b"1099 PRE-PRINTED & BLANK FORMSIndividual Laser Packs1099-MISC9595 VOID CORRECTED OMB No. 1545-0115 APEX LMA PAYER'S name, stretadres,city CORRECTED(ifchecked) postal code$ 31Rents $ 4 2 Royalties OMB 1099-MISCPAYERS name, street address, city or town, state or province, country, ZIP 1 Rents or town, state or province,country, and ZIP or foreign FormNo.1545-0115 APEX LM3 DETACH BEFORE MAILING ON OCR LASER BOND PAPER USING HEAT RESISTANT INKSMANUFACTUREDor foreign postal code, and telephone no. (Rev. January 2022)$ 2 Royalties Form1099-MISC Miscellaneous$ 5Other income proceeds $ 6Federal income tax withheldFor calendar year PAYERS TIN RECIPIENTS TIN $ 3 Other income $ (Rev. 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January 2022) Information TFP 5111 $ 5Other income proceeds $ 6Federal income tax withheld(Rev. January 2022)17 State/Payers state no. 18 State income For calendar year For calendar year Form(Rev. 1-2022)41-0852411 $ $ 3 Other income $ $ 20 Copy B $ 7 Fishingboat $ 8Medical and health care payments 20$ 4 Federal income tax withheld Miscellaneous 1099-MISCPAYERS TIN www.irs.gov/Form1099MISC Department of the Treasury - Internal Revenue Service For Recipient PAYERS TIN RECIPIENTS TIN Payer made direct sales Substitute payments in lieu of InformationDo Not Cut or Separate Forms on This PageDo Not Cut or Separate Forms on This Page consumer products to dividends or interestRECIPIENTS TIN 5 Fishing boat proceeds 6 Medical and health careof $5,000 or more oftotaling $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 anForPrivacyActRECIPIENT'S name, stret adres, city or town, state or province, country, and ZIP or foreign postal code $ 7 Payer made direct sales$ 8 Substitute payments in lieu RECIPIENT'S name,streadrescityor town, country,andZIP or foreignpostal code Crop insurance proceeds $ 12attorney andPaperwork9595 VOID CORRECTED OMB No. 1545-0115 $ of dividends or interest information and is$ 11 Fish purchased for resale $ 15Section 409A deferrals Notice,GeneralPAYERS name, street address, city or town, state or province, country, ZIP 1 Rents consumer products to10 Gross proceeds paid to anbeing furnished to14 Excess golden parachute compensation Certain Reductionsee Actcurrent theor foreign postal code, and telephone no. $ 2 Royalties recipient for resaleMiscellaneousthe IRS. 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January 2022) Information Certain APEX LMBL LM3 $ $ $ Statetax 5114 DepartmentoftheTreasury $ $ -InternalRevenueService18 State income 12 Section 409A deferralsFor calendar year 11 20Fish purchased for resalePAYERS TIN $ 5 Fishing boat proceeds $ 4 Federal income tax withheld $ 15Copy B Information Form (Rev. 1-2022)www.irs.gov/Form1099MISC Department of the Treasury - Internal Revenue Service For Recipient Returns.RECIPIENTS TIN $ requirement $ 14 Excess golden parachutecompensationRECIPIENT'S name, stret adres Account number (see instructions) $ 2nd TIN not. 6 Medical and health care$ 17 State/Payers state no. $ 18 State income TFP 5108paymentspayments$ 16 State tax withheld, city or town, state or province, country, and ZIP or foreign postal code7 Payer made direct sales$ 8 of dividends or interest This is important tax$$totaling $5,000 or more ofSubstitute payments in lieuinformation and is consumer products to$ $ being furnished to Form1099-MISC(Rev. 1-2022) Department of the Treasury - Internal Revenue Service9 recipient for resalewww.irs.gov/Form1099MISC the IRS. If you are Crop insurance proceeds 10 Gross proceeds paid to anFront Blankattorney return, a negligence $ 11 Fish purchased for resale $ 12 Section 409A deferrals penalty or other sanction may be or foreign postal code, and telephone no. $ VOID CORRECTED with W-2 Instructions imposed on you if this income is 13 requirement 14 Excess golden parachute$ 15compensation OMB No. 1545-0115 Miscellaneous PAYERS name, street address, city or town, state or province, country, ZIP1 Rents taxable and the IRS payments $ 2 Royalties determines that itInformation LM3BL 51731099-MISCForm has not been Account number (see instructions) $ 16 State tax withheld $ 17 State/Payers state no. $ on back side. Copy C TFP 5159reported.(Rev. January 2022)For calendar year 18 State income$ $ 3 Other income $ $ 20 For Payer$ $ 5 Fishing boat proceeds 4 Federal income tax withheld orStateCopy2Form1099-MISC(Rev. 1-2022)LMB(keep for your records)5111 RECIPIENTS TIN Department of the Treasury - Internal Revenue Service orCopy Required Envelope:PAYERS TIN www.irs.gov/Form1099MISC 6 Medical and health care paymentsRECIPIENT'S name, stret adres, city or town, state or province, country, and ZIP or foreign postal code $ 7 Payer made direct sales$ 8 Substitute payments in lieu For Privacy Act totaling $5,000 or more of$ of dividends or interest Front Blank APEX: DWM3consumer products toand Paperwork 9 recipient for resale 10 Gross proceeds paid to anReduction Act Crop insurance proceeds attorney Notice, see the $ 11 Fish purchased for resale $ 12 Section 409A deferrals current GeneralInstructions for13 requirement $ 14 Excess golden parachute$ 15 compensation with W-2 InstructionsTFP: 52521CertainInformationReturns.paymentsAccount number (see instructions) 2nd TIN not. $ 16 State tax withheld $ 17 State/Payers state no. on back side.Form1099-MISC(Rev. 1-2022) LMC/LM2 $ 5112 $ 18 State income or foreign postal code, and telephone no. CORRECTED (if checked) OMB No. 1545-0115 MiscellaneousAPEX LMB2$ $www.irs.gov/Form1099MISC Department of the Treasury - Internal Revenue Service 1 Rents DETACH BEFORE MAILINGMANUFACTURED ON OCR LASER BOND PAPER USING HEAT RESISTANT INKSPAYERS name, street address, city or town, state or province, country, ZIP $ 2 Royalties Form1099-MISC Information(Rev. January 2022)THIS PANEL CONTAINS $ 3 Other income For calendar yearCopy B204 Federal income tax withheldPAYERS TIN RECIPIENTS TIN $ 5 Fishing boat proceeds $ 6 Medical and health care payments For Recipient1099MISC COPY B BACKER INFORMATIONRECIPIENT'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 9 recipient for resale attorney the IRS. If you are Crop insurance proceeds$ 11 Fish purchased for resale $ 12 Section 409A deferrals return, a negligence penalty or other sanction may be imposed on you if this income is 13 requirement $ 14 Excess golden parachute$ 15 compensation taxable and the IRS payments determines that it has not been 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 L109618 State income$Form1099-MISC(Rev. 1-2022) (keep for your records) $ www.irs.gov/Form1099MISC $ Form1096 Annual Summary and Transmittal of DETACH BEFORE MAILING MANUFACTURED ON OCR LASER BOND PAPER USING HEAT RESISTANT INKSCOPY B BACKER INFORMATION Department of the Treasury - Internal Revenue Service Department of the TreasuryU.S. Information Returns 2022 TFP 5100Internal Revenue ServiceFILERS nameCORRECTED (if checked) OMB No. 1545-0115 Street address (including room or suite number)PAYERS name, street address, city or town, state or province, country, ZIP1 Rentsor foreign postal code, and telephone no. Form1099-MISC Miscellaneous $ 2 Royalties (Rev. January 2022) Information City or town, state or province, country, and ZIP or foreign postal codeFor calendar year $ 3 Other income 20 Name of person to contact Telephone number For Ofcial Use Only4 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 1096income tax return,$ $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-CAP 1099-DIV1099-G1099-INT1099-K1099-LS Payer made direct salesdividends or interest 32 50 81 78 84 03 74 83 80 79 85 73 91 86 92 10 16consumer products to$ 10 Gross proceeds paid to an 9 recipient for resaleRequired Envelope: $ Crop insurance proceeds $ attorney 1099-LTC1099-MISC 1099-NEC 1099-OID1099-PATR1099-Q1099-QA 1099-R1099-S1099-SA 1099-SB 3921392254985498-ESA5498-QA 5498-SA 93 95 71 96 97 31 1A 98 75 94 43 25 26 28 72 2A 2711 Fish purchased for resale 12 Section 409A deferrals$ $APEX: DWMR or DWMRS Account number (see instructions) 13 requirement $ 14 Excess golden parachute$ 15compensation 18 State income Return this entire page to the Internal Revenue Service. Photocopies are not acceptable. payments Send this form, with the copies of the form checked in box 6, to the IRS in a at mailer (not folded).16 State tax withheld 17 State/Payers state no. 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.$ $TFP: 77771 or 77772 Form1099-MISC(Rev. 1-2022) LMB2 $ $ SignatureTitleDate www.irs.gov/Form1099MISC Department of the Treasury - Internal Revenue Service InstructionsFuture developments. For the latest information about developments related to Form 1096, such as legislation enacted after it wasform must be the same as those you enter in the upper left area of published, go to www.irs.gov/Form1096. Forms 1097, 1098, 1099, 3921, 3922, 5498, or W-2G.Reminder. The only acceptable method of electronically information returns listed on this form in box 6 with the IRS is throughWhen to le. File Form 1096 as follows.the FIRE System. See Pub. 1220.February 28, 2023.Purpose of form. Use this form to transmit paper Forms 1097, 1098, 1099, 3921, 3922, 5498, and W-2G to the IRS. Caution:electronically but fail to do so, and you do notWhere To Filehave an approved waiver, you may be subject to a penalty. Thefollowing.Taxpayer First Act of 2019, enacted July 1, 2019, authorized the Department of the Treasury and the IRS to issue regulations thatIf your principal business, ofce reduce the 250-return requirement for 2021 tax returns. If those www.irs.gov/Form1099or agency, or legal residence inUse the following regulations are issued and effective for 2022 tax returns required to bethe case of an individual, isaddressexplaining the change. Until regulations are issued, however, thelocated inInformation Returns. part F in the 2022 General Instructions for CertainFlorida, Georgia, Kentucky, Maine,Internal Revenue Serviceinformation, see Alabama, Arizona, Arkansas, Delaware, Massachusetts, Mississippi, NewP.O. Box 149213 of the number of returns. Hampshire, New Jersey, New Mexico,Austin, TX 78714-9213New York, North Carolina, Ohio, Texas, Who must le.Vermont, VirginiaCaution: Your name and TIN must match the name and TIN used on your 94X series tax return(s) or you may be subject to information return penalties. Do not use the name and/or TIN of your paying agent or service bureau.For more information and the Privacy Act and Paperwork Reduction Act Notice,L1096 41-0852411 5100 Form1096(2022)see the 2022 General Instructions for Certain Information Returns.(5) 1096 Transmittal forms are included with each Federal Copy A (Red) form orderAPEX - Sheets per packTFP - Forms per pack50s500s100s1000sFORM DESCRIPTION( 10 or 25 forms (5 00 formsL1096L10965005100per package) 5100Bper package) 1096 Annual Transmittal For U.S. Information ReturnsLMALMA50051105110B1099-MISC Federal Copy A1 Page Equals 2 FormsLMBLMB50051115111B1099-MISC Recipient Copy B1 Page Equals 2 FormsLMCLM2LMCLM250051125112B1099-MISC Payer Copy C and/or State Copy1 Page Equals 2 FormsLMBLLMBL50051085108B1099-MISC Blank With Backer Instructions Copy B1 Page Equals 2 FormsN/AN/A51595159B1099-MISC Blank With Copy B Backer With Stub1 Page Equals 2 Forms50s500s100s500sLM3LM350051145114B1099-MISC 3-Up Recipient Copy B and Payer Copy C and State or File Copy1 Page Equals 1 FormLM3BLLM3BL50051735173B1099-MISC Blank Copy B, C Backer1 Page Equals 1 FormLMB2LMB2500N/AN/A1099-MISC Recipient Copy B, 21 Page Equals 1 Form29"