rents PAYERS name, street address, city or town, state or province, country, ZIP Payers RTN (optional)or foreign postal code, and telephone no. or foreign postal code, and telephone no.Interest $ 2 Royalties 2021 Miscellaneous1 Interest income 2021 IncomeInformation$ 3 Other income Form 1099-MISC Copy A $ 2 Early withdrawal penalty Form1099-INT Copy A4 Federal income tax withheldPAYERS TIN RECIPIENTS TIN $ 5 Fishing boat proceeds $ 6 Medical and health care paymentsInternal RevenuePAYERS TIN RECIPIENTS TIN$ 3 Interest on U.S. Savings Bonds and Treas. obligations Internal Revenue Service CenterFor RECIPIENTS name $ 7 Payer made direct sales$ 8 Substitute payments in lieu ofFile with Form 1096. CORRECTED (if checked) OMB No. 1545-0115 RECIPIENTS name $ $ $ 4 Federal income tax withheld $ 75 Investment expenses Service CenterForCORRECTED (if checked) OMB No. 1545-0112 Interest totaling $5,000 or more ofdividends or interest For Privacy Act1 Rents File with Form 1096. Payers RTN (optional) MANUFACTURED ON OCR LASER BOND PAPER USING HEAT RESISTANT INKSMANUFACTURED ON OCR LASER BOND PAPER USING HEAT RESISTANT INKSStreet address (including apt. no.) $ consumer products to$ $ 10 Gross proceeds paid to anand Paperwork$ $ 2 Royalties 2021 Miscellaneous$ 6 Foreign tax paid $ 9 Foreign country or U.S. possession PAYERS name, street address, city or town, state or province, country, ZIP$ 1 Interest income 2021 IncomePAYERS name, street address, city or town, state or province, country, ZIP recipient for resale Reduction Actor foreign postal code, and telephone no.or foreign postal code, and telephone no.9 Crop insurance proceeds attorney Notice, see theForm 1099-MISC Information 8 Tax-exempt interest interest For Privacy Act2 Early withdrawal penalty Form1099-INT Copy B2021 General Street address (including apt. no.) and Paperwork City or town, state or province, country, and ZIP or foreign postal code 11 Fish purchased for resale 12 Section 409A deferrals Instructions forCertain3 Other income 4 Federal income tax withheld City or town, state or province, country, and ZIP or foreign postal code 10 Market discount 11 Bond premium Reduction Act Notice, see the Information Copy B 2021 GeneralAccount number (see instructions) requirement 2nd TIN not. $ 13 Excess golden parachute$ 14 compensation Returns.RECIPIENTS TIN $ 5 Fishing boat proceeds $ 6 Medical and health care payments For Recipient requirement $ 12 Bond premium on Treasury obligations $ 13 Bond premium on tax-exempt bond Instructions forCertainRECIPIENTS TIN $ 3 Interest on U.S. Savings Bonds and Treas. obligations For RecipientPAYERS TINpayments PAYERS TIN InformationReturns. $ 15 State tax withheld $ 16 State/Payers state no. 17 State income t adres, city or town, state or province, country, and ZIP or foreign postal code $ 7totaling $5,000 or more of$ 8 Substitute payments in lieu ofAccount number (see instructions) 2nd TIN not. $ 14 Tax-exempt and tax credit$ 15 State16$ $ 17 State tax withheld stretadres,cityortown,stateorprovince,country,andZIPorforeignpostalcode $ $ 4 Federal income tax withheld $ 5 Investment expenses This is important tax $ $ RECIPIENT\'S name, stre Payer made direct salesdividends or interest This is important taxbond CUSIP no. RECIPIENT\'Sname, information and is Form1099-MISC 41-0852411 www.irs.gov/Form1099MISC $ Department of the Treasury - Internal Revenue Service $ consumer products to$ 10 Gross proceeds paid to anbeing furnished to41-0852411 www.irs.gov/Form1099INT Department of the Treasury - Internal Revenue Service $ 6 Foreign tax paid 7 Foreign country or U.S. possession being furnished to the recipient for resale information and is Do Not Cut or Separate Forms on This PageDo Not Cut or Separate Forms on This Page 9 Crop insurance proceeds attorney the IRS. If you are8 Tax-exempt interest 9 interest IRS. If you are Form1099-INTDo Not Cut or Separate Forms on This PageDo Not Cut or Separate Forms on This Page return, a negligence $ 11 Fish purchased for resale $ 12 Section 409A deferrals return, a negligence$ 10 Market discount $ 11 Bond premium sanction may be penalty or otherpenalty or other sanction may be imposed on you if this income isthis income is or foreign postal code, and telephone no. VOID CORRECTED $ OMB No. 1545-0115 Account number (see instructions) requirement $ $ 13 Excess golden parachute$ $ 14 compensation imposed on you if9292 VOID CORRECTED OMB No. 1545-0112 Interestrequirement $ $ 12 Bond premium on Treasury obligations $ $ 13 Bond premium on tax-exempt bond taxable and the IRS PAYERS name, street address, city or town, state or province, country, ZIP 1 Rents taxable and the IRSPayers RTN (optional) determines that it has PAYERS name, street address, city or town, state or province, country, ZIPnot been reported.2 Royalties 2021 Miscellaneouspayments 16 State/Payers state no. determines that it1 Interest income 2021 Account number (see instructions) 14 Tax-exempt and tax credit15 State1617 State tax withheldor foreign postal code, and telephone no.has not been Information reported. Income bond CUSIP no.15 State tax withheld 17 State incomePAYERS TIN RECIPIENTS TIN $ 3 Other income Form 1099-MISC FormCopy A (keep for your records) www.irs.gov/Form1099MISC $ $ Department of the Treasury - Internal Revenue Service $ $ RECIPIENTS TIN$ $ 2 Early withdrawal penalty Form1099-INT Form1099-INT (keep for your records) www.irs.gov/Form1099INT Department of the Treasury - Internal Revenue Service $ $4 Federal income tax withheld$ 5 Fishing boat proceeds $ 6 Medical and health care paymentsInternal RevenuePAYERS TIN Copy AService CenterFor3 Interest on U.S. Savings Bonds and Treas. obligations Internal Revenue For 1099-MISCRECIPIENTS name $ 7 totaling $5,000 or more of$ 8 Substitute payments in lieu ofFile with Form 1096. CORRECTED (if checked) OMB No. 1545-0115 RECIPIENTS name $ $ 4 Federal income tax withheld $ 75 Investment expenses Service Center CORRECTED (if checked) OMB No. 1545-0112 Interest Payer made direct salesdividends or interest For Privacy Act1 Rents File with Form 1096. Payers RTN (optional)Street address (including apt. no.) $ consumer products to$ $ 10 Gross proceeds paid to anand Paperwork$ 2 Royalties 2021 Miscellaneous$ 6 Foreign tax paid 9 Foreign country or U.S. possession PAYERS name, street address, city or town, state or province, country, ZIP1 Interest income 2021 IncomePAYERS name, street address, city or town, state or province, country, ZIP recipient for resale Reduction Actor foreign postal code, and telephone no.9 Crop insurance proceeds attorney or foreign postal code, and telephone no. Street address (including apt. no.) For Privacy Act Notice, see the 2021 General Information 8 Tax-exempt interest interest and Paperwork$ 2 Early withdrawal penalty Form1099-INT Copy BCity or town, state or province, country, and ZIP or foreign postal code $ 11 Fish purchased for resale $ 12 Section 409A deferrals Instructions for RECIPIENTS TIN $ $ 3 Other income $ Form 1099-MISC City or town, state or province, country, and ZIP or foreign postal code $ $ 10 Market discount $ $ 11 Bond premium Reduction ActRECIPIENTS TIN $ 3 Interest on U.S. Savings Bonds and Treas. obligations For RecipientCertain Notice, see the Information 4 Federal income tax withheld Copy B 2021 Generalpayments Returns. Medical and health care payments For Recipient requirement 12 Bond premium on Treasury obligations13 Bond premium on tax-exempt bond Instructions forCertainAccount number (see instructions) requirement 2nd TIN not.13 Excess golden parachute 14 compensation PAYERS TIN 5 Fishing boat proceeds 6InformationPAYERS TINForm1099-MISC LMA 41-0852411 5110 $ 15 State tax withheld $ 16 State/Payers state no. 17 State income t 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 ofAccount number (see instructions) 41-0852411 2nd TIN not. $ 14 Tax-exempt and tax credit$ 15 State16$ $ Returns. stretadres,cityortown,stateorprovince,country,andZIPorforeignpostalcode $ $ $ 4 Federal income tax withheld $ 5 Investment expenses This is important tax www.irs.gov/Form1099MISC $ $ RECIPIENT\'S name, stre Payer made direct salesdividends or interest This is important taxLIA 5120 bond CUSIP no. 17 State tax withheld 6 Foreign tax paid 7 Foreign country or U.S. possession information and is $ $ consumer products to10 Gross proceeds paid to anbeing furnished towww.irs.gov/Form1099INT RECIPIENT\'Sname, 8 Tax-exempt interest 9 interest being furnished to the Department of the Treasury - Internal Revenue Service recipient for resale information and isDepartment of the Treasury - Internal Revenue Service IRS. If you are Form1099-INT9 Crop insurance proceeds attorney the IRS. If you arereturn, a negligence penalty or otherpenalty or other $ 11 Fish purchased for resale $ 12 Section 409A deferrals return, a negligence$ 10 Market discount $ 11 Bond premiumimposed on you if sanction may be sanction may bethis income is imposed on you iftaxable and the IRS Account number (see instructions) requirement $ 13 Excess golden parachute$ 14 compensation this income isrequirement $ 12 Bond premium on Treasury obligations $ 13 Bond premium on tax-exempt bond determines that it has taxable and the IRSnot been reported.payments determines that it has not been $ $ 15 State tax withheld $ 16 State/Payers state no. $ reported. Account number (see instructions) $ 14 Tax-exempt and tax credit$ 15 State16$ $ 17 State tax withheld17 State income bond CUSIP no.Form1099-MISC LMB (keep for your records) 5111www.irs.gov/Form1099MISC $ Department of the Treasury - Internal Revenue Service $ Form1099-INT LIB (keep for your records) 5121 www.irs.gov/Form1099INT Department of the Treasury - Internal Revenue ServiceOUR BASIC 1099-MISCELLANEOUS FORMAT backers and can be used for various 1099 forms (i.e. 1099DIV, 1099INT, Form 1099MISC, the most common form variant of Form 1099,1099R). You can choose from a 2-Up format with or without stub. used to report miscellaneous income. There are three parts to the 1099-Miscellaneous formthe Federal Copy A, Recipient Copy BPACKAGED SETSand Payer Copy C and/or State Copy. All Copy As, Copy Bs, Copy CsOur packaged sets offer everything you need together in one are printed separately and must be collated. Each sheet of our basicconvenient package for 25 to 50 recipients and 20 to 100 recipients. 1099-Miscellaneous form contains information for two recipients.Ourpackagedsetscontainalltheformsneededtoprocess Forms are available as packages of 50 8-1/2" x 11" sheets yieldinginformation as required by your reporting agency.Laser form type 100 individual 1099 forms. Bulk packages of 500 sheets yieldingdepends on your software. If your software only prints the variable 1,000 forms are also available.dataontheforms,youwillrequirepre-printedforms.Ifyour software includes laser form files that print complete 1099 form 1099-MISCELLANEUOUS BLANK FORMS copies you will require blank perforated paper. Forms are available FOR YOUR SOFTWARE as packages of 50 8-1/2 x 11" sheets yielding 100 individual 1099 Blank forms are available with or without Copy B and Copy C backerforms. Bulk packages of 500 sheets yielding 1,000 forms are also information pre-printed. Blank forms are also available with multipleavailable. PARTS DESCRIPTION 1099 & 1098 FORMS 1099R 1099S 1098 5498PAYERS COPIES PAYERS COPIES PAYERS COPIES PAYERS COPIESCopy AFor Internal Revenue Service Copy AFor Internal Revenue Service Copy AFor Internal Revenue Service Copy AFor Internal RevenueCopy 1For State, City or State/Copy 1 For State Copy State/Copy 1For State Copy ServiceLocal Tax Dept. Copy CFiler, Payer, Creditor, Lender Copy CFor Recipient/Lender/Filer/Copy CFor Trustee or Issuer Copy DFile Copy or File CopyDonors Records PARTICIPANTS COPYRecipients Copies RECIPIENTS COPIES RECIPIENTS COPY Copy BFor ParticipantCopy BFor Recipient to file with IRS Copy BTransferor, Debtor, Recipient Copy BFor Payer/Borrower/Student/Donor Copy CFor Recipients Records or Borrower Copy DFor DoneeCopy 2For Recipient to file withCopy 2For Recipient to file with State State, City or Local Tax Dept.26'