b"1099 PRE-PRINTED & BLANK FORMSTFP 1099-MISC Laser Packaged SetsTFP 1099-MISC LASER PACKAGED SETTFP 5110 TFP 5111 TFP 5112 TFP 51009595 VOID CORRECTED OMB No. 1545-0115 CORRECTED (if checked) OMB No. 1545-0115 VOID CORRECTED OMB No. 1545-0115 Do Not Staple 6969 OMB No. 1545-0108PAYERS name, street address, city or town, state or province, country, ZIP 1 Rents Form1099-MISC PAYERS name, street address, city or town, state or province, country, ZIP$ 1 Rents Form1099-MISC PAYERS name, street address, city or town, state or province, country, ZIP$ 1 Rents Form1099-MISC Form1096 Annual Summary and Transmittal of 2022 DETACH BEFORE MAILINGDETACH BEFORE MAILINGMANUFACTURED ON OCR LASER BOND PAPER USING HEAT RESISTANT INKSDETACH BEFORE MAILINGMANUFACTURED ON OCR LASER BOND PAPER USING HEAT RESISTANT INKS MANUFACTURED ON OCR LASER BOND PAPER USING HEAT RESISTANT INKSor foreign postal code, and telephone no. or foreign postal code, and telephone no. or foreign postal code, and telephone no.$ 2 Royalties (Rev. January 2022) Miscellaneous2 Royalties (Rev. January 2022) Miscellaneous2 Royalties (Rev. January 2022) MiscellaneousU.S. Information ReturnsDepartment of the Treasury For calendar yearInformation For calendar yearInformation For calendar yearInformationInternal Revenue ServiceFILERS name$ 20 $ 20 $ 203 Other income 4 Federal income tax withheld Copy A 3 Other income 4 Federal income tax withheld Copy B 3 Other income 4 Federal income tax withheld Copy CPAYERS TIN RECIPIENTS TIN $ 5 Fishing boat proceeds $ 6 Medical and health carePAYERS TIN ForRECIPIENTS TIN $ 5 Fishing boat proceeds $ 6 Medical and health careFor Recipient RECIPIENTS TIN $ 5 Fishing boat proceeds $ 6 Medical and health careor For PayerStreet address (including room or suite number)payments Internal Revenuepayments PAYERS TIN payments StateCopy2Service Center orCopyCity or town, state or province, country, and ZIP or foreign postal codeRECIPIENTS name $ 7 totaling $5,000 or more of$ 8 of dividends or interest File with Form 1096. res, city or town, state or province, country, and ZIP or foreign postal code $ 7 totaling $5,000 or more of$ 8 of dividends or interest This is important taxres, city or town, state or province, country, and ZIP or foreign postal code $ 7 totaling $5,000 or more of$ 8 of dividends or interest For Privacy ActTelephone number For Ofcial Use OnlyPayer made direct salesSubstitute payments in lieuRECIPIENT'S name, stret ad Payer made direct salesSubstitute payments in lieuRECIPIENT'S name, stret ad Payer made direct salesSubstitute payments in lieu Name of person to contactFor Privacy Act Street address (including apt. no.) $ consumer products to$ 10 Gross proceeds paid to anand Paperwork$ consumer products to$ 10 Gross proceeds paid to aninformation and is$ consumer products to$ 10 Gross proceeds paid to anand Paperwork2 Social security number Fax number $ 4 Federal income tax withheld $ 5 Total amount reported with this Form 1096 TFP 77771recipient for resale Reduction Actrecipient for resale being furnished torecipient for resale Email addressReduction Act 9 Crop insurance proceeds $ attorney Notice, see the 9 Crop insurance proceeds $ attorney the IRS. If you are9 Crop insurance proceeds $ attorney Notice, see the 3 Total number of formscurrent General return, a negligencecurrent General1 Instructions forpenalty or other City or town, state or province, country, and ZIP or foreign postal code 11 Fish purchased for resale 12 Section 409A deferrals Certain 11 Fish purchased for resale 12 Section 409A deferrals imposed on you if11 Fish purchased for resale 12 Section 409A deferrals Instructions forCertain 50 10981098-C1098-E1098-F 74 83 1099-A1099-B1099-C1099-CAP 1099-DIV1099-G1099-INT1099-K1099-LS Information sanction may beInformation 81 78 84 03 1098-Q1098-T 80 79 85 73 91 86 92 10 166 W-2G 1097-BTC$ $ Returns. $ $ this income is$ $ Returns.taxable and the IRS3213 requirement 14 Excess golden parachute 15 compensation 13 requirement 14 Excess golden parachute 15 compensation determines that it13 requirement 14 Excess golden parachute 15 compensationpayments payments has not beenpayments$ $ $ $ reported. $ $ 1099-LTC1099-MISC 1099-NEC 1099-OID1099-PATR1099-Q1099-QA 1099-R1099-S1099-SA 1099-SB 3921392254985498-ESA5498-QA 5498-SA Account number (see instructions) 2nd TIN not.16 State tax withheld 17 State/Payers state no. 18 Account number (see instructions) 16 State tax withheld 17 State/Payers state no. 18 Account number (see instructions) 2nd TIN not.16 State tax withheld 17 State/Payers state no. 18 State income 95 71 96 97 31 1A 98 75 94 43 25 26 28 72 2A 27State income State income 93$ $ $ $ $ $$ $ $ $ $ $Form1099-MISC(Rev. 1-2022)41-0852411 www.irs.gov/Form1099MISC Department of the Treasury - Internal Revenue ServiceForm1099-MISC(Rev. 1-2022) (keep for your records) www.irs.gov/Form1099MISC Department of the Treasury - Internal Revenue ServiceForm1099-MISC(Rev. 1-2022) www.irs.gov/Form1099MISC Department of the Treasury - Internal Revenue ServiceDo Not Cut or Separate Forms on This PageDo Not Cut or Separate Forms on This Page Return this entire page to the Internal Revenue Service. Photocopies are not acceptable. Send this form, with the copies of the form checked in box 6, to the IRS in a at mailer (not folded).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.9595 VOID CORRECTED OMB No. 1545-0115 CORRECTED (if checked) OMB No. 1545-0115 VOID CORRECTED OMB No. 1545-0115 SignatureTitleDate PAYERS name, street address, city or town, state or province, country, ZIP 1 Rents PAYERS name, street address, city or town, state or province, country, ZIP1 Rents PAYERS name, street address, city or town, state or province, country, ZIP1 Rentsor foreign postal code, and telephone no. (Rev. January 2022) or foreign postal code, and telephone no. $ 2 Royalties Form1099-MISC Miscellaneous$ 2 Royalties Form1099-MISC Miscellaneousform must be the same as those you enter in the upper left area of or foreign postal code, and telephone no.$ Form1099-MISC Miscellaneous(Rev. January 2022) Information (Rev. January 2022) InstructionsFuture developments. For the latest information about developments 2 Royalties For calendar yearInformation For calendar yearFor calendar yearInformation Forms 1097, 1098, 1099, 3921, 3922, 5498, or W-2G.related to Form 1096, such as legislation enacted after it was published, go to www.irs.gov/Form1096.$ 20 $ 20 $ 20 Reminder. The only acceptable method of electronically throughWhen to le. File Form 1096 as follows.3 Other income 4 Federal income tax withheld Copy A 3 Other income 4 Federal income tax withheld Copy B 3 Other income 4 Federal income tax withheld information returns listed on this form in box 6 with the IRS isCopy CPAYERS TIN RECIPIENTS TIN $ 5 Fishing boat proceeds $ 6 Medical and health carePAYERS TIN ForRECIPIENTS TIN $ 5 Fishing boat proceeds $ 6 Medical and health careFor Recipient RECIPIENTS TIN $ 5 Fishing boat proceeds $ 6 Medical and health careor the FIRE System. See Pub. 1220.February 28, 2023.Internal Revenuepayments PAYERS TIN payments For PayerPurpose of form. Use this form to transmit paper Forms 1097, 1098, payments Service Center StateCopy21099, 3921, 3922, 5498, and W-2G to the IRS. orCopyCaution: RECIPIENTS name $ 7 totaling $5,000 or more of$ 8 of dividends or interest File with Form 1096. res, city or town, state or province, country, and ZIP or foreign postal code $ 7 totaling $5,000 or more of$ 8 of dividends or interest This is important taxres, city or town, state or province, country, and ZIP or foreign postal code $ 7 totaling $5,000 or more of$ 8 of dividends or interest For Privacy Act electronically but fail to do so, and you do notWhere To FilePayer made direct salesSubstitute payments in lieuRECIPIENT'S name, stret ad Payer made direct salesSubstitute payments in lieuRECIPIENT'S name, stret ad Payer made direct salesSubstitute payments in lieu have an approved waiver, you may be subject to a penalty. Thefollowing.For Privacy ActTaxpayer First Act of 2019, enacted July 1, 2019, authorized the consumer products to$ and Paperworkconsumer products to$ being furnished toconsumer products to$ Department of the Treasury and the IRS to issue regulations thatIf your principal business, ofceUse the following Street address (including apt. no.) recipient for resale 10 Gross proceeds paid to anReduction Actrecipient for resale 10 Gross proceeds paid to aninformation and isrecipient for resale 10 Gross proceeds paid to anand Paperworkor agency, or legal residence inaddressreduce the 250-return requirement for 2021 tax returns. If those Reduction Act current General return, a negligenceregulations are issued and effective for 2022 tax returns required to be www.irs.gov/Form1099located inCity or town, state or province, country, and ZIP or foreign postal code $ 9 Crop insurance proceeds $ attorney Notice, see the$ 9 Crop insurance proceeds $ attorney the IRS. If you are$ 9 Crop insurance proceeds $ attorney Notice, see thethe case of an individual, is Internal Revenue Service Instructions for penalty or othercurrent General Alabama, Arizona, Arkansas, Delaware, explaining the change. Until regulations are issued, however, the 11 Fish purchased for resale 12 Section 409A deferrals Certain 11 Fish purchased for resale 12 Section 409A deferrals imposed on you if11 Fish purchased for resale 12 Section 409A deferrals Instructions for Florida, Georgia, Kentucky, Maine,P.O. Box 149213 Information sanction may beInformation Returns. part F in the 2022 General Instructions for CertainMassachusetts, Mississippi, New information, seeReturns. $ $ this income is$ $ Certain Hampshire, New Jersey, New Mexico,Austin, TX 78714-9213InformationReturns. Vermont, Virginia$ $ payments taxable and the IRS13 requirement 14 Excess golden parachute 15compensation of the number of returns. New York, North Carolina, Ohio, Texas, 13 requirement 14 Excess golden parachute 15 compensation 13 requirement 14 Excess golden parachute 15 compensation determines that itpayments Who must le. payments has not been $ $ $ $ reported. $ $ Caution: Your name and TIN must match the name and TIN used on State income State income your 94X series tax return(s) or you may be subject to information Account number (see instructions) 2nd TIN not.16 State tax withheld 17 State/Payers state no. 18 Account number (see instructions) 16 State tax withheld 17 State/Payers state no. 18 Account number (see instructions) 2nd TIN not.16 State tax withheld 17 State/Payers state no. 18 State income$ $ $ $ $ $ return penalties. Do not use the name and/or TIN of your paying agent or service bureau.Form(Rev. 1-2022)LMA 41-0852411 5110 $ $ (Rev. 1-2022)LMB 5111 $ www.irs.gov/Form1099MISC $ (Rev. 1-2022) LMC/LM2 $ 5112 $ For more information and the Privacy Act and Paperwork Reduction Act Notice,L1096 41-0852411 5100 Form1096(2022)1099-MISCwww.irs.gov/Form1099MISC Department of the Treasury - Internal Revenue ServiceForm1099-MISC(keep for your records) Department of the Treasury - Internal Revenue ServiceForm1099-MISCwww.irs.gov/Form1099MISC Department of the Treasury - Internal Revenue Servicesee the 2022 General Instructions for Certain Information Returns.TFP 1099-MISC LASER PACKAGED SETFOR 50 EMPLOYEES TFP 1099-MISC BLANK LASER PACKAGED SETTFP 5110 TFP 5144 TFP 510061023-Part PRE-PACKAGED CONVENIENCE SET includes: 9595 VOID CORRECTED OMB No. 1545-0115 MiscellaneousDo Not Staple 6969 Annual Summary and Transmittal of OMB No. 1545-01085110 (50), 5111 (50), 5112 (100), 5100 - 1096 (3) PAYERS name, street address, city or town, state or province, country, ZIP$ $ 1 Rents Form 1099-MISC Information Form1096 U.S. Information Returns 2022 DETACH BEFORE MAILINGDETACH BEFORE MAILING MANUFACTURED ON OCR LASER BOND PAPER USING HEAT RESISTANT INKSMANUFACTURED ON OCR LASER BOND PAPER USING HEAT RESISTANT INKSor foreign postal code, and telephone no.2 Royalties (Rev. January 2022) Department of the Treasury For calendar yearInternal Revenue Service$ 3 Other income $ 20 Copy A FILERS name6102E3-Part PRE-PACKAGED CONVENIENCE SET includes: PAYERS TIN RECIPIENTS TIN $ 5 Fishing boat proceeds $ 4 Federal income tax withheld Internal RevenueStreet address (including room or suite number) For Ofcial Use Only6 Medical and health careService CenterFor paymentsRECIPIENTS name 7 totaling $5,000 or more of8 of dividends or interest File with Form 1096. City or town, state or province, country, and ZIP or foreign postal codeTelephone number5110 (50), 5111 (50), 5112 (100), 5100 - 1096 (3), 77772 Envelopes (50) Street address (including apt. no.) $ Payer made direct sales$ $ Substitute payments in lieuFor Privacy Act16Name of person to contact 2 Social security number Fax number 1099-A 79 $ 4 Federal income tax withheld 91 $ 5 Total amount reported with this Form 1096consumer products toand PaperworkEmail addressrecipient for resale Reduction Act attorney current General City or town, state or province, country, and ZIP or foreign postal code 9 Crop insurance proceeds 10 Gross proceeds paid to anNotice, see the W-2G 1097-BTC10981098-C1098-E1098-F 74 3 Total number of forms 1099-B1099-C1099-CAP 1099-DIV1099-G1099-INT1099-K1099-LS 11 Fish purchased for resale12 Section 409A deferrals Instructions for 1098-Q1098-T 80 85 73 86 92 10 16Certain61034-Part PRE-PACKAGED CONVENIENCE SET includes: Account number (see instructions) 41-0852411 13 requirement $ $ $ $ 14 Excess golden parachute$ $ 15 compensation $ $ Information 32 50 81 78 97 84 03 1099-QA83 1099-S1099-SA 1099-SB 3921392254985498-ESA5498-QA 5498-SA Returns.payments2nd TIN not.16 State tax withheld 17 State/Payers state no. 18 State income 1099-LTC1099-MISC 1099-NEC 1099-OID1099-PATR1099-Q 1A 1099-R 75 94 43 25 26 28 72 2A 2793 95 71 96 31 985110 (50), 5111 (50), 5112 (100), 5100 - 1096 (3)Do Not Cut or Separate Forms on This PageDo Not Cut or Separate Forms on This Page Send this form, with the copies of the form checked in box 6, to the IRS in a at mailer (not folded).Form 1099-MISC (Rev. 1-2022) www.irs.gov/Form1099MISC Department of the Treasury - Internal Revenue Service Return this entire page to the Internal Revenue Service. Photocopies are not acceptable. 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.6103E4-Part PRE-PACKAGED CONVENIENCE SET includes: PAYERS name, street address, city or town, state or province, country, ZIP$ 1 Rents OMB No. 1545-0115 MiscellaneousSignatureTitleDate 9595 VOID CORRECTEDor foreign postal code, and telephone no. 2 Royalties Form 1099-MISC Information Instructions form must be the same as those you enter in the upper left area of (Rev. January 2022) Future developments. For the latest information about developments related to Form 1096, such as legislation enacted after it was 5110 (50), 5111 (50), 5112 (100), 5100 - 1096 (3), 77772 Envelopes (50) PAYERS TIN RECIPIENTS TIN $ $ 3 Other income $ For calendar yearCopy A Reminder. The only acceptable method of electronically throughForms 1097, 1098, 1099, 3921, 3922, 5498, or W-2G.20 published, go to www.irs.gov/Form1096. When to le. File Form 1096 as follows.Federal income tax withheld information returns listed on this form in box 6 with the IRS is5 Fishing boat proceeds 4 Medical and health careInternal Revenuethe FIRE System. See Pub. 1220.February 28, 2023.6 payments Service CenterFor1099, 3921, 3922, 5498, and W-2G to the IRS. $ 7 Payer made direct sales$ 8 of dividends or interest File with Form 1096. Purpose of form. Use this form to transmit paper Forms 1097, 1098, Where To FileCaution: 61055-Part PRE-PACKAGED CONVENIENCE SET includes: RECIPIENTS name $ totaling $5,000 or more of$ $ Substitute payments in lieuFor Privacy Acthave an approved waiver, you may be subject to a penalty. Thefollowing. located inUse the following electronically but fail to do so, and you do not consumer products toand PaperworkTaxpayer First Act of 2019, enacted July 1, 2019, authorized theIf your principal business, ofce Department of the Treasury and the IRS to issue regulations that recipient for resale attorney Reduction Act reduce the 250-return requirement for 2021 tax returns. If those www.irs.gov/Form1099or agency, or legal residence in regulations are issued and effective for 2022 tax returns required to be Street address (including apt. no.) 9 Crop insurance proceeds 10 Gross proceeds paid to anNotice, see theexplaining the change. Until regulations are issued, however, thethe case of an individual, isaddresscurrent GeneralInstructions forinformation, see part F in the 2022 General Instructions for CertainFlorida, Georgia, Kentucky, Maine,P.O. Box 149213 5110 (50), 5111 (25), 5112 (75), 5100 - 1096 (3)City or town, state or province, country, and ZIP or foreign postal code $ $ 11 Fish purchased for resale $ $ 12 Section 409A deferrals Information Information Returns. Alabama, Arizona, Arkansas, Delaware,Internal Revenue ServiceCertain Massachusetts, Mississippi, NewAustin, TX 78714-9213Returns. of the number of returns. Hampshire, New Jersey, New Mexico, New York, North Carolina, Ohio, Texas, 13 requirement 14 Excess golden parachute 15 compensation Who must le.Vermont, VirginiapaymentsCaution: 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 FOR 25 EMPLOYEES Account number (see instructions) LMA41-0852411 2nd TIN not. $ $ 16 State tax withheld 17 State/Payers state no. $ $ 18 State income 5144M return penalties. Do not use the name and/or TIN of your paying agentL1096 41-0852411 5100 Form 1096 (2022)or service bureau.Form 1099-MISC (Rev. 1-2022) 5110 www.irs.gov/Form1099MISC Department of the Treasury - Internal Revenue Service For more information and the Privacy Act and Paperwork Reduction Act Notice, see the 2022 General Instructions for Certain Information Returns.6103254-Part PRE-PACKAGED CONVENIENCE SET includes: TFP 1099-NEC LASER PACKAGED SET5110 (25), 5111 (25), 5112 (50), 5100 (3)TFP NEC5110 TFP NEC5111 TFP NEC5112 TFP 51006103E254-Part PRE-PACKAGED CONVENIENCE SET includes: 7171 VOID CORRECTED OMB No. 1545-0116 NonemployeeCORRECTED (if checked) OMB No. 1545-0116 VOID CORRECTED Do Not Staple 6969 Annual Summary and Transmittal of OMB No. 1545-01085110 (25), 5111 (25), 5112 (50), 5100 - 1096 (3), 77772 Envelopes (25) PAYERS name, street address, city or town, state or province, country, ZIP1 Nonemployee compensation Form 20 or foreign postal code, and telephone no. res RECIPIENTS TIN $ 1 Nonemployee compensation Form or foreign postal code, and telephone no. tad,or orprovince, S TIN ZIPorforeignpostalcode $ 2Nonemployee compensation OMB No. 1545-0116 Compensation U.S. Information Returns 2022or foreign postal code, and telephone no. PAYERS name, street address, city or town, state or province, country, ZIP__DETACH BEFORE MAILING PAYERS name, street address, city or town, state or province, country, ZIP DETACH BEFORE MAILING FormForm1096 Nonemployee DETACH 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 INKS 1099-NEC Compensation1099-NEC Nonemployee 1099-NECDepartment of the Treasury (Rev. January 2022) (Rev. January 2022) Compensation (Rev. January 2022)For calendar year For calendar year Internal Revenue ServiceRECIPIENT RECIPIENTS TIN $ PAYERS TIN t ad For Internal Revenue20 name,stre rescitytown,state RECIPIENT and 20 FILERS name Copy CFor calendar yearCopy A PAYERS TIN Copy B For PayerPAYERS TINS name consumer products to recipient for resale , city or town, state or province, country, and ZIP or foreign postal code consumer products to recipient for resale information and is being1 Payer made direct sales totaling $5,000 or more of Street address (including room or suite number)6105255-Part PRE-PACKAGED CONVENIENCE SET includes: Street address (including apt. no.) 41-0852411 2nd TIN not.$ $ 3 2 Payer made direct sales totaling $5,000 or more of5 $ $ File with Form 1096. $ $ $ 3 2 Payer made direct sales totaling $5,000 or more of(Rev. 1-2022) $ $ For Recipient country, 2nd TIN not. $ $ $ 3 4 Federal income tax withheld Name of person to contact 16$ $ and/or State Telephone number 1099-B $ 1099-C1099-CAPFor Ofcial Use Only $ 1099-LS RECIPIENT'S name, stre Service Center RECIPIENT'S This is important taxCopy 1 or Copy 2City or town, state or province, country, and ZIP or foreign postal code 4 Federal income tax withheld s state no. Paperwork Reduction Act current 4 Federal income tax withheld furnished to the IRS. If you areconsumer products to recipient for resaleCity or town, state or province, country, and ZIP or foreign postal codePaperwork Reduction For Privacy Act and Act Notice, see the current GeneralFax numberFor Privacy Act and sanction may be imposed onInstructions for Certain Notice, see thenegligence penalty or other General Instructions for you if this income is taxable 5110 (25), 5111 (25), 5112 (75), 5100 - 1096 (3) Account number (see instructions) $ State tax withheld 6 State/Payer Form 1099-NECCertain Information 5 State tax withheld 6 State/Payers state no. and the IRS determines that it5 State tax withheld 6 State/PayerEmail addresss state no. 1098 7 Information Returns. 03 74 3 Total number of forms 79 4 Federal income tax withheld 91 5 Total amount reported with this Form 10967 State incomeReturns. 7 State income State incomehas not been reported.Account number (see instructions) Account number (see instructions) 2 Social security numberForm 1099-NEC (Rev. 1-2022) www.irs.gov/Form1099NEC Department of the Treasury - Internal Revenue Service Form 1099-NEC (Rev. 1-2022) (keep for your records)Do Not Cut or Separate Forms on This PageDo Not Cut or Separate Forms on This Page www.irs.gov/Form1099NEC Department of the Treasury - Internal Revenue Service www.irs.gov/Form1099NEC Department of the Treasury - Internal Revenue Service 1098-Q1098-T1099-A 85 73 1099-DIV1099-G1099-INT1099-K 16W-2G 1097-BTC 81 1098-C1098-E1098-F 83 80 86 92 1032 50 78 847171 VOID CORRECTED OMB No. 1545-0116 CORRECTED (if checked) VOID CORRECTED OMB No. 1545-0116 1099-OID1099-PATR1099-Q1099-QA 1099-R1099-S1099-SA 1099-SB 3921392254985498-ESA5498-QA 5498-SA PAYERS name, street address, city or town, state or province, country, ZIPPAYERS name, street address, city or town, state or province, country, ZIP PAYERS name, street address, city or town, state or province, country, ZIPor foreign postal code, and telephone no. OMB No. 1545-0116 NonemployeeForm 1099-NEC 71 96 97 31TFP 1099-NEC LASER PACKAGED LASER SET or foreign postal code, and telephone no. RECIPIENTS TIN $ 1 Nonemployee compensation Form 1099-NEC t adres Nonemployee$ 1 Nonemployee compensation Form or foreign postal code, and telephone no. tad,or orprovince,country,andZIPorforeignpostalcode $ 1 Nonemployee compensation 1099-LTC1099-MISC 1099-NECNonemployee1A 98 75 94 43 25 26 28 72 2A 27 1099-NEC 93 95(Rev. January 2022) Compensation (Rev. January 2022) Compensation (Rev. January 2022) CompensationFor calendar year For calendar year For calendar yearRECIPIENT 20 PAYERS TIN For Internal Revenue20 name,stre rescitytown,state Copy B 20 Copy C dge and belief, they are true, correct, Copy A PAYERS TIN RECIPIENTS TIN Return this entire page to the Internal Revenue Service. Photocopies are not acceptable. RECIPIENTS TIN For PayerPAYERS TINS name (Rev. 1-2022) 41-0852411 $ 3 2 Payer made direct sales totaling $5,000 or more of$ File with Form 1096. $ 3 2 Payer made direct sales totaling $5,000 or more of(Rev. 1-2022) $ For Recipient $ $ 45 Federal income tax withheld 3 Send this form, with the copies of the form checked in box 6, to the IRS in a at mailer (not folded). $ $RECIPIENT'S name, stre Service Center RECIPIENT'S This is important taxconsumer products to recipient for resaleand complete. Copy 1 or Copy 2For Privacy Act and4 Federal income tax withheld furnished to the IRS. If you areSignature and/or State Title Dateconsumer products to recipient for resale , city or town, state or province, country, and ZIP or foreign postal code consumer products to recipient for resale information and is being2 Payer made direct sales totaling $5,000 or more of Under penalties of perjury, I declare that I have examined this return and accompanying documents and, to the best of my knowleGeneral Instructions for and the IRS determines that itFor Privacy Act andnegligence penalty or other FOR 50 EMPLOYEES Street address (including apt. no.) 2nd TIN not. $ $ 4 Federal income tax withheld $ Paperwork Reduction Act$ $ 5 State tax withheld 6 State/Payers state no. $ sanction may be imposed on2nd TIN not.$ State tax withheld Instructions Paperwork Reductionform must be the same as those you enter in the upper left area of City or town, state or province, country, and ZIP or foreign postal code 5 State tax withheld 6 State/Payers state no. Notice, see the currentyou if this income is taxable6 State/Payers state no. Act Notice, see the current GeneralCertain Information has not been reported. Instructions for CertainAccount number (see instructions) Account number (see instructions)7 State incomeReturns. 7 State income related to Form 1096, such as legislation enacted after it wasForms 1097, 1098, 1099, 3921, 3922, 5498, or W-2G.7 Information Returns.Future developments. For the latest information about developments State incomeAccount number (see instructions) published, go to www.irs.gov/Form1096.1099-NECForm 1099-NEC (Rev. 1-2022) (keep for your records) Form 1099-NECReminder. The only acceptable method of electronicallythroughWhen to le. File Form 1096 as follows.NEC61023-Part PRE-PACKAGED CONVENIENCE SET includes: Form7171 VOID www.irs.gov/Form1099NEC Department of the Treasury - Internal Revenue Service www.irs.gov/Form1099NEC Department of the Treasury - Internal Revenue Service www.irs.gov/Form1099NEC information returns listed on this form in box 6 with the IRS is1098,February 28, 2023.Do Not Cut or Separate Forms on This PageDo Not Cut or Separate Forms on This Page Department of the Treasury - Internal Revenue Servicethe FIRE System. See Pub. 1220. Use this form to transmit paper Forms 1097,Purpose of form. 1099, 3921, 3922, 5498, and W-2G to the IRS. Caution: or foreign postal code, and telephone no. CORRECTED Form PAYERS name, street address, city or town, state or province, country, ZIPVOID CORRECTED OMB No. 1545-0116electronically but fail to do so, and you do notWhere To FilePAYERS name, street address, city or town, state or province, country, ZIPOMB No. 1545-0116 CORRECTED (if checked) OMB No. 1545-0116 NonemployeeForm 1099-NEC Nonemployeefollowing. Use the following or foreign postal code, and telephone no. PAYERS name, street address, city or town, state or province, country, ZIPTaxpayer First Act of 2019, enacted July 1, 2019, authorized theIf your principal business, ofce Formor foreign postal code, and telephone no. have an approved waiver, you may be subject to a penalty. The NEC5110 (50), NEC5111 (50), NEC5112 (50), 5100 - 1096 (3) PAYER RECIPIENTS TIN $ Nonemployee compensation1099-NEC t adres Nonemployee$ 1 Nonemployee compensation1099-NEC stretadres,city Compensation or or S TIN ZIPorforeignpostalcode $ 2Nonemployee compensation (Rev. January 2022) Compensation or agency, or legal residence in addressDepartment of the Treasury and the IRS to issue regulations that (Rev. January 2022) Compensation (Rev. January 2022) reduce the 250-return requirement for 2021 tax returns. If thosethe case of an individual, is For calendar year For calendar year regulations are issued and effective for 2022 tax returns required to belocated inRECIPIENTS TINS name 20 PAYERS TIN For Internal Revenue20 name, town,state RECIPIENT and For calendar year www.irs.gov/Form1099Alabama, Arizona, Arkansas, Delaware,Internal Revenue ServiceRECIPIENTS TIN PAYERS TIN Copy B 20 Copy C Florida, Georgia, Kentucky, Maine,P.O. Box 149213 Copy A explaining the change. Until regulations are issued, however, the 1 Payer made direct sales totaling $5,000 or more of3 File with Form 1096. 2 Payer made direct sales totaling $5,000 or more of3 For Recipient country, 1 Payer made direct sales totaling $5,000 or more of3 Copy 1 or Copy 2 Massachusetts, Mississippi, NewAustin, TX 78714-9213information, see part F in the 2022 General Instructions for Certain RECIPIENT'S name, stre Service Center RECIPIENT'S This is important taxInformation Returns. For Payer Hampshire, New Jersey, New Mexico, NEC6102E3-Part PRE-PACKAGED CONVENIENCE SET includes: NEC5110 (50), Street address (including apt. no.) $ 2 consumer products to recipient for resale , city or town, state or province, country, and ZIP or foreign postal code $ consumer products to recipient for resale information and is being$ 4consumer products to recipient for resale and/or State New York, North Carolina, Ohio, Texas,Instructions for 4 Federal income tax withheld province, of the number of returns. Paperwork ReductionVermont, VirginiaForm 1099-NEC (Rev. 1-2022)NECLMA41-0852411NEC5110 $ 4 Federal income tax withheld Form 1099-NEC$ Notice, see theReturns. NEC5111 $ 5 State tax withheld Forms state no. $ $ furnished to the IRS. If you areNEC5112 2nd TIN not. $ $ 5 Federal income tax withheld Who must le.$ $ For Privacy Act andL1096 41-0852411 5100 Form 1096 (2022)City or town, state or province, country, and ZIP or foreign postal code 5 State tax withheld 6 State/Payers state no. $ For Privacy Act and current$ negligence penalty or otherState tax withheld your 94X series tax return(s) or you may be subject to information Paperwork Reduction Actsanction may be imposed onAct Notice, see theGeneralCertain Information and the IRS determines that itCaution: Your name and TIN must match the name and TIN used on you if this income is taxableInstructions for Certaincurrent Generalhas not been reported. or service bureau. 7 Information Returns.7 State income 7 State income return penalties. Do not use the name and/or TIN of your paying agent NEC5111 (50), NEC5112 (50), 5100 - 1096 (3), DW19WS Envelopes (50) Account number (see instructions) 2nd TIN not.$ Account number (see instructions) NECLMB(keep for your records) 6 State/PayerAccount number (see instructions) NECLMCwww.irs.gov/Form1099NEC 6 State/Payers state no. State incomeFor more information and the Privacy Act and Paperwork Reduction Act Notice, (Rev. 1-2022) www.irs.gov/Form1099NEC Department of the Treasury - Internal Revenue Service see the 2022 General Instructions for Certain Information Returns.1099-NECwww.irs.gov/Form1099NEC Department of the Treasury - Internal Revenue Service 1099-NEC (Rev. 1-2022) Department of the Treasury - Internal Revenue ServiceNEC61034-Part PRE-PACKAGED CONVENIENCE SET includes:NEC5110 (50), NEC5111 (50), NEC5112 (100),5100 - 1096 (3) (3) 1096 Transmittal forms are included with each setNEC6103E4-Part PRE-PACKAGED CONVENIENCE SET includes: NEC5110 (50),NEC5111 (50), NEC5112 (100), 5100 - 1096 (3), DW19WS Envelopes (50) TFP 1099-MISC BLANK LASER PACKAGED SETNEC61055-Part PRE-PACKAGED CONVENIENCE SET includes:NEC5110 (50), NEC5111 (50),NEC5112 (150), 5100 - 1096 (3) FOR 50 EMPLOYEESFOR 25 EMPLOYEES 61745-Part PRE-PACKAGED CONVENIENCE SET includes:NEC6103254-Part PRE-PACKAGED CONVENIENCE SET includes: 5110 (50), 5144 (200), 5100 - 1096 (3)NEC5110 (25), NEC5111 (25), NEC5112 (50), 5100 - 1096 (3) TFP 1099-NEC BLANK LASER PACKAGED SETNEC6103E25 4-Part PRE-PACKAGED CONVENIENCE SET includes: NEC5110 (25), NEC5111 (50), NEC5112 (50), 5100 - 1096 (3),FOR 50 EMPLOYEESDW19WS Envelopes (25) NEC61745-Part PRE-PACKAGED CONVENIENCE SET includes:NEC6105255-Part PRE-PACKAGED CONVENIENCE SET includes: NEC5110 (50), NEC5144 (200), NEC5100 - 1096 (3)NEC5110 (25), NEC5111 (25), NEC5112 (75), 5100 - 1096 (3)39"