b"1099 PRE-PRINTED FORMSIndividual Laser Packs1099-A (ACQUISITION) 1099-B (BROKER) 1099-C (CANCELLATION OF DEBT)8080 VOID CORRECTED 7979 VOID CORRECTED OMB No. 1545-0715 8585 VOID CORRECTED 1 OMB No. 1545-2281 DETACH BEFORE MAILINGDETACH BEFORE MAILINGDETACH BEFORE MAILING MANUFACTURED ON OCR LASER BOND PAPER USING HEAT RESISTANT INKSMANUFACTURED ON OCR LASER BOND PAPER USING HEAT RESISTANT INKSMANUFACTURED ON OCR LASER BOND PAPER USING HEAT RESISTANT INKSLENDERS name, street address, city or town, state or province, country, ZIP orOMB No. 1545-0877 PAYERS name, street address, city or town, state or province, country, ZIP Applicable checkbox on Form 8949 Proceeds FromCREDITORS name, street address, city or town, state or province, country, 1099-A or foreign postal code, and telephone no. Barter Exchange foreign postal code, and telephone no. FormAcquisition or2022 Broker andZIP or foreign postal code, and telephone no. 2 Amount of debt discharged Form1099-C Cancellation (Rev. January 2022) Abandonment ofForm1099-B Transactions $ (Rev. January 2022) of DebtFor calendar yearSecured Property 1a Description of property (Example: 100 sh. XYZ Co.) 3 Interest, if included in box 2 For calendar year 201 Date of lenders acquisition or 2 Balance of principalCopy A 1b Date acquired 1cDate sold or disposed CREDITORS TIN DEBTORS TIN $ 4 Debt description 20 Copy ALENDERS TIN BORROWERS TIN knowledge of abandonment outstanding For BORROWERS name 3 $ 4 Fair market value of property Internal RevenuePAYERS TIN RECIPIENTS TIN 1d Proceeds 1eCost or other basis Copy A DEBTORS name For Service Center Internal Revenue File with Form 1096.$ $ Service Center$ For Privacy Act$ 1f Accrued market discount $ 1g Wash sale loss disallowed ForStreet address (including apt. no.) 5 Check here if the debtor was personally liable for. . . . . . . .File with Form 1096. Street address (including apt. no.) 5 Check if the borrower was personally liable for repayment ofand PaperworkRECIPIENTS name Short-term gain or loss 3Check if proceeds from: Internal Revenuerepayment of the debtFor Privacy Act and the debt . . . . . . . . . . .Reduction ActService CenterPaperwork Reduction City or town, state or province, country, and ZIP or foreign postal code 6 Description of property Notice, see the2 Long-term gain or loss Collectibles File with Form 1096. City or town, state or province, country, and ZIP or foreign postal code Act Notice, see the current GeneralOrdinary QOF current General Account number (see instructions) Instructions for CertainStreet address (including apt. no.) 4Federal income tax withheld5Check if noncoveredAccount number (see instructions) 6 7 Fair market value of property Instructions for Information$ 6Reported to IRS: security For Privacy ActForm (Rev. 1-2022) 41-0852411 www.irs.gov/Form1099C $ Certain Information Returns.Returns.Form(Rev. 1-2022) 41-0852411 www.irs.gov/Form1099A Department of the Treasury - Internal Revenue Service City or town, state or province, country, and ZIP or foreign postal code Gross proceeds 7Check if loss is not allowedand PaperworkDo1099-CDepartment of the Treasury - Internal Revenue ServiceDo1099-A LENDERS name, street address, city or town, state or province, country, ZIP orOMB No. 1545-0877 8 CORRECTED (if checked) Reduction ActBroker andNotCutorSeparateFormsonThisPage CORRECTED (if checked) DoNotCut orSeparateFormsonThisPage 1NotC utorSeparateFormsonThisPageDoNotCut orSeparateFormsonThisPageCORRECTED (if checked) based on amount in 1dPAYERS name, street address, city or town, state or province, country, ZIP Net proceeds Applicable 9checkbox on Form 8949 OMB No. 1545-0715 Proceeds FromZIP or foreign postal code, and telephone no. DETACH BEFORE MAILINGMANUFACTURED ON OCR LASER BOND PAPER USING HEAT RESISTANT INKSDETACH BEFORE MAILINGMANUFACTURED ON OCR LASER BOND PAPER USING HEAT RESISTANT INKSDETACH BEFORE MAILINGMANUFACTURED ON OCR LASER BOND PAPER USING HEAT RESISTANT INKSforeign postal code, and telephone no. Form1099-A Acquisition oror foreign postal code, and telephone no. 2nd TIN not. 2022 on closed contracts open contracts12/31/2021 Notice, see the CREDITORS name, street address, city or town, state or province, country,OMB No. 1545-22812022 General 8080 VOID CORRECTED OMB No. 1545-0877 (Rev. January 2022) Abandonment ofAccount number (see instructions) requirement $ open contracts12/31/2022 $ 2022 Barter Exchange8585 VOID CORRECTED 1 $ 2 Amount of debt discharged Form1099-C Cancellation LENDERS name, street address, city or town, state or province, country, ZIP orForm20 For calendar yearCopy B CUSIP number 15 16State tax withheld 10 IRS 11on contracts Instructions forCertainTransactions CREDITORS name, street address, city or town, state or province, country,$ 2 Amount of debt discharged OMB No. 1545-2281 (Rev. January 2022) of Debt of Debtforeign postal code, and telephone no. (Rev. January 2022) 20Acquisition or Secured Property 14State name $ $ Form1099-B ZIP or foreign postal code, and telephone no. DEBTORS TIN $ Form1099-C For calendar yearCopy BInformationReturns. LENDERS TIN BORROWERS TIN 1099-A 2 Balance of principalFor Borrower $ 1a Description of property (Example: 100 sh. XYZ Co.) CREDITORS TIN 3 Interest, if included in box 2 20 Cancellation 1 Date of lenders acquisition orAbandonment of knowledge of abandonment outstanding 12Check if basis reported to 1b Date acquired13Bartering 1cDate sold or disposed (Rev. January 2022)For calendar yearSecured Property return, a negligence1099-B PAYERS TIN 41-0852411 $ 1d Proceeds $ 1eCost or other basis Copy B CREDITORS TIN DEBTOR'Sname,stret ad DEBTORS TIN stateorprovince, country,andZIP 3 Interest, if included in box 24 Debt descriptionFor calendar yearCopy A For DebtorBORROWER'S name, stret adres, city or town, state or province, country, and ZIP or foreign postal code outstanding $ 4 Fair market value of property ForThis is important taxForm$ RECIPIENTS TIN www.irs.gov/Form1099B $ Department of the Treasury - Internal Revenue Service For Recipient res, cityortown, $ orforeignpostalcode 20 information and is being information and is being 1 Date of lenders acquisition or 3 2 Balance of principalCopy A This is important tax LENDERS TIN BORROWERS TIN knowledge of abandonment furnished to the IRS. If4 Debt description$ $ Internal Revenuepenalty or otherDo Not Cut or Separate Forms on This PageDo Not Cut or Separate Forms on This Page DEBTORS name 5 If checked, the debtor was personally liable for. . . . . . . .furnished to the IRS. If 1fAccrued market discount 1g Wash sale loss disallowed For 4 Fair market value of property Service CenterBORROWERS name 3 5 If checked, the borrower was personally liable for repayment. . . . . . . . . . sanction may beRECIPIENT'Sname,stretadres,cityortown,stateorprovince,country,andZIPorforeignpostalcode $ Short-term gain or loss $checked, proceeds from: repayment of the debtInternal Revenuereturn, a negligenceService Center penalty or other of the debtFile with Form 1096.imposed on you if7979 VOID CORRECTED 2 Long-term gain or loss 3IfCollectibles Broker andStreet address (including apt. no.) 5 Check here if the debtor was personally liable for. . . . . . . .File with Form 1096.sanction may be $ taxable income resultsimposed on you if Account number (see instructions) the debt . . . 6 Description of property . . . . . . . .For Privacy Actfrom this transactionPAYERS name, street address, city or town, state or province, country, ZIP Applicable checkbox onOrdinary Form 8949 OMB No. 1545-0715QOF Proceeds FromAccount number (see instructions) repayment of the debt6 7 Fair market value of property taxable income results Street address (including apt. no.) 5 Check if the borrower was personally liable for repayment ofand Paperworkor foreign postal code, and telephone no. $ 4Federal income tax withheld5security This is important taxCity or town, state or province, country, and ZIP or foreign postal code $ For Privacy Act andfrom this transaction and the IRS determinesPaperwork Reductionthat it has not been City or town, state or province, country, and ZIP or foreign postal code 6 Description of property Notice, see thethat it has not been reported. 2022 Barter ExchangeAct Notice, see thereported.Reduction ActIf checked, noncoveredinformation and isand the IRS determines www.irs.gov/Form1099A current General6Reported to IRS: Form1099-B Transactionsbeing furnished toAccount number (see instructions)Form 1099-C(Rev. 1-2022) (keep for your records) 6 VOID www.irs.gov/Form1099C current General Account number (see instructions) VOID CORRECTED Instructions for CertainVOID Gross proceeds 7Ifbased on amount in 1d return, a negligenceCORRECTED 1 Certain Information Returns.Form1099-A(Rev. 1-2022) (keep for your records) Department of the Treasury - Internal Revenue Service 1a Description of property (Example: 100 sh. XYZ Co.) the IRS. If you areInstructions forchecked, loss is not allowed 7 Fair market value of propertyDepartment of the Treasury - Internal Revenue ServiceLENDERS name, street address, city or town, state or province, country, ZIP orInformation1b Date acquired CORRECTED penalty or otherForm 1099-C(Rev. 1-2022) CREDITORS name, street address, city or town, state or province, country,OMB No. 1545-2281Returns.OMB No. 1545-0877 PAYERS name, street address, city or town, state or province, country, ZIPsanction may be41-0852411 $ DETACH BEFORE MAILINGDETACH BEFORE MAILINGDETACH BEFORE MAILINGForm1099-A(Rev. 1-2022) 41-0852411 Department of the Treasury - Internal Revenue Service Acquisition orNet proceeds1cDate sold or disposedApplicable c9heckbox on Form 8949 OMB No. 1545-0715 Proceeds FromZIP or foreign postal code, and telephone no.www.irs.gov/Form1099C Department of the Treasury - Internal Revenue Service MANUFACTURED ON OCR LASER BOND PAPER USING HEAT RESISTANT INKSMANUFACTURED ON OCR LASER BOND PAPER USING HEAT RESISTANT INKSMANUFACTURED ON OCR LASER BOND PAPER USING HEAT RESISTANT INKSCORRECTED (if checked) Form20 $ (Rev. January 2022) Copy B or For Lender RECIPIENTS name Account number (see instructions)RECIPIENTS TIN $ requirement $ 82022 on closed contracts $ Copy A imposed on you ifTransactions ZIP or foreign postal code, and telephone no. CORRECTED 1 and $ 2 Amount of debt discharged3 OMB No. 1545-2281(Rev. January 2022) of Debt of Debtforeign postal code, and telephone no.www.irs.gov/Form1099A OMB No. 1545-0877 Form1099-A Abandonment ofPAYERS TIN CUSIP number or foreign postal code, and telephone no.1d Proceeds $ $ 1eCost or other basis open contracts12/31/2021 2022 Broker andCREDITORS name, street address, city or town, state or province, country, 1 2 Amount of debt discharged Form1099-C Cancellation DoNotCutorSeparateFormsonThisPageDoNotCut orSeparateFormsonThisPage this income is LENDERS name, street address, city or town, state or province, country, ZIP or(Rev. January 2022) For calendar yearCopy C 14State name 15$ 1f Accrued market discount10 open contracts12/31/2022 $ Form1099-B Barter ExchangeDoNotCutorSeparateFormsonThisPage CORRECTED (if checked) DoNotCut orSe$parateFormsonThisPage Copy Ctaxable and the IRS foreign postal code, and telephone no. CORRECTED 1099-A 20 Acquisition or Secured Property $ $ 11on contracts Fordetermines that it8585 VOID $Interest, if included in box 2 For calendar year 1g Wash sale loss disallowed has not been 8080 VOID 1 Date of lenders acquisition orAbandonment of16State tax withheld 1a Description of property (Example: 100 sh. XYZ Co.) CREDITORS name, street address, city or town, state or province, country,DEBTORS TIN OMB No. 1545-2281 Form1099-C 20 Cancellation LENDERS name, street address, city or town, state or province, country, ZIP orBORROWERS TIN OMB No. 1545-0877For calendar year 2 Balance of principal outstanding Short-term gain or loss 3Check if proceeds from: Internal Revenuereported. ZIP or foreign postal code, and telephone no.CREDITORS TIN 4 Debt description(Rev. January 2022)1099-A 3 Acquisition or Secured Property 2 Long-term gain or loss12If checked, basis reported$ 1cDate sold or disposed 2 Amount of debt discharged postal Form1099-C 20 Cancellation foreign postal code, and telephone no. t ad LENDERS TIN 1 Date of lenders acquisition or 3 Form20 knowledge of abandonment $ 4 Fair market value of property StateCopy FormPAYERS TIN $ $ Ordinary to IRS QOF $ 1b Date acquired13Bartering Service CenterCopyand/or1or Copy C CREDITORS TIN CREDITORS TIN t ad DEBTOR'S or name,stret adres, cityortown, and state $ or or province, country, ZIP 3 Interest, if included in box 2 For calendar year. . of Debt . . . . . .Copy B For Creditor(Rev. 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RECIPIENT'Sname,stretadres,cityortown, 4Federal income tax withheldwww.irs.gov/Form1099B5Check if noncovered$ 1g Wash sale loss disallowed Copy DEBTOR'Sname,stre res, citytown,stateorprovince, country, ZIP 3 Interest, if included in box 24 Debt descriptionFor calendar yearCopy AThis is important taxand Paperwork For calendar year , city or town, state or province, country, and ZIP or foreign postal code 2 Balance of principal 4 Fair market value of property . . . . . . . . . information and is being. 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IfInstructions for 6 Description of property5 If checked, the borrower was personally liable for repayment. . . . . . . . . . imposed on you ifInformationPAYERS name, street address, city or town, state or province, country, ZIP Net proceeds Applicable checkbox onLong-term gain or lossOrdinary Form 8949 OMB No. 1545-0715QOF Proceeds Fromrepayment of the debt 6 Internal Revenuereturn, a negligence 4 Fair market value of property Service Center sanction may be9 open contracts12/31/2021 Collectibles Service Center penalty or other of the debtFile with Form 1096.Returns. Account number (see instructions)or foreign postal code, and telephone no. 2nd TIN not. 2022 on closed contracts Notice, see the 7 Fair market value of property Certain Information Returns.City or town, state or province, country, and ZIP or foreign postal code 6 Description of property $ For Privacy Actfrom this transaction14State name 15 16State tax withheld 10 11on contracts6Reported to IRS: Form2022 GeneralTransactions and PaperworkCity or town, state or province, country, and ZIP or foreign postal code repayment of the debt 6 www.irs.gov/Form1099C $ $ imposed on you if Street address (including apt. no.) 1099-A(Rev. 1-2022) the debt . . . 6 Description of property . . . . . . . . taxable income resultsCUSIP number requirement $ open contracts12/31/2022 $ $ Gross proceeds 2022 Barter ExchangeFor Privacy ActStreet address (including apt. no.) Form 1099-C(Rev. 1-2022) 5 Check here if the debtor was personally liable for. . . . . . . .File with Form 1096.sanction may be Instructions for4Federal income tax withheld5Check if noncovered www.irs.gov/Form1099A and the IRS determinessecurity taxable income results Account number (see instructions)Form5 Check if the borrower was personally liable for repayment ofand Paperworkthat it has not been reported. Certain Reduction ActAccount number (see instructions) For Privacy Act andfrom this transaction Reduction Act1099-B Paperwork Reduction Department of the Treasury - Internal Revenue Service Information Department of the Treasury - Internal Revenue Service7Check if loss is not allowed Notice, see the1a Description of property (Example: 100 sh. XYZ Co.) 7 Fair market value of property and the IRS determines Returns. Act Notice, see the that it has not been reported.based on amount in 1dFormFormLAA (Rev. 1-2022) 5146 VOID www.irs.gov/Form1099A current GeneralForm1099-B PAYERS TIN 5153 $ 41-0852411 $ IRS $ $ $ Net proceeds1cDate sold or disposed9 open contracts12/31/2021 Notice, see the Account number (see instructions)Form 1099-C(Rev. 1-2022) (keep for your records) 6 VOID www.irs.gov/Form1099C 1 current General 1099-A41-0852411 (keep for your records) CORRECTED Instructions for CertainLBA $ 12Check if basis reported to 1b Date acquired13Bartering82022 on closed contracts $ Copy B 2022 GeneralForm 1099-C(Rev. 1-2022) LCA ZIP or foreign postal code, and telephone no.www.irs.gov/Form1099C CORRECTED Instructions for Department of the Treasury - Internal Revenue Service7 Fair market value of propertyDepartment of the Treasury - Internal Revenue ServiceAccount number (see instructions) LENDERS name, street address, city or town, state or province, country, ZIP orInformationAccount number (see instructions)RECIPIENTS TIN www.irs.gov/Form1099B 2nd TIN not. $ 1eCost or other basis For Recipient Information CREDITORS name, street address, city or town, state or province, country,Certain Information Returns.1099-A(Rev. 1-2022) foreign postal code, and telephone no.www.irs.gov/Form1099A OMB No. 1545-0877 Returns. Acquisition orCUSIP number 15 andZIPorforeignpostalcode requirement $ Department of the Treasury - Internal Revenue Service Instructions forCertain 5137 41-0852411 1 $ 2 Amount of debt discharged OMB No. 1545-2281 Cancellation OMB No. 1545-0877 1d Proceedsforeign postal code, and telephone no. CORRECTED (if checked) Form1099-A Form1099-A Abandonment ofRECIPIENT'Sname,stretad 14State name , stateorprovince,country, $ $ 1fAccrued market discount10 open contracts12/31/2022 $ Returns. CREDITORS name, street address, city or town, state or province, country,Department of the Treasury - Internal Revenue ServiceForm1099-C of DebtDepartment of the Treasury - Internal Revenue Service(Rev. January 2022) rescityortown, 16State tax withheld $ $ 1g Wash sale loss disallowed11on contracts ZIP or foreign postal code, and telephone no. CORRECTED (if checked)$ OMB No. 1545-2281(Rev. January 2022)LENDERS name, street address, city or town, state or province, country, ZIP or(Rev. January 2022) For calendar yearCopy C $ 2 Short-term gain or loss IRSchecked, proceeds from:13Bartering $ 3 Interest, if included in box 2 For calendar year LENDERS TIN BORROWERS TIN 1 Date of lenders acquisition or20 Acquisition or Secured Property Form1099-B Ordinary 3IfCollectibles $ This is important taxCREDITORS TIN DEBTORS TIN$ 2 Amount of debt discharged4 Debt description 1099-C 20 CancellationCopy CAbandonment ofLong-term gain or loss12Check if basis reported toForm LENDERS TIN BORROWER'S name, stret adres, city or town, state or province, country, and ZIP or foreign postal code For calendar year 2 Balance of principal outstanding For Borrower or For Lender $ 4Federal income tax withheldwww.irs.gov/Form1099B5IfQOF information and isCREDITORS TIN DEBTOR'Sname,stret adres, cityortown,stateorprovince, country,andZIP 3 Interest, if included in box 2 (Rev. January 2022) of Debt For Creditorknowledge of abandonment Secured Propertychecked, noncovered Department of the Treasury - Internal Revenue Service For calendar year knowledge of abandonment3 20 $ Copy B StateCopy 6Reported to IRS: security being furnished toDEBTORS TIN $orforeignpostalcode 20 Copy B For Privacy Act 1 Date of lenders acquisition or 2 Balance of principalthe IRS. If you are BORROWERS TIN $ outstanding $ 4 Fair market value of property For Privacy ActVOID Gross proceeds 7Ifbased on amount in 1d return, a negligence4 Debt description 5 Check here if the debtor was personally liable for. . . . . . . For Debtor .and Paperworkchecked, loss is not allowed and PaperworkCORRECTED5 Check if the borrower was personally liable for repayment of information and is being This is important taxNotice, see theor foreign postal code, and telephone no. 82022 on closed contractsApplicable c9heckbox on Form 8949 OMB No. 1545-0715 Proceeds FromThis is important taxNotice, see the BORROWER'S name, stret adres, city or town, state or province, country, and ZIP or foreign postal code3 4 Fair market value of property furnished to the IRS. IfReduction ActPAYERS name, street address, city or town, state or province, country, ZIP Net proceeds penalty or otherDEBTOR'Sname,stret adres, cityortown,stateorprovince, country,andZIPorforeignpostalcode repayment of the debtinformation and is beingReduction Act the debt$ . . . . . . . . . . . . current GeneralAccount number (see instructions) open contracts12/31/2021 sanction may beBroker andfurnished to the IRS. Ifcurrent General 6 Description of property return, a negligenceInstructions for$ $ 2022 Barter Exchange5 If checked, the debtor was personally liable for. . . . . . . .return, a negligenceInstructions for imposed on you if 5 If checked, the borrower was personally liable for repayment. . . . . . . . . . penalty or otherCertainCUSIP number requirement 10 open contracts12/31/2022 11on contracts Formthis income isTransactions Account number (see instructions) repayment of the debt 6 7 Fair market value of property Certain Information Returns.6 Description of propertysanction may beInformationtaxable and the IRS$ sanction may be imposed on you if1099-BAccount number (see instructions) of the debttaxable income resultsReturns. determines that itpenalty or other 1a Description of property (Example: 100 sh. XYZ Co.) imposed on you if has not been Account number (see instructions)Form1099-A(Rev. 1-2022) www.irs.gov/Form1099A from this transaction14State name 15 16State tax withheld $ to IRS $ reported. Form 1099-C(Rev. 1-2022) 6 www.irs.gov/Form1099C taxable income results and the IRS determinesfrom this transaction Department of the Treasury - Internal Revenue Service $ 12If checked, basis reported 1b Date acquired13Bartering 1cDate sold or disposed Account number (see instructions) 7 Fair market value of propertyDepartment of the Treasury - Internal Revenue Servicewww.irs.gov/Form1099A that it has not been reported. Form1099-B PAYERS TIN $ RECIPIENTS TIN $ $ $ 1g Wash sale loss disallowed Copyand/or1or Copy C Form 1099-C(Rev. 1-2022)LCB (keep for your records) VOID www.irs.gov/Form1099C 1 $ and the IRS determines that it has not been reported.Form1099-A(Rev. 1-2022)LAB (keep for your records) 5147 Department of the Treasury - Internal Revenue Service LBB 5154 (Keep for your records) www.irs.gov/Form1099B1d ProceedsDepartment of the Treasury - Internal Revenue Service1eCost or other basis For Payer 5138 Department of the Treasury - Internal Revenue Serviceforeign postal code, and telephone no. VOID CORRECTED OMB No. 1545-0877 Acquisition orRECIPIENT'Sname,stretadres,cityortown,stateorprovince,country,andZIPorforeignpostalcode $ 1fAccrued market discount $ 3Check if proceeds from: State,2 ZIP or foreign postal code, and telephone no. CORRECTED OMB No. 1545-2281LENDERS name, street address, city or town, state or province, country, ZIP orCopy CREDITORS name, street address, city or town, state or province, country, Form1099-A Abandonment of2 Long-term gain or loss Collectibles 2 Amount of debt discharged Form1099-C Cancellation Short-term gain or loss(Rev. January 2022)For calendar yearSecured Property Ordinary QOF $ (Rev. January 2022) of Debt20 4Federal income tax withheld5Check if noncovered3 Interest, if included in box 2 For calendar year LENDERS TIN BORROWERS TIN 1 Date of lenders acquisition or 2 Balance of principalCopy C $ 6Reported to IRS: security For Privacy ActCREDITORS TIN DEBTORS TIN $ 4 Debt description 20 Copy Cknowledge of abandonment outstanding For Lender Gross proceeds 7Check if loss is not allowedand PaperworkFor Creditor$ orStateCopy based on amount in 1d Reduction Act BORROWER'S name, stret adres, city or town, state or province, country, and ZIP or foreign postal code3 4 Fair market value of property Net proceeds Notice, see theDEBTOR'Sname,stret adres, cityortown,stateorprovince, country,andZIPorforeignpostalcodeFor Privacy ActAccount number (see instructions) 2nd TIN not. 82022 on closed contracts 9 open contracts12/31/2021 2022 GeneralFor Privacy Act $ and PaperworkInstructions forand Paperwork Reduction ActReduction Act 5 Check if the borrower was personally liable for repayment of. . . . . . . . . . . . Notice, see theCUSIP number requirement $ open contracts12/31/2022 $ Certain 5 Check here if the debtor was personally liable for. . . . . . . .Notice, see the the debt current General10 11on contracts Information repayment of the debtcurrent General 6 Description of property Instructions for CertainReturns. Instructions for Information14State name 15 16State tax withheld $ $Account number (see instructions) Returns. $ 12Check if basis reported to 13Bartering Account number (see instructions) 6 7 Fair market value of property Certain Information Returns.$ IRS $ $Form1099-A(Rev. 1-2022) LAC www.irs.gov/Form1099A 5148 Department of the Treasury - Internal Revenue Service Form1099-B LBC 5155 www.irs.gov/Form1099B Department of the Treasury - Internal Revenue Service Form 1099-C(Rev. 1-2022) LCC 5139 www.irs.gov/Form1099C Department of the Treasury - Internal Revenue ServiceRequired Envelope: Required Envelope: Required Envelope:APEX/TFP: DW19W or DW19WS APEX: DWMR or DWMRS APEX/TFP: DW19W or DW19WSTFP: 77771 or 77772(5) 1096 Transmittal forms are included with each Federal Copy A (Red) form orderAPEX - Sheets per packTFP - Forms per pack50s100sFORM DESCRIPTIONLAA51461099-A Federal Copy A1 Page Equals 3 FormsLAB51471099-A Borrower Copy B1 Page Equals 3 FormsLAC51481099-A Lender Copy C and/or State Copy1 Page Equals 3 FormsLBA51531099-B Federal Copy A1 Page Equals 2 FormsLBB51541099-B Recipient Copy B1 Page Equals 2 FormsLBC51551099-B Payer Copy C and/or State/Copy 1, 21 Page Equals 2 FormsLCA51371099-C Federal Copy A1 Page Equals 3 FormsLCB51381099-C Debtor Copy B1 Page Equals 3 FormsLCC51391099-C Creditor Copy C1 Page Equals 3 Forms31"