b"PRE-PRINTED AND BLANK 1099 FORMSTXFXPX 1099MISC PACKAGED SETSTFP 1099MISC PACKAGED LASER SETTFP 5110 TFP 5111 TFP 5112 TFP 5100or foreign postal code, and telephone no. VOID CORRECTED OMB No. 1545-0115 or foreign postal code, and telephone no. CORRECTED (if checked) OMB No. 1545-0115 or foreign postal code, and telephone no. VOID CORRECTED OMB No. 1545-0115 Do Not Staple 6969 Annual Summary and Transmittal of OMB No. 1545-0108PAYERS 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 Rents Form1096 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 INKS$ 2 Royalties 2021 Information $ 2 Royalties 2021 Information $ 2 Royalties 2021 Information U.S. Information Returns 2021(Rev. February 2021)MiscellaneousMiscellaneousMiscellaneous Department of the Treasury Internal Revenue ServiceFILERS name$ Form 1099-MISC $ Form 1099-MISC $ Form 1099-MISC3 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 C$ $ PAYERS TIN RECIPIENTS TIN $ 5 Fishing boat proceeds $ 6 Medical and health care payments For Recipient RECIPIENTS TIN $ 5 Fishing boat proceeds $ 6 Medical and health care payments orState Street address (including room or suite number)PAYERS TIN RECIPIENTS TIN 5 Fishing boat proceeds 6 Medical and health care paymentsInternal Revenue ForPAYERS TIN For PayerService Center or Copy2CopyCity or town, state or province, country, and ZIP or foreign postal codeRECIPIENTS name $ 7 totaling $5,000 or more of$ 8 Substitute payments in lieu ofFile with Form 1096. res, city or town, state or province, country, and ZIP or foreign postal code $ 7 Payer made direct sales$ 8 Substitute payments in lieu of RECIPIENT'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 ofName of person to contact Telephone number For Ofcial Use OnlyPayer made direct salesdividends or interest RECIPIENT'S name, stret ad totaling $5,000 or more ofdividends or interest This is important taxtotaling $5,000 or more ofdividends or interest For Privacy Act For Privacy Act consumer products to$ and Paperworkconsumer products to$ being furnished toconsumer products to$ and PaperworkFax numberrecipient for resale Reduction Actrecipient for resale information and isrecipient for resale Email addressStreet address (including apt. no.) $ 9 Crop insurance proceeds $ 10 Gross proceeds paid to anNotice, see the$ 9 Crop insurance proceeds $ 10 Gross proceeds paid to anthe IRS. If you are$ 9 Crop insurance proceeds $ 10 Gross proceeds paid to anReduction Act2 Social security number 3 Total number of forms $ 4 Federal income tax withheld $ 5 Total amount reported with this Form 1096 TFP 7777-2Notice, see the City or town, state or province, country, and ZIP or foreign postal code 11 Fish purchased for resale attorney 2021 General 11 Fish purchased for resale attorney return, a negligence11 Fish purchased for resale attorney 2021 General 1 12 Section 409A deferrals Instructions for 12 Section 409A deferrals penalty or other12 Section 409A deferrals Instructions for Certainimposed on you if6 Certain 50 10981098-C1098-E1098-F1098-Q1098-T1099-A1099-B1099-C1099-CAP 1099-DIV1099-G1099-INT1099-K1099-LS Information sanction may beInformation 81 78 84 03 74 83 80 79 85 73 91 86 92 10 16$ $ Returns.$ $ this income is$ $ Returns.W-2G 1097-BTCtaxable and the IRS32payments payments determines that itpaymentsAccount number (see instructions) requirement 2nd TIN not.13 Excess golden parachute 14 compensation Account number (see instructions) requirement 13 Excess golden parachute 14 compensation Account number (see instructions) requirement 2nd TIN not.13 Excess golden parachute 14 compensationhas not been $ $ $ $ reported. $ $ 1099-LTC1099-MISC 1099-NEC 1099-OID PATR1099-Q1099-QA 1099-R1099-S1099-SA 1099-SB 3921392254985498-ESA5498-QA 5498-SA 93 1099-15 State tax withheld 16 State/Payers state no. 17 State income 15 State tax withheld 16 State/Payers state no. 17 State income 15 State tax withheld 16 State/Payers state no. 17 State income 95 71 96 97 31 1A 98 75 94 43 25 26 28 72 2A 27$ $ $ $ $ $$ $ $ $ $ $Form1099-MISC 41-0852411 www.irs.gov/Form1099MISC Department of the Treasury - Internal Revenue ServiceForm1099-MISC (keep for your records) www.irs.gov/Form1099MISC Department of the Treasury - Internal Revenue ServiceForm1099-MISC 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.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. or foreign postal code, and telephone no. or foreign postal code, and telephone no. InstructionsMiscellaneousMiscellaneousMiscellaneous $ 2 Royalties 2021 Information $ 2 Royalties 2021 Information $ 2 Royalties 2021 Information form must be the same as those you enter in the upper left area of Future developments. For the latest information about developments related to Form 1096, such as legislation enacted after it was $ Form 1099-MISC $ Form 1099-MISC $ Form 1099-MISC published, go to www.irs.gov/Form1096.throughForms 1097, 1098, 1099, 3921, 3922, 5498, or W-2G.Reminder. The only acceptable method of electronically3 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 is When to le. File Form 1096 as follows.Copy CPAYERS TIN RECIPIENTS TIN $ 5 Fishing boat proceeds $ 6 Medical and health care payments PAYERS TIN RECIPIENTS TIN $ 5 Fishing boat proceeds $ 6 Medical and health care payments For Recipient RECIPIENTS TIN $ 5 Fishing boat proceeds $ 6 Medical and health care payments or the FIRE System. See Pub. 1220.February 28, 2022.Internal Revenue ForPAYERS TIN For PayerPurpose of form. Use this form to transmit paper Forms 1097, 1098, Service Center StateCopy2 Where To File1099, 3921, 3922, 5498, and W-2G to the IRS. orCopyCaution: RECIPIENTS name $ 7 totaling $5,000 or more of$ 8 Substitute payments in lieu ofFile 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 Substitute payments in lieu ofThis is important taxres, 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 ofelectronically but fail to do so, and you do not have an approvedfollowing.Payer made direct salesdividends or interest RECIPIENT'S name, stret ad Payer made direct salesdividends or interest RECIPIENT'S name, stret ad Payer made direct salesdividends or interest waiver, you may be subject to a penalty. The Taxpayer First Act of For Privacy Actconsumer products to$ being furnished toconsumer products to$ For Privacy ActIf your principal business, ofceUse the following consumer products to$ and Paperworkrecipient for resale information and isrecipient for resale 2019, enacted July 1, 2019, authorized the Department of theor agency, or legal residence inaddressrecipient for resale Reduction ActCrop insurance proceeds attorney the IRS. If you are9 Crop insurance proceeds 10 Gross proceeds paid to anand Paperworkthe case of an individual, is Treasury and the IRS to issue regulations that reduce the 250-return requirement for 2021 tax returns. If those regulations are issued and Street address (including apt. no.) 9 Crop insurance proceeds 10 Gross proceeds paid to anNotice, see the910 Gross proceeds paid to anattorney Reduction Actlocated inNotice, see the an article at www.irs.gov/Form1099 explaining the change. Until City or town, state or province, country, and ZIP or foreign postal code $ 11 Fish purchased for resale $ attorney 2021 General $ 11 Fish purchased for resale $ 12 Section 409A deferrals return, a negligence$ 11 Fish purchased for resale $ 12 Section 409A deferrals 2021 General Alabama, Arizona, Arkansas, Delaware,Internal Revenue Service sanction may beregulations are issued, however, the number remains at 250, aspart F in the 12 Section 409A deferrals Instructions forCertain penalty or otherInstructions for Florida, Georgia, Kentucky, Maine,Austin Submission Processing Center 2021 General Instructions for Certain Information Returns.Information imposed on you ifCertain Massachusetts, Mississippi, NewP.O. Box 149213 Returns. $ $ taxable and the IRS2nd TIN not. $ 13 Excess golden parachute$ 14 compensation Information Hampshire, New Jersey, New Mexico,Austin, TX 78714$ $ this income isof the number of returns. New York, North Carolina, Ohio, Texas, Returns.payments payments determines that itWho must le. Account number (see instructions) requirement 2nd TIN not.13 Excess golden parachute 14 compensation Account number (see instructions) requirement 13 Excess golden parachute 14 compensation Account number (see instructions) requirement payments Vermont, Virginiahas not been $ $ $ $ reported. $ $15 State tax withheld 16 State/Payers state no. 17 State income 15 State tax withheld 16 State/Payers state no. 17 State income 15 State tax withheld 16 State/Payers state no. 17 State income$ $ $ $ $ $$ $ $ $ $ $ For more information and the Privacy Act and Paperwork Reduction Act Notice,L1096 41-0852411 5100 Form1096(2021)see the 2021 General Instructions for Certain Information Returns.Form1099-MISC LMA 41-0852411 5110 www.irs.gov/Form1099MISC Department of the Treasury - Internal Revenue ServiceForm1099-MISC LMB (keep for your records) 5111 www.irs.gov/Form1099MISC Department of the Treasury - Internal Revenue ServiceForm1099-MISC LMC/LM2 www.irs.gov/Form1099MISC 5112 Department of the Treasury - Internal Revenue ServiceTFP 1099-MISC PACKAGED LASER SETPARTS TFP 1099MISC PACKAGED BLANK LASER SETTFP 5110 TFP 5144 TFP 5100FOR 50 EMPLOYEES or foreign postal code, and telephone no. VOID CORRECTED OMB No. 1545-0115 MiscellaneousDo Not Staple 6969 Annual Summary and Transmittal of OMB No. 1545-0108PAYERS name, street address, city or town, state or province, country, ZIP 1 Rents Form1096 DETACH BEFORE MAILINGDETACH BEFORE MAILING MANUFACTURED ON OCR LASER BOND PAPER USING HEAT RESISTANT INKSMANUFACTURED ON OCR LASER BOND PAPER USING HEAT RESISTANT INKS61023-Part PRE-PACKAGED CONVENIENCE SET includes: 50 - 5110, $ $ $ 2 Royalties 3$ 462021 Information Department of the TreasuryU.S. Information Returns 2021(Rev. February 2021)Internal Revenue ServiceOther income Form 1099-MISC Copy A FILERS nameFederal income tax withheld50- 5111, 50 - 5112, 3 - 5100 1096 PAYERS TIN RECIPIENTS TIN $ 5 Fishing boat proceeds $ Medical and health care paymentsInternal RevenueStreet address (including room or suite number) For Ofcial Use OnlyService CenterFor RECIPIENTS name 7 Payer made direct sales$ 8 Substitute payments in lieu ofFile with Form 1096. 16City or town, state or province, country, and ZIP or foreign postal codeTelephone numberFax number3 Total number of forms $ 4 Federal income tax withheld $ 5 Total amount reported with this Form 1096totaling $5,000 or more ofdividends or interest For Privacy ActName of person to contactrecipient for resale and Paperwork 6102E3-Part PRE-PACKAGED CONVENIENCE SET includes: 50 - 5110, Street address (including apt. no.) $ consumer products to$ 10 Gross proceeds paid to anNotice, see theEmail address 1098 2 Social security number 1098-Q1098-T1099-A1099-B1099-C1099-CAP 1099-DIV1099-G1099-INT1099-K1099-LS 9 Crop insurance proceeds attorney Reduction Act 2021 GeneralCity or town, state or province, country, and ZIP or foreign postal code 11 Fish purchased for resale12 Section 409A deferrals Instructions for W-2G 1097-BTC 81 1098-C1098-E1098-F 74 83 80 79 85 73 91 86 92 10 16CertainInformation50- 5111, 50 - 5112, 3 - 5100 1096, 50 - 77772 Envelopes Account number (see instructions) requirement 2nd TIN not. $ $ 13 Excess golden parachute$ $ 14 compensation Returns. 32 50 1099-NEC78 84 03 1099-QA 1099-R1099-S1099-SA 1099-SB 3921 26 54985498-ESA5498-QA 5498-SA payments1099-LTC1099-MISC71 1099-OID PATR1099-Q 1A 98 75 94 43 25 3922 28 72 2A 2793 95 96 1099- 31Form41-0852411 $ $ 15 State tax withheld 16 State/Payers state no. $ $ 17 State income 9761034-Part PRE-PACKAGED CONVENIENCE SET includes: 50 - 5110, 1099-MISC www.irs.gov/Form1099MISC Department of the Treasury - Internal Revenue Service Send this form, with the copies of the form checked in box 6, to the IRS in a at mailer (not folded).Do 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. 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.50- 5111, 100 - 5112, 3 - 5100 1096 PAYERS name, street address, city or town, state or province, country, ZIP$ 1 Rents OMB No. 1545-0115 MiscellaneousSignatureTitleDate VOID CORRECTEDor foreign postal code, and telephone no. 2 Royalties Information Instructions form must be the same as those you enter in the upper left area of 2021 Future developments. For the latest information about developments related to Form 1096, such as legislation enacted after it wasForms 1097, 1098, 1099, 3921, 3922, 5498, or W-2G.$ $ 5Other income $ Form61099-MISC Copy A published, go to www.irs.gov/Form1096.throughWhen to le. File Form 1096 as follows.Reminder. The only acceptable method of electronically 6103E4-Part PRE-PACKAGED CONVENIENCE SET includes: 50 - 5110, PAYERS TIN RECIPIENTS TIN $ 3 Fishing boat proceeds $ 4 Federal income tax withheld Internal Revenueinformation returns listed on this form in box 6 with the IRS is February 28, 2022.the FIRE System. See Pub. 1220. Medical and health care payments Service CenterForPurpose of form. Use this form to transmit paper Forms 1097, 1098, Where To File1099, 3921, 3922, 5498, and W-2G to the IRS. Caution: File with Form 1096. electronically but fail to do so, and you do not have an approved 50- 5111, 100 - 5112, 3 - 5100 1096, 50 - 77772 Envelopes RECIPIENTS name $ 7 Payer made direct sales$ $ 8 Substitute payments in lieu of For Privacy Actwaiver, you may be subject to a penalty. The Taxpayer First Act offollowing. located in Use the following 2019, enacted July 1, 2019, authorized the Department of the totaling $5,000 or more ofdividends or interest and Paperworkrequirement for 2021 tax returns. If those regulations are issued andIf your principal business, ofceaddressconsumer products to10 Gross proceeds paid to anReduction ActTreasury and the IRS to issue regulations that reduce the 250-returnor agency, or legal residence in Street address (including apt. no.) recipient for resale attorney Notice, see thean article at www.irs.gov/Form1099 explaining the change. Untilthe case of an individual, is 9 Crop insurance proceeds2021 General 2021 General Instructions for Certain Information Returns. part F in theFlorida, Georgia, Kentucky, Maine,Internal Revenue Service City or town, state or province, country, and ZIP or foreign postal code 11 Fish purchased for resale12 Section 409A deferrals Instructions for regulations are issued, however, the number remains at 250, asAlabama, Arizona, Arkansas, Delaware,Austin Submission Processing Center Certain Hampshire, New Jersey, New Mexico,P.O. Box 149213 61055-Part PRE-PACKAGED CONVENIENCE SET includes: 50 - 5110, Account number (see instructions) requirement 2nd TIN not. $ $ 13 Excess golden parachute$ $ 14 compensation Information of the number of returns. Massachusetts, Mississippi, NewAustin, TX 78714payments Returns. Who must le.New York, North Carolina, Ohio, Texas, Vermont, Virginia50- 5111, 150 - 5112, 3 - 5100 1096 Form 1099-MISC LMA 41-0852411 5110 $ $ 15 State tax withheld 16 State/Payers state no. $ $ 17 State income 5144M For more information and the Privacy Act and Paperwork Reduction Act Notice,L1096 41-0852411 5100 Form 1096 (2021)www.irs.gov/Form1099MISC Department of the Treasury - Internal Revenue Service see the 2021 General Instructions for Certain Information Returns.FOR 25 EMPLOYEES TFP 1099NEC PACKAGED LASER SET6103254-Part PRE-PACKAGED CONVENIENCE SET includes: 25 - 5110, TFP NEC5110 TFP NEC5111 TFP NEC5112 TFP 510025- 5111, 50 - 5112, 3 - 5100, 25 - 77772 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. 1545-0108PAYERS name, street address, city or town, state or province, country, ZIPPAYERS 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 Form1096DETACH 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 INKSor foreign postal code, and telephone no. or foreign postal code, and telephone no. or foreign postal code, and telephone no. OMB No. 1545-0116Compensation Department of the TreasuryCompensation 20216103E254-Part PRE-PACKAGED CONVENIENCE SET includes: 25 - 5110, PAYERS TIN RECIPIENTS TIN $ Nonemployee compensation 2021 t adres Compensation $ 2Nonemployee compensation 2021 stretadres,city Nonemployeeor or S TIN ZIPorforeignpostalcode $ 2Nonemployee compensation 2021 NonemployeeU.S. Information Returns(Rev. February 2021)Internal Revenue ServiceFILERS nameForm 1099-NEC RECIPIENTS TIN Form 1099-NEC RECIPIENT Form 1099-NEC Copy CPAYERS TIN Copy A PAYERS TIN Copy B Street address (including room or suite number)RECIPIENTS name 1 Payer made direct sales totaling $5,000 or more of3 For Internal Revenue1 Payer made direct sales totaling $5,000 or more of3 For Recipient country,and 1 Payer made direct sales totaling $5,000 or more of3 Copy 1 or Copy 2Service Center stateprovince, For Payer25- 5111, 50 - 5112, 3 - 5100 1096, 25 - 77772 Envelopes Street address (including apt. no.) 41-0852411 $ $ 2 consumer products to recipient for resale 51099-NEC $ $ File with Form 1096. $ $ $ consumer products to recipient for resale name, $ $ town,This is important tax2nd TIN not.$ $ $ 4consumer products to recipient for resaleCity or town, state or province, country, and ZIP or foreign postal codeAct Notice, see the Returns. 16$ $ 03 74 Telephone number 80 1099-B $ 1099-C1099-CAPFor Ofcial Use Only $ 1099-LS RECIPIENT'S name, stre , city or town, state or province, country, and ZIP or foreign postal code RECIPIENT'S information and is beingand/or Statefurnished to the IRS. If you are For Privacy Act andnegligence penalty or otherFor Privacy Act and City or town, state or province, country, and ZIP or foreign postal code Federal income tax withheld Paperwork Reduction Act 20214 Federal income tax withheld s state no. sanction may be imposed on5 Federal income tax withheld Name of person to contactGeneral Instructions for2021Fax numberNotice, see theyou if this income is taxablePaperwork Reduction GeneralCertain Information has not been reported. 7 State income Instructions forAccount number (see instructions) 2nd TIN not.$ 4 State tax withheld 6 State/Payers state no. 7 State income Returns. 5 State tax withheld and the IRS determines that itState tax withheld 6 State/PayerEmail addresss state no. Certain Information 3 Total number of forms4 Federal income tax withheld5 Total amount reported with this Form 10966105255-Part PRE-PACKAGED CONVENIENCE SET includes: 25 - 5110, Form 1099-NEC www.irs.gov/Form1099NEC Account number (see instructions) www.irs.gov/Form1099NEC 6 State/PayerAccount number (see instructions) www.irs.gov/Form1099NEC W-2G 1097-BTC1098 2 Social security number 1098-Q1098-T1099-A 79 85 73 1099-DIV1099-G1099-INT1099-K 167 State incomeDepartment of the Treasury - Internal Revenue Service Form 1099-NECForm(keep for your records)Do Not Cut or Separate Forms on This PageDo Not Cut or Separate Forms on This Page Department of the Treasury - Internal Revenue Service Department of the Treasury - Internal Revenue Service32 50 81 1098-C1098-E1098-F 83 91 86 92 1078 8425- 5111, 75- 5112, 3 - 5100 1096 7171 VOID CORRECTED OMB No. 1545-0116 NonemployeeCORRECTED (if checked) OMB No. 1545-0116 VOID CORRECTED OMB No. 1545-0116 1099-NEC 1099-OID PATR1099-Q1099-QA 1099-R1099-S1099-SA 1099-SB 3921392254985498-ESA5498-QA 5498-SA or foreign postal code, and telephone no. PAYERS name, street address, city or town, state or province, country, ZIPPAYERS name, street address, city or town, state or province, country, ZIP93 95 96 1099- 31PAYERS name, street address, city or town, state or province, country, ZIPor foreign postal code, and telephone no. or foreign postal code, and telephone no. 1099-LTC1099-MISC71 Nonemployee1A 98 75 94 43 25 26 28 72 2A 272021 Compensation 2021 Nonemployee2021 CompensationCompensation 97 1099-NECPAYERS TIN RECIPIENTS TIN $ 1 Nonemployee compensation Form 1099-NEC t adres Copy A $ Nonemployee compensation1099-NEC stretadres,cityortown,stateor RECIPIENTS TIN ZIPorforeignpostalcode $ 1 Nonemployee compensation Form Copy C dge and belief, they are true, correct, For Internal RevenueFormPAYERS TIN Copy B Return this entire page to the Internal Revenue Service. Photocopies are not acceptable. RECIPIENTS name 2 Payer made direct sales totaling $5,000 or more of PAYERS TIN RECIPIENTS TIN 1 Payer made direct sales totaling $5,000 or more ofFor Recipient country,and Send this form, with the copies of the form checked in box 6, to the IRS in a at mailer (not folded).For PayerService Center RECIPIENT'S province, consumer products to recipient for resaleUnder penalties of perjury, I declare that I have examined this return and accompanying documents and, to the best of my knowleRECIPIENT'S name, stre , city or town, state or province, country, and ZIP or foreign postal code2 consumer products to recipient for resale name, This is important tax2 Payer made direct sales totaling $5,000 or more ofand/or StateTFP 1099-NEC PACKAGED LASER SET Street address (including apt. no.) 41-0852411 $ $ 3 5consumer products to recipient for resale 1099-NEC $ $ File with Form 1096. $ $ $ 3 4 Federal income tax withheld Forms state no. $ $ information and is being2nd TIN not.$ $ $ 43 5 Federal income tax withheld and complete. $ $ Copy 1 or Copy 2throughTitleDate For Privacy Act andfurnished to the IRS. If you areFor Privacy Act and Paperwork Reduction Actnegligence penalty or otherSignature Paperwork Reduction Federal income tax withheld GeneralNotice, see thesanction may be imposed onGeneral Instructions for Instructions for2021 you if this income is taxableAct Notice, see the 2021 City or town, state or province, country, and ZIP or foreign postal code $ 4 State tax withheld Certain InformationReturns.5 State tax withheld and the IRS determines that itState tax withheld Instructions Certain Information form must be the same as those you enter in the upper left area of has not been reported. Future developments. 7 State incomeReturns.Account number (see instructions) 2nd TIN not. 6 State/Payers state no.Account number (see instructions) 6 State/PayerAccount number (see instructions) 6 State/Payers state no.For the latest information about developmentsForms 1097, 1098, 1099, 3921, 3922, 5498, or W-2G.7 State income 7 State income related to Form 1096, such as legislation enacted after it was published, go to www.irs.gov/Form1096.Form(keep for your records) Reminder. The only acceptable method of electronicallyForm 1099-NEC www.irs.gov/Form1099NEC Department of the Treasury - Internal Revenue Service www.irs.gov/Form1099NEC Department of the Treasury - Internal Revenue Servicewww.irs.gov/Form1099NEC information returns listed on this form in box 6 with the IRS is When to le. File Form 1096 as follows.Do Not Cut or Separate Forms on This PageDo Not Cut or Separate Forms on This Page 1099-NEC Department of the Treasury - Internal Revenue Servicethe FIRE System. See Pub. 1220. PARTS 7171 VOID CORRECTED PAYERS name, street address, city or town, state or province, country, ZIPOMB No. 1545-0116 VOID CORRECTED Purpose of form. Use this form to transmit paper Forms 1097, 1098, February 28, 2022.1099, 3921, 3922, 5498, and W-2G to the IRS. Caution: PAYERS name, street address, city or town, state or province, country, ZIPOMB No. 1545-0116 CORRECTED (if checked) PAYERS name, street address, city or town, state or province, country, ZIPOMB No. 1545-0116 Where To Fileor foreign postal code, and telephone no. or foreign postal code, and telephone no. or foreign postal code, and telephone no. electronically but fail to do so, and you do not have an approvedfollowing.waiver, you may be subject to a penalty. The Taxpayer First Act of 2019, enacted July 1, 2019, authorized the Department of the 2021 Nonemployee2021 NonemployeeTreasury and the IRS to issue regulations that reduce the 250-returnIf your principal business, ofceUse the following RECIPIENTS TINS name Form S TIN t adres Compensation S TIN $ 1 Nonemployee compensation Form PAYERS TIN stretadres,city Compensation or or S TIN ZIPorforeignpostalcode $ 2Nonemployee compensation 2021 Nonemployee Returns. or agency, or legal residence inaddressCompensationrequirement for 2021 tax returns. If those regulations are issued and FOR 50 EMPLOYEES PAYER RECIPIENTS TIN $ 1 Nonemployee compensation1099-NEC Copy A1099-NEC town,state RECIPIENT and an article at www.irs.gov/Form1099 explaining the change. Untilpart F in thethe case of an individual, isInternal Revenue Service RECIPIENT Copy B Form 1099-NEC Copy C located inregulations are issued, however, the number remains at 250, as 2 Payer made direct sales totaling $5,000 or more of PAYER For Internal Revenue2 Payer made direct sales totaling $5,000 or more ofFor Recipient country, 1 Payer made direct sales totaling $5,000 or more ofFor Payer Alabama, Arizona, Arkansas, Delaware,Austin Submission Processing Center RECIPIENT'S name, stre , city or town, state or province, country, and ZIP or foreign postal code RECIPIENT'S information and is being2021 General Instructions for Certain Information Florida, Georgia, Kentucky, Maine,P.O. Box 149213 Service Center This is important taxof the number of returns. and/or State New York, North Carolina, Ohio, Texas, 3 consumer products to recipient for resale File with Form 1096. 3 consumer products to recipient for resale name, furnished to the IRS. If you are3 consumer products to recipient for resale Copy 1 or Copy 2 Massachusetts, Mississippi, NewAustin, TX 78714province, Hampshire, New Jersey, New Mexico, For Privacy Act andsanction may be imposed onWho must le.For Privacy Act and NEC61023-Part PRE-PACKAGED CONVENIENCE SET includes: Street address (including apt. no.) 41-0852411 2nd TIN not. $ $ $ 54 Federal income tax withheld s state no. $ $ Paperwork Reduction ActNEC5111 $ $ $ 4 Federal income tax withheld Form_ 1099-NEC $ $ negligence penalty or other2nd TIN not. $ $ $ 5 Federal income tax withheld4s state no. $ $ Paperwork Reduction 2021Vermont, Virginia L1096 41-0852411 5100 Form 1096 (2021) Instructions for2021 GeneralCertain InformationGeneralNotice, see theyou if this income is taxableAct Notice, see theInstructions forCity or town, state or province, country, and ZIP or foreign postal code State tax withheld 6 State/Payer Certain InformationReturns. 5 State tax withheld 6 State/Payers state no. and the IRS determines that itState tax withheld 6 State/Payer 7 State income Returns.has not been reported.Account number (see instructions) Account number (see instructions)7 State income 7 State income For more information and the Privacy Act and Paperwork Reduction Act Notice, Account number (see instructions)50 - NEC5110, 50- NEC5111, 50 - NEC5112, 3 - 5100 1096 Form 1099-NEC NECLMA NEC5110www.irs.gov/Form1099NEC Department of the Treasury - Internal Revenue Service www.irs.gov/Form1099NEC Department of the Treasury - Internal Revenue Servicewww.irs.gov/Form1099NEC see the 2021 General Instructions for Certain Information Returns.Form 1099-NEC NECLMB(keep for your records) NECLMC NEC5112 Department of the Treasury - Internal Revenue ServiceNEC6102E3-Part PRE-PACKAGED CONVENIENCE SET includes: 50 - NEC5110, 3 Transmittal 1096 forms are included with each set50- NEC5111, 50 - NEC5112, 3 - 5100 1096, 50 - 22222 EnvelopesNEC61034-Part PRE-PACKAGED CONVENIENCE SET includes:50 - NEC5110, 50- NEC5111, 100 - NEC5112, 3 - 5100 1096 TFP 1099-MISC BLANK PACKAGED LASER SETNEC6103E4-Part PRE-PACKAGED CONVENIENCE SET includes: 50 - NEC5110,50- NEC5111, 100 - NEC5112, 3 - 5100 1096, 50 - 22222 Envelopes PARTSNEC61055-Part PRE-PACKAGED CONVENIENCE SET includes: FOR 50 EMPLOYEES50 - NEC5110, 50- NEC5111, 150 - NEC5112, 3 - 5100 1096 61745-Part PRE-PACKAGED CONVENIENCE SET includes: 50 - 5110,FOR 25 EMPLOYEES 200- 5144, 3 - 5100 1096NEC6103254-Part PRE-PACKAGED CONVENIENCE SET includes: TFP 1099-NEC BLANK PACKAGED LASER SET25 - NEC5110, 25- NEC5111, 50 - NEC5112, 3 - 5100 1096NEC6103E254-Part PRE-PACKAGED CONVENIENCE SET includes: 25 - NEC5110,PARTS 25- NEC5111, 50 - NEC5112, 3 - 5100 1096, 25 - 22222 Envelopes FOR 50 EMPLOYEESNEC6105255-Part PRE-PACKAGED CONVENIENCE SET includes: NEC61745-Part PRE-PACKAGED CONVENIENCE SET includes:25 - NEC5110, 25- NEC5111, 75- NEC5112, 3 - 5100 1096 50 - NEC5110, 200- NEC5144, 3 - NEC5100 109640"