b"1099 PRE-PRINTED FORMSApex 1099-MISC, 1099-NEC, 1099-INT SetsAPEX DWMR or DWMRSAPEX 1099-MISC LASER PACKAGED SETAPEX LMA APEX LMB APEX LMCLM2 APEX L1096Do Not Staple 69699595 VOID CORRECTED CORRECTED (if checked)VOID CORRECTEDPAYERS name, street address, city or town, state or province, country, ZIP PAYERS name, street address, city or town, state or province, country, ZIP OMB No. 1545-0115 1 Rents Form1096 1 Rents Annual Summary and Transmittal of OMB No. 1545-0108 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.1 Rents or foreign postal code, and telephone no. OMB No. 1545-0115 OMB No. 1545-0115PAYERS name, street address, city or town, state or province, country, ZIP $ 2 Royalties Form1099-MISC $ Miscellaneous 1099-MISC $ Miscellaneous U.S. Information Returns 2022FormForm1099-MISC Miscellaneous (Rev. January 2022) 2 Royalties Department of the Treasury2 Royalties Information (Rev. January 2022) InformationFor calendar yearInformation (Rev. January 2022) For calendar year Internal Revenue ServiceFILERS nameFor calendar year $ 20 $ 20 $ 20$ 3 Other income $ 4 Federal income tax withheld3 Other income Copy A$ 4 Federal income tax withheld Copy B$ 4 Federal income tax withheld Copy C3 Other incomePAYERS TIN RECIPIENTS TINPAYERS TIN 5 Fishing boat proceedsRECIPIENTS TIN6 Medical and health care paymentsPAYERS TIN $ 5 Fishing boat proceeds Street address (including room or suite number) 6 Medical and health careor For PayerFor$ For RecipientInternal Revenuepayments 5 Fishing boat proceeds payments StateCopy2RECIPIENTS TIN6 Medical and health care Service Center orCopyCity or town, state or province, country, and ZIP or foreign postal code$ consumer products to$ $ File with Form 1096. $ Payer made direct sales$ 8 of dividends or interest For Privacy ActFor Ofcial Use Only$ Telephone numberName of person to contactRECIPIENTS name RECIPIENT'S name, stret adres7 , city or town, state or province, country, aRnEdC ZIPI EoNr Tfo'Sre niganm peo, starle ceto adedres, city or town, state or province, country, and ZIP or foreign postal code7totaling $5,000 or more ofSubstitute payments in lieu totaling $5,000 or more of8 of dividends or interest7 Payer made direct sales8 of dividends or interest This is important tax Payer made direct salesSubstitute payments in lieuFor Privacy Act Substitute payments in lieu recipient for resale totaling $5,000 or more ofconsumer products to$ Fax number and Paperwork and Paperworkinformation and is Street address (including apt. no.) Crop insurance proceeds $ attorney consumer products toEmail address recipient for resale 10 Gross proceeds paid to anReduction Act5 Total amount reported with this Form 1096Reduction Act $ being furnished to recipient for resaleCity or town, state or province, country, and ZIP or foreign postal code $ 9$ 10 Gross proceeds paid to an 9 Crop insurance proceeds $ 10 Gross proceeds paid to anthe IRS. If you areattorney 1098-T1099-A Notice, see the73 91 $ 1099-G1099-INT1099-K1099-LSAPEX 1099-NEC LASER PACKAGED SET* Notice, see the attorney 9 Crop insurance proceeds 3 Total number of formscurrent Generalcurrent General2 Social security number 4 Federal income tax withheld1return, a negligence$11 Fish purchased for resale $ Instructions forCertain$ $ penalty or otherInstructions for$6sanction may be 12 Section 409A deferrals11 Fish purchased for resale 32 12 Section 409A deferrals 1098-C imposed on you if1098-Q 83 80 1099-B Certain 1099-DIV 86 92 10 16Information 1097-BTC1098 11 Fish purchased for resale $ 12 Section 409A deferrals 79 InformationW-2G1098-E1098-F 1099-C1099-CAP $ $ $ Returns. 50 81 $ 78 84 this income is74 Returns.03 85taxable and the IRS determines that it payments 13 requirement payments 13 requirement payments has not been 13 requirement 14 Excess golden parachute15 compensation 14 Excess golden parachute15 compensation 14 Excess golden parachute15 compensationAccount number (see instructions) 2nd TIN not. $ 16 State tax withheld $ $ 1099-LTC1099-MISC 1099-NEC$ 1099-OID1099-PATR reported. 1099-QA 1099-R1099-S1099-SA 1099-SB 3921392254985498-ESA5498-QA 5498-SASTANDARD SETS (34 Sheets for 100 Recipients)Account number (see instructions) 17 State/Payers state no.16 State tax withheld18 State income 93 $ 95 71 96 97 31 $ 1A 98 75 94 43 25 26 28 72 2A 271099-QAccount number (see instructions) 17 State/Payers state no. 18 State income 17 State/Payers state no. 18 State income2nd TIN not.16 State tax withheld$ 1099-MISC $$ $ $ $ $Form1099-MISC(Rev. 1-2022)41-0852411 Form1099-MISC$ (keep for your records) $ $ $ $ NEC959133-Part SET includes: (34 Sheets EACH) 1099-NEC Copy A, B, C(Rev. 1-2022) (Rev. 1-2022) Return this entire page to the Internal Revenue Service. Photocopies are not acceptable. www.irs.gov/Form1099MISC Form Department of the Treasury - Internal Revenue ServiceDepartment of the Treasury - Internal Revenue ServiceDepartment of the Treasury - Internal Revenue Servicewww.irs.gov/Form1099MISC www.irs.gov/Form1099MISCDo Not Cut or Separate Forms on This PageDo Not Cut or Separate Forms on This PageSend this form, with the copies of the form checked in box 6, to the IRS in a at mailer (not folded).9595 VOID CORRECTED 1 Rents Under penalties of perjury, I declare that I have examined this return and accompanying documents and, to the best of my knowle dge and belief, they are true, correct,NEC959144-Part SET includes: (34 Sheets EACH) 1099-NEC Copy A, B, C, Cand complete.CORRECTED (if checked)VOIDCORRECTED OMB No. 1545-0115 Title DatePAYERS name, street address, city or town, state or province, country, ZIP PAYERS name, street address, city or town, state or province, country, ZIP OMB No. 1545-0115 Signature 1 Rentsor foreign postal code, and telephone no. or foreign postal code, and telephone no.1 Rents PAYERS name, street address, city or town, state or province, country, ZIP OMB No. 1545-0115or foreign postal code, and telephone no.$ Form1099-MISC $ Miscellaneous 1099-MISC $ Miscellaneous 1099-MISC Miscellaneous Instructions Form $ 2 Royalties (Rev. January 2022) $ 2 Royalties Form20 $ 2 Royalties Information (Rev. January 2022) Information NEC959155-Part SET includes: (34 Sheets EACH) 1099-NEC Copy A, B, C, C, 2Future developments. For the latest information about developments For calendar yearInformation (Rev. January 2022) For calendar yearform must be the same as those you enter in the upper left area of related to Form 1096, such as legislation enacted after it was For calendar yearForms 1097, 1098, 1099, 3921, 3922, 5498, or W-2G.20 published, go to www.irs.gov/Form1096. 20 When to le. File Form 1096 as follows.3 Other income 4 Federal income tax withheld3 Other income Reminder. The only acceptable method of electronicallythroughCopy CCopy A4 Federal income tax withheld 4 Federal income tax withheld$ $ $ the FIRE System. See Pub. 1220.Copy B$ February 28, 2023.information returns listed on this form in box 6 with the IRS isPAYERS TIN RECIPIENTS TINPAYERS TIN 5 Fishing boat proceedsRECIPIENTS TIN6 Medical and health care paymentsPAYERS TIN 5 Fishing boat proceeds Forpayments $ 3 Other income For Recipient 6 Medical and health careor For Payer STANDARD SETS w/ Envelopes (34 Sheets for 100 Recipients)$Purpose of form. Use this form to transmit paper Forms 1097, 1098, Internal Revenue 6 Medical and health carepayments StateCopy2RECIPIENTS TIN 5 Fishing boat proceeds1099, 3921, 3922, 5498, and W-2G to the IRS. Service Center orCopyCaution: $ $ $ File with Form 1096.electronically but fail to do so, and you do notWhere To File$ $ $RECIPIENTS name RECIPIENT'S name, stret adres7 , city or town, state or province, country, aRndE CZIPI EoNr Tfo'Sre niganm peo, starle ceto dadedres, city or town, state or province, country, and ZIP or foreign postal code7 Payer made direct sales $ 8 of dividends or interest following. located inUse the following NEC95913E3-Part SET includes: (34 Sheets EACH) 1099-NEC Copy A, B, C,have an approved waiver, you may be subject to a penalty. The totaling $5,000 or more of8 of dividends or interest7totaling $5,000 or more of8 of dividends or interesttotaling $5,000 or more ofSubstitute payments in lieuFor Privacy Act Payer made direct salesSubstitute payments in lieuFor Privacy Act Substitute payments in lieuThis is important tax Payer made direct sales Taxpayer First Act of 2019, enacted July 1, 2019, authorized the and Paperworkinformation and isIf your principal business, ofce Department of the Treasury and the IRS to issue regulations that consumer products to$ consumer products toconsumer products toand Paperworkaddressrecipient for resale recipient for resale reduce the 250-return requirement for 2021 tax returns. If thoseor agency, or legal residence in Street address (including apt. no.) 9 Crop insurance proceeds 10 Gross proceeds paid to anReduction Act $ attorney recipient for resale 10 Gross proceeds paid to anReduction Act being furnished to regulations are issued and effective for 2022 tax returns required to be www.irs.gov/Form1099Notice, see the attorney Notice, see the the IRS. If you areattorney the case of an individual, is 9 Crop insurance proceeds 10 Gross proceeds paid to an 9 Crop insurance proceedsCity or town, state or province, country, and ZIP or foreign postal code $ 11 Fish purchased for resale $ $ current General $ return, a negligencecurrent General Internal Revenue Service + DW19W (100)explaining the change. Until regulations are issued, however, the Instructions forCertain$ 12 Section 409A deferrals penalty or otherInstructions forinformation, see 11 Fish purchased for resale $ 12 Section 409A deferrals Alabama, Arizona, Arkansas, Delaware, Information Returns. part F in the 2022 General Instructions for CertainMassachusetts, Mississippi, New 12 Section 409A deferrals11 Fish purchased for resale sanction may beFlorida, Georgia, Kentucky, Maine, Information imposed on you ifCertainP.O. Box 149213 this income isInformation Austin, TX 78714-9213Returns. $ $ $ Returns.$ $ taxable and the IRSNew York, North Carolina, Ohio, Texas, of the number of returns. $ Hampshire, New Jersey, New Mexico, Account number (see instructions) 13 requirement $ 14 Excess golden parachute$ 15 compensation $ 14 Excess golden parachute$ 15 compensation $ 14 Excess golden parachute$ 15compensation Vermont, Virginia NEC95914E4-Part SET includes: (34 Sheets EACH) 1099-NEC Copy A, B, C, C, 13 determines that it payments 13 requirement payments Who must le.requirement payments has not been reported.Caution: 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 Account number (see instructions) 17 State/Payers state no.16 State tax withheld18 State income 17 State/Payers state no. 18 State income 17 State/Payers state no. 18 State income2nd TIN not.16 State tax withheld Account number (see instructions) return penalties. Do not use the name and/or TIN of your paying agent 2nd TIN not.16 State tax withheldForm1099-MISC(Rev. 1-2022)LMA 41-0852411Form 5110 $ LMB(keep for your records)5111 $ $ or service bureau. $ $ 5112 $ L1096 41-0852411 5100 Form1096(2022) + DW19W (100)$ $ For more information and the Privacy Act and Paperwork Reduction Act Notice, $ $ $1099-MISC $ Form Department of the Treasury - Internal Revenue ServiceDepartment of the Treasury - Internal Revenue ServiceDepartment of the Treasury - Internal Revenue Servicewww.irs.gov/Form1099MISC 1099-MISC(Rev. 1-2022) see the 2022 General Instructions for Certain Information Returns.(Rev. 1-2022) www.irs.gov/Form1099MISCLMC/LM2 www.irs.gov/Form1099MISCNEC95915E5-Part SET includes: (34 Sheets EACH) 1099-NEC Copy A, B, C, C, 2,(3) Transmittal 1096 forms are included with each set + DW19W (100)STANDARD SET w/ Self-Seal Envelopes (34 Sheets for 100 Recipients)APEX 1099-MISC LASER PACKAGED SET*NEC95914ES 4-Part SET includes: (34 Sheets EACH) 1099-NEC Copy A, B, C, C, + DW19WS (100)STANDARD SETS (50 Sheets for 100 Recipients) MINI SETS (17 Sheets for 50 Recipients)959133-Part SET includes: (50 Sheets EACH) 1099-MISC Copy A, B, C NEC959184-Part SET includes: (17 Sheets EACH) 1099-NEC Copy A, B, C, C959144-Part SET includes: (50 Sheets EACH) 1099-MISC Copy A, B, C, C MINI SETS w/ Envelopes (17 Sheets for 50 Recipients)959155-Part SET includes: (50 Sheets EACH) 1099-MISC Copy A, B, C, C, 2 NEC95918E4-Part SET includes: (17 Sheets EACH) 1099-NEC Copy A, B, C, C,STANDARD SETS w/ Envelopes (50 Sheets for 100 Recipients) + DW19W (50)95913E3-Part SET includes: (50 Sheets EACH) 1099-MISC Copy A, B, C, MINI SETS w/ Self-Seal Envelopes (17 Sheets for 50 Recipients)+ DWMR (100) NEC95918ES 4-Part SET includes: (17 Sheets EACH) 1099-NEC Copy A, B, C, C,95914E4-Part SET includes: (50 Sheets EACH) 1099-MISC Copy A, B, C, C,+ DW19WS (50)+ DWMR (100) VALUE SETS w/ Self-Seal Envelopes (7 Sheets for 20 Recipients)95915E5-Part SET includes: (50 Sheets EACH) 1099-MISC Copy A, B, C, C, 2, NEC95903ES 3-Part SET includes: (7 Sheets EACH) 1099-NEC Copy A, B, C,+ DWMR (100) + DW19WS (20)STANDARD SET w/ Self-Seal Envelopes (50 Sheets for 100 Recipients) NEC95904ES 4-Part SET includes: (7 Sheets EACH) 1099-NEC Copy A, B, C, C, 95914ES4-Part SET includes: (50 Sheets EACH) 1099-MISC Copy A, B, C, C,+ DW19WS (20)+ DWMRS (100) NEC95905ES 5-Part SET includes: (7 Sheets EACH) 1099-NEC Copy A, B, C, C, 2,MINI SETS (25 Sheets 50 Recipients) + DW19WS (20)959184-Part SET includes: (25 Sheets EACH) 1099-MISC Copy A, B, C, C APEX 1099-INT LASER PACKAGED SET* MINI SETS w/ Envelopes (25 Sheets for 50 Recipients)95918E4-Part SET includes: (25 Sheets EACH) 1099-MISC Copy A, B, C, C, STANDARD SETS (50 Sheets for 100 Recipients)+ DWMR (50) 959233-Part SET includes: (50 Sheets EACH) 1099-INT Copy A, B, CMINI SETS w/ Self-Seal Envelopes (25 Sheets for 50 Recipients) 959244-Part SET includes: (50 Sheets EACH) 1099-INT Copy A, B, C, C95918ES4-Part SET includes: (25 Sheets EACH) 1099-MISC Copy A, B, C, C, STANDARD SETS w/ Envelopes (50 Sheets for 100 Recipients)+ DWMRS (50) 95923E3-Part SET includes: (50 Sheets EACH) 1099-INT Copy A, B, C VALUE SETS w/ Self-Seal Envelopes (10 Sheets for 20 Recipients) + DWMR (100)95903ES3-Part SET includes: (10 Sheets EACH) 1099-MISC Copy A, B, C, 95924E4-Part SET includes: (50 Sheets EACH) 1099-INT Copy A, B, C, C, + DWMRS (20) + DWMR (100)95904ES4-Part SET includes: (10 Sheets EACH) 1099-MISC Copy A, B, C, C,VALUE SETS w/ Self-Seal Envelopes (10 Sheets for 20 Recipients)+ DWMRS (20) 95907ES3-Part SET includes: (10 Sheets EACH) 1099-INT Copy A, B, C 95905ES5-Part SET includes: (10 Sheets EACH) 1099-MISC Copy A, B, C, C, 2, + DWMRS (20)+ DWMRS (20) 95908ES4-Part SET includes: (10 Sheets EACH) 1099-INT Copy A, B, C, C, + DWMRS (20)42"