Page 6 - Pressure Seal Tax Catalog
P. 6

Stock Pressure Seal 1099                                                                                          Stock Pressure Seal 1099 & 1098

                  J                                                          REMOVE SIDE EDGES FIRST                                         REMOVE SIDE EDGES FIRST
                                                                                                                                                                                                        REMOVE SIDE EDGES FIRST
                                     REMOVE SIDE EDGES FIRST
                  9138922          SLIDE FINGER BETWEEN FRONT & MIDDLE PANEL TO OPEN  SLIDE FINGER BETWEEN FRONT & MIDDLE PANEL TO OPEN    SLIDE FINGER BETWEEN FRONT & MIDDLE PANEL TO OPEN          THEN FOLD AND TEAR THIS STUB ALONG PERFORATION
                                                                                                                                                                                                   3  2
                                                                                                                                                                 VOID
                                                                                                                                                          1  PAYER’S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.
                                                                                                                                                                   CORRECTED
                                                                                                                                                                                                  1                 REMOVE THESE EDGES FIRST
                                                                                                                                                                    1a Total ordinary dividends
                 TXE 1099MISC-B                  FOLD, CREASE AND TEAR ALONG PERFORATION  REMOVE THESE EDGES FIRST  9138859  PAYER’S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.  $ 1 Rents  OMB No. 1545-0115  TXE 1099DIV         8289762  PAYER’S TIN  1b Qualified dividends  2b Unrecap. Sec. 1250 gain  Dividends and  FOLD, CREASE AND TEAR ALONG PERFORATION 8
                                                                                                                                                                        OMB No. 1545-0110
                                                                                           2
                                                                                                                                                                        Form  1099-DIV
                                                                                                                                                                    $
                                                                                                                                                                        (Rev. January 2024)
                                                                                                   CORRECTED (if checked)
                             REMOVE THESE EDGES FIRST FOLD, CREASE AND TEAR ALONG PERFORATION  REMOVE THESE EDGES FIRST  FOLD, CREASE AND TEAR ALONG PERFORATION    TXE 1099MISC        RECIPIENT’S name, street address (including apt. no.), city or town, state or province, country, and ZIP or foreign postal code  2 Royalties  (Rev. December 2026)  Miscellaneous  REMOVE THESE EDGES FIRST  FOLD, CREASE AND TEAR ALONG PERFORATION  RECIPIENT’S name, Street address (including apt. no.), City or town, state or province, country, and ZIP or foreign postal code 3 2e Section 897 ordinary dividends  $ $ 2d Collectibles (28%) gain  income tax return, Copy 2  REMOVE THESE EDGES FIRST FOLD, CREASE AND TEAR ALONG PERFORATION  9139047
                                                                                                                                                                    $
                                                                                                                                                                        For calendar year
                                                                                                                                                                            Distributions
                                                                                          REMOVE THESE EDGES FIRST
                                                                                                                                                                    2a Total capital gain distr.
                                                                                                                                                          REMOVE THESE EDGES FIRST
                                                                                                                                                                    $
                                                                                                        Form 1099-MISC
                                                                                                                                                                RECIPIENT’S TIN
                                                                                                                                                                    2c Section 1202 gain
                                                                                                                                                                    $
                                                                                                            Information
                                                                                                        For calendar year
                                                                                                    $
                                                                                                                                                         FOLD, CREASE AND TEAR ALONG PERFORATION
                                                                                         FOLD, CREASE AND TEAR ALONG PERFORATION
                                                                                                                                                                            To be filed with
                                                                                                                                                                    $
                                                                                                    3 Other income
                                                                                                                                                                            recipient’s state
                                                                                                                                                                        $
                                                                                                                                                                        2f Section 897 capital gain
                                                                                                        4 Federal income tax withheld
                                                                                            PAYER’S TIN
                                                                                                    $
                                                                                                RECIPIENT’S TIN
                                                                                                        $
                                                                                                                                                                    Nondividend distributions
                                                                                                                                                                    $
                                                                                                                                                                            when required.
                                                                                                    5 Fishing boat proceeds
                                                                                                                                                                        4
                                                                                                                                                                        Federal income tax withheld
                                                                                                        6 Medical and health care payments
                                                                                                                                                                        $
                                                                                                    $
                                                                                                             Copy 2
                                                                                                                                                                    5
                                                                                                        $
                                                                                                                                                                        6
                                                                                                                                                                    $
                                                                                                                                                                    Section 199A dividends
                                                                                                        8 Substitute payments in lieu of
                                                                                                    7 Payer made direct sales
                                                                                                            To be filed
                                                                                                                                                                        Investment expenses
                                                                                                                                                                    7
                                                                                                        dividends or interest
                                                                                                                                                                        $
                                                                                                    totaling $5,000 or more of
                                                                                                    consumer products to
                                                                                                                                                                    Foreign tax paid
                                                                                                    recipient for resale
                                                                                                            recipient’s
                                                                                                                                                                        Foreign country or U.S. possession
                                                                                                    9 Crop insurance proceeds
                                                                                                            tax return,
                                                                                                    $
                                                                                                        attorney
                                                                                                        $
                                                                                                                                                                       $
                                                                                 Box 7. If checked, consumer products totaling $5,000 or more were sold to you for resale on a buy-sell, a  Account number (see instructions)  FATCA filing requirement  11 $ 13a Cash Tips  $ 10 Gross proceeds paid to an  state income when with  beneficiaries. It is generally treated as effectively connected to a trade or business within the  C  3 E  Account number (see instructions)  11  FATCA filing requirement  $ 12 $ 14 $ 9 Cash liquidation distributions  8 10 Noncash liquidation distributions
                                                                                                                                                                    Exempt-interest dividends
                                                                                                                                                                       13
                                                                                                    Fish purchased for resale
                                                                                                        12 Section 409A deferrals
                                                                                                                                                                       $
                                                                                                                                                                        Specified private activity bond interest dividends
                                                                                                             required.
                                                                                 deposit-commission, or another basis. Generally, report any income from your sale of these products on
                                                                                                                                                                     15
                                                                                                                                                                    State
                                                                                                        $
                                                                                                                                                                        State tax withheld
                                                                                                                                                                       16
                                                                                                                                                                     State identification no.
                                                                                                                                                                       $
                                                                                                    $
                                                                                                                                                 bution reduces your basis and is not taxable. Any amount received in excess of your basis is tax-
                                                                                                                                                           Form 1099-DIV
                                                                                                        13b TTOC
                                                                                 behalf as a result of a loan of your securities. Report on the “Other income” line of Schedule 1 (Form 1040).
                                                                                                                                                 United States. See the instructions for your tax return.
                                        Box 7. If checked, consumer products totaling $5,000 or more were sold to you for resale on a buy-sell, a  Box 8. Shows substitute payments in lieu of dividends or tax-exempt interest received by your broker on your  14 Overtime Compensation  15 Nonqualified deferred compensation  Box 3. Shows a return of capital. To the extent of your cost (or other basis) in the stock, the distri-  www.irs.gov/Form1099DIV  $
                                                                                 Box 10. Shows gross proceeds paid to an attorney in connection with legal services. Report only the taxable
                                                                                                    $
                                                                        Recipient’s taxpayer identification number (TIN). For your protection, this form may show only the last four
                                                                                                                                        Recipient’s taxpayer identification number (TIN). For your protection, this form may show only
                                                                                                        $
                                                                                                                                                 able to you as capital gain. See Pub. 550.
                              Instructions for Recipient  deposit-commission, or another basis. Generally, report any income from your sale of these products on  Schedule C (Form 1040).  16 State tax withheld  17 State/Payer’s state no.  18 State income  Box 4. Shows backup withholding. A payer must backup withhold on certain payments if you did  PAYER’S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.  Department of the Treasury - Internal Revenue Service
                                                                                 Box 9. Report this amount on Schedule F (Form 1040).
                                        Box 8. Shows substitute payments in lieu of dividends or tax-exempt interest received by your broker on your
                              Recipient’s taxpayer identification number (TIN). For your protection, this form may show only the last four
                                                                        digits of your social security number (SSN), individual taxpayer identification number (ITIN), adoption taxpayer
                                        Schedule C (Form 1040).
                                                                                                                                        the last four digits of your TIN (SSN, ITIN, ATIN, or EIN). However, the issuer has reported your
                                                                                                    $
                                                                                                                                                 Box 5. Shows the portion of the amount in box 1a that may be eligible for the 20% qualified busi-
                                                                                                                                                                  CORRECTED (if checked)
                                                                                                           $
                                                                        identification number (ATIN), or employer identification number (EIN). However, the payer has reported your
                              digits of your social security number (SSN), individual taxpayer identification number (ITIN), adoption taxpayer  behalf as a result of a loan of your securities. Report on the “Other income” line of Schedule 1 (Form 1040).  Instructions for Recipient  Box 11. Shows the amount of cash you received for the sale of fish if you are in the trade or business of catching  3  Form 1099-MISC  www.irs.gov/Form1099MISC  $  Department of the Treasury - Internal Revenue Service  Instructions for Recipient  not give your TIN to the payer. See Form W-9 for information on backup withholding. Include this  65074  1a Total ordinary dividends  OMB No. 1545-0110  Y
                                                                                                                                                  ness income deduction under section 199A. See the instructions for Form 8995 and Form 8995-A.
                              identification number (ATIN), or employer identification number (EIN). However, the payer has reported your
                                                                                                                                                 amount on your income tax return as tax withheld.
                                        Box 10. Shows gross proceeds paid to an attorney in connection with legal services. Report only the taxable
                                                                                 part as income on your return.
                                                                                                           $
                                                                                 (NQDC) plan that is subject to the requirements of section 409A plus any earnings on current- and prior-year
                                        Box 9. Report this amount on Schedule F (Form 1040).
                                                                                                                                        Box 1a. Shows total ordinary dividends that are taxable. Include this amount on the “Ordinary divi-
                              complete TIN to the IRS.
                              Account number. May show an account or other unique number the payer assigned to distinguish your  Box 11. Shows the amount of cash you received for the sale of fish if you are in the trade or business of catching  Account number. May show an account or other unique number the payer assigned to distinguish your  Box 12. May show current-year deferrals as a nonemployee under a nonqualified deferred compensation  PAYER’S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.  1 Rents  Account number. May show an account or other unique number the payer assigned to distinguish  Box 6. Shows your share of expenses of a nonpublicly offered RIC, generally a nonpublicly offered  1b Qualified dividends  Form  1099-DIV  Dividends and  OMB No. 1545-1574
                                                                                                                                                                    $
                                                                                                                                        complete TIN to the IRS.
                                                                                                                                        dends” line of Form 1040 or 1040-SR. Also report it on Schedule B (Form 1040), if required.
                                                                                                   CORRECTED (if checked)
                                        part as income on your return.
                                                                        FATCA filing requirement. If the FATCA filing requirement box is checked, the payer is reporting on this Form
                                                                                                                                                  mutual fund. This amount is included in box 1a.
                              FATCA filing requirement. If the FATCA filing requirement box is checked, the payer is reporting on this Form  fish.  complete TIN to the IRS.  Box 13a. Shows the total amount of cash tips. “Cash tips” include tips received in cash or charged. This  OMB No. 1545-0115  your account.  Box 7. Shows the foreign tax that you may be able to claim as a deduction or a credit on Form     $  For calendar year  Distributions  FILER’S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone number  1  Payments received for qualified  CORRECTED (if checked)
                                                                                                                                        rates. See the Instructions for Form 1040 for how to determine this amount and where to report.
                              account.
                                                                                                                                                                       (Rev. January 2024)
                                                                                 fish.
                              1099 to satisfy its account reporting requirement under chapter 4 of the Internal Revenue Code. You may also  Box 12. May show current-year deferrals as a nonemployee under a nonqualified deferred compensation  3  1099 to satisfy its account reporting requirement under chapter 4 of the Internal Revenue Code. You may also  amount has been included in the amount reported in box 3. Use the amount in box 13a when determining the  $ 2 Royalties  Form 1099-MISC  Miscellaneous  Box 1b. Shows the portion of the amount in box 1a that may be eligible for reduced capital gains  1040 or 1040-SR. See the Instructions for Form 1040.  PAYER’S TIN  2a Total capital gain distr.  $ 2b Unrecap. Sec. 1250 gain  $  Tuition
                                                                                  Box 13b. Shows up to two Treasury Tipped Occupation Code(s) (TTOC) for your tipped occupation(s). Use this
                                                                                                                                                  Box 8. This box should be left blank if a RIC reported the foreign tax shown in box 7.
                                                                                                                                         The amount shown may be dividends a corporation paid directly to you as a participant (or ben-
                                                                        Amounts shown may be subject to self-employment (SE) tax. Individuals should see the Instructions for
                                                                                                                                                                                                                               tuition and related expenses
                                        (NQDC) plan that is subject to the requirements of section 409A plus any earnings on current- and prior-year
                                                                                                                                                  Boxes 9 and 10. Show cash and noncash liquidation distributions.
                                                                                                                                                  satisfy its account reporting requirement under chapter 4 of the Internal Revenue Code. You may
                              have a filing requirement. See the Instructions for Form 8938.
                              Amounts shown may be subject to self-employment (SE) tax. Individuals should see the Instructions for
                                                                        account.
                                                                                 deferrals.
                                                                                 qualified tip deduction in Part II of Schedule 1-A (Form 1040).
                                                                                                                                        your Form 1040 or 1040-SR but treat it as a plan distribution, not as investment income, for any
                                                                                                                                                                    $
                                                                                  code 000 is used, a and no other code is included in box 13b, your cash tips are not qualified tips; do not use
                                                                        Schedule SE (Form 1040). Corporations, fiduciaries, or partnerships must report the amounts on the
                                        deferrals.
                                        amount has been included in the amount reported in box 3. Use the amount in box 13a when determining the
                                                                                                        (Rev. December 2026)
                              Schedule SE (Form 1040). Corporations, fiduciaries, or partnerships must report the amounts on the  Box 13a. Shows the total amount of cash tips. “Cash tips” include tips received in cash or charged. This  have a filing requirement. See the Instructions for Form 8938.  code(s) in determining the deduction for qualified tips in Part II of Schedule 1-A (Form 1040). If the occupation  $ 3 Other income  4 Federal income tax withheld  Information  eficiary of a participant) in an employee stock ownership plan (ESOP). Report it as a dividend on  Box 11. If the FATCA filing requirement box is checked, the payer is reporting on this Form 1099 to  RECIPIENT’S TIN  $ 2c Section 1202 gain  2d Collectibles (28%) gain  For Recipient  2  Form 1098-T 26  Statement
                                                                                                                                                                            Copy B
                                                                                                        For calendar year
                              appropriate lines of their tax returns.
                                                                        cannot get this form corrected, attach an explanation to your tax return and report your information correctly.
                                                                                                                                        estate investment trust (REIT). See How To Report in the Instructions for Schedule D (Form 1040).
                                                                                  Box 14. Shows the total amount of qualified overtime compensation. This amount has been included in the
                                                                                                                                                  calendar year. See the Instructions for Form 1040 for where to report. This amount may be subject
                                                                                                                                                  also have a filing requirement. See the Instructions for Form 8938.
                              Form 1099-MISC incorrect? If this form is incorrect or has been issued in error, contact the payer. If you
                                                                                  amount reported in box 3. Use the amount in box 14 when determining the qualified overtime compensation
                                                                                                                                                                       $
                                                                                                                                        But, if no amount is shown in boxes 2b, 2c, 2d, and 2f and your only capital gains and losses are
                                        qualified tip deduction in Part II of Schedule 1-A (Form 1040).
                                        code(s) in determining the deduction for qualified tips in Part II of Schedule 1-A (Form 1040). If the occupation
                               cannot get this form corrected, attach an explanation to your tax return and report your information correctly.  Box 13b. Shows up to two Treasury Tipped Occupation Code(s) (TTOC) for your tipped occupation(s). Use this  Form 1099-MISC incorrect? If this form is incorrect or has been issued in error, contact the payer. If you  the amount reported in box 13a for the deduction for qualified tips.  PAYER’S TIN  RECIPIENT’S TIN  $ $ 5 Fishing boat proceeds  $ 6 Medical and health care payments  For Recipient  Box 2a. Shows total capital gain distributions from a regulated investment company (RIC) or real  Box 12. Shows exempt-interest dividends from a mutual fund or other RIC paid to you during the  RECIPIENT’S name, Street address (including apt. no.), City or town, state or province, country, and ZIP or foreign postal code 3 $ 2e Section 897 ordinary dividends  $ 2f Section 897 capital gain  This is important tax  FILER’S employer id
                                                                        appropriate lines of their tax returns.
                                                                                                                                         capital gain distributions, you may be able to report the amounts shown in box 2a on your Form
                                                                                                                                                  Box 13. Shows exempt-interest dividends subject to the alternative minimum tax. This amount is
                                                                        Box 1. Report rents from real estate on Schedule E (Form 1040). However, report rents on Schedule C (Form
                               Box 1. Report rents from real estate on Schedule E (Form 1040). However, report rents on Schedule C (Form
                                                                                                                                        other purpose.
                                                                                                                                                                                                                                      Copy B
                                                                                                            Copy B
                                        code 000 is used, a and no other code is included in box 13b, your cash tips are not qualified tips; do not use
                               1040) if you provided significant services to the tenant, sold real estate as a business, or rented personal
                                                                                                                                         1040 or 1040-SR rather than Schedule D. See the Instructions for Form 1040.
                                                                                  section 409A. Any amount included in box 12 that is currently taxable is also included in this box. Report this
                                                                                  amount as income on your tax return. This income is also subject to a substantial additional tax to be
                                                                                  deduction in Part III of Schedule 1-A (Form 1040).
                                                                                                                                                                       4
                                                                                                                                         certain depreciable real property. See the Unrecaptured Section 1250 Gain Worksheet in the
                                                                                                                                                                            information and is
                                                                        Box 2. Report royalties from oil, gas, or mineral properties; copyrights; and patents on Schedule E (Form 1040).
                                                                                                                                                                    Nondividend distributions
                                                                                                                                                  Nominees. If this form includes amounts belonging to another person, you are considered a nomi-
                                                                                                                                                                   $
                                                                                                                                                  included in box 12. See the Instructions for Form 6251.
                                                                        However, report payments for a working interest as explained in the Schedule E (Form 1040) instructions. For
                               Box 2. Report royalties from oil, gas, or mineral properties; copyrights; and patents on Schedule E (Form 1040).
                                        Box 14. Shows the total amount of qualified overtime compensation. This amount has been included in the
                               property as a business. See Pub. 527.  the amount reported in box 13a for the deduction for qualified tips.  1040) if you provided significant services to the tenant, sold real estate as a business, or rented personal  Box 15. Shows income as a nonemployee under an NQDC plan that does not meet the requirements of  RECIPIENT’S name, street address (including apt. no.), city or town, state or province, country, and ZIP or foreign postal code  7 Payer made direct sales  $ 8 Substitute payments in lieu of  This is important tax  Box 2b. Shows the portion of the amount in box 2a that is unrecaptured section 1250 gain from  to backup withholding. See Box 4 above.  5 $ Section 199A dividends  $ 6  Federal income tax withheld  the IRS. If you are  TXE 1098T    STUDENT’S name, street address (including apt. no.), city or town, state or province, country, and ZIP or foreign postal code  4 $ Adjustments made for a  5 $  Scholarships or grants
                                                                                                                                                                            being furnished to
                                                                                                                                                                                                                              prior year
                                                                                                                                         Box 2c. Shows the portion of the amount in box 2a that is section 1202 gain from certain small
                                                                                                                                                  Boxes 14–16. State income tax withheld reporting boxes.
                               However, report payments for a working interest as explained in the Schedule E (Form 1040) instructions. For
                                        amount reported in box 3. Use the amount in box 14 when determining the qualified overtime compensation
                                                                                                    totaling $5,000 or more of
                                                                                                                                                  owners to show their share of the income, and you must furnish a Form 1099-DIV to each. A
                                                                                                                                                                                                                                      tax information
                                                                                                                                         business stock that may be subject to an exclusion. See the Schedule D (Form 1040) instructions.
                                                                                                        dividends or interest
                                                                        Box 3. Generally, report this amount on the “Other income” line of Schedule 1 (Form 1040) and identify the
                                                                                                            information and is
                                                                                                    consumer products to
                                                                                  Future developments. For the latest information about developments related to Form 1099-MISC and its
                                                                                                                                                  spouse is not required to file a nominee return to show amounts owned by the other spouse. See
                                                                                                                                                                       Investment expenses
                                        deduction in Part III of Schedule 1-A (Form 1040).
                                                                                                                                         Box 2d. Shows the portion of the amount in box 2a that is 28% rate gain from sales or exchanges
                                                                                                                                                                                                                                      and is being
                                                                                                                                                                            required to file a
                                                                                                                                                                                                                                      furnished to the
                                        section 409A. Any amount included in box 12 that is currently taxable is also included in this box. Report this
                                                                                                    recipient for resale
                                                                                  Boxes 16–18. Show state or local income tax withheld from the payments.
                               royalties on timber, coal, and iron ore, see Pub. 544.  Box 15. Shows income as a nonemployee under an NQDC plan that does not meet the requirements of  property as a business. See Pub. 527.  reported on Form 1040, 1040-SR, or 1040-NR. See the instructions for your tax return.  9 Crop insurance proceeds  $ 10 Gross proceeds paid to an  being furnished to the  Instructions for Schedule D (Form 1040).  nee recipient. You must file Form 1099-DIV (with a Form 1096) with the IRS for each of the other  7 $  Foreign tax paid  $ 8  Foreign country or U.S. possession  return, a negligence  6  Adjustments to  7  Checked if the amount  IRS. This form must
                               Box 3. Generally, report this amount on the “Other income” line of Schedule 1 (Form 1040) and identify the
                                                                                                                                                                            penalty or other
                                                                        royalties on timber, coal, and iron ore, see Pub. 544.
                               payment. The amount shown may be payments received as the beneficiary of a deceased employee, prizes,
                                                                                  Free File Program. Go to www.irs.gov/FreeFile to see if you qualify for no-cost online federal tax preparation,
                                                                                                                                                                                                                                  in box 1  includes
                                                                        awards, taxable damages, Indian gaming profits, or other taxable income. See Pub. 525. If it is trade or
                                                                                                                                                                                                                              scholarships or grants
                                                                                                            IRS. If you are
                                                                                                                                         Box 2e. Shows the portion of the amount in box 1a that is section 897 gain attributable to disposi-
                                                                                                                                                                                                                                     be used to complete
                                                                                                                                                                                                                              for a prior year
                                                                                                                                                                                                                                  amounts for an
                                                                                                                                                                            sanction may be
                               awards, taxable damages, Indian gaming profits, or other taxable income. See Pub. 525. If it is trade or  amount as income on your tax return. This income is also subject to a substantial additional tax to be  payment. The amount shown may be payments received as the beneficiary of a deceased employee, prizes,  instructions, such as legislation enacted after they were published, go to www.irs.gov/Form1099MISC.  $ 11 Fish purchased for resale  12 Section 409A deferrals  required to file a return,  of collectibles. If required, use this amount when completing the 28% Rate Gain Worksheet in the  the current General Instructions for Certain Information Returns.  PSE-Z-BLANK-POP   Account number (see instructions)  11  9 Cash liquidation distributions  $ 10 Noncash liquidation distributions  this income is taxable  Service Provider/Acct. No. (see instr.)  8 Checked if at   $ 9  Checked if a  10 Ins. contract reimb./refund  education cre
                                                                                                                                                                                                                                     Form 8863 to claim
                                                                                                                                                                                                                                  academic period
                                                                                                        attorney
                                        reported on Form 1040, 1040-SR, or 1040-NR. See the instructions for your tax return.
                                                                                                                                                                                                                                  beginning January -
                                                                                                       $
                                                                                                                                                                           imposed on you if
                               business income, report this amount on Schedule C or F (Form 1040).
                                                                         business income, report this amount on Schedule C or F (Form 1040).
                                                                                                                                                                                                                                      Give it to the
                                                                                                           a negligence penalty or
                                                                                                                                                                                                                                  March 2027
                               Box 4. Shows backup withholding or withholding on Indian gaming profits. Generally, a payer must backup
                                                                         withhold if you did not furnish your TIN. See Form W-9 and Pub. 505 for more information. Report this amount
                                                                                                                                         Instructions for Schedule D (Form 1040).
                                        Boxes 16–18. Show state or local income tax withheld from the payments.
                                                                                                                                                                   $
                                                                                                           other sanction may be
                               withhold if you did not furnish your TIN. See Form W-9 and Pub. 505 for more information. Report this amount
                                                                                                                                                                            and the IRS
                                                                                                                                                                                                                                      tax preparer or
                                        instructions, such as legislation enacted after they were published, go to www.irs.gov/Form1099MISC.
                                                                                                                                                                   12
                                                                                                                                                                    Exempt-interest dividends
                                                                         Box 5. Shows the amount paid to you as a fishing boat crew member by the operator, who considers you to be
                                                                                                                                                                           determines that it has
                                                                                                           imposed on you if this
                                                                                                                                         Note: Boxes 2e and 2f apply only to foreign persons and entities whose income maintains its
                                                                                                                                         tion of U.S. real property interests (USRPI).
                                                                                                                                                                                                                                  $
                                        Free File Program. Go to www.irs.gov/FreeFile to see if you qualify for no-cost online federal tax preparation,
                                                                         self-employed. Self-employed individuals must report this amount on Schedule C (Form 1040). See Pub. 334.
                                                                                                           income is taxable and
                               Box 5. Shows the amount paid to you as a fishing boat crew member by the operator, who considers you to be
                               on your income tax return as tax withheld.  Future developments. For the latest information about developments related to Form 1099-MISC and its  Box 4. Shows backup withholding or withholding on Indian gaming profits. Generally, a payer must backup  e-filing, and direct deposit or payment options.  Account number (see instructions)  FATCA filing requirement  $ 13a Cash Tips  13b TTOC $  the IRS determines that  Box 2f. Shows the portion of the amount in box 2a that is section 897 gain attributable to disposi-  Form 1099-DIV  FATCA filing requirement  $ 14  State  15 State identification no.  $ 13 $ 16  Specified private activity bond interest dividends  not been reported.  Form 1098-T  (keep for your records)  leasthalf-time student www.irs.gov/Form1098T graduate student Department of the Treasury - Internal Revenue Service  prepare the tax use it to return.
                                                                                                                                         character when passed through or distributed to its direct or indirect foreign owners or
                               self-employed. Self-employed individuals must report this amount on Schedule C (Form 1040). See Pub. 334.
                                        e-filing, and direct deposit or payment options.
                                                                                                    $
                                                                                                                                                                       State tax withheld
                                                                                                            it has not been
                               Box 6. For individuals, report on Schedule C (Form 1040).  on your income tax return as tax withheld.  14 Overtime Compensation  15 Nonqualified deferred compensation  reported.  tion of USRPI.  (keep for your records)  www.irs.gov/Form1099DIV  $
                                                                                                    $
                                                                         Box 6. For individuals, report on Schedule C (Form 1040).
                                                                                                       $
                                                                                                    16 State tax withheld
                                                                                                    $
                                                                                                    $
                                                                                                           $
                                                                                           Form 1099-MISC  (keep for your records)  www.irs.gov/Form1099MISC  17 State/Payer’s state no.  18 State income  Department of the Treasury - Internal Revenue Service
                                                                                                           $
                                                                                                        Department of the Treasury - Internal Revenue Service
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                     TXE 1099MISC-B                                               TXE 1099MISC                                                    TXE 1099DIV                                                  TXE 1098T
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                  9138942          SLIDE FINGER BETWEEN FRONT & MIDDLE PANEL TO OPEN  SLIDE FINGER BETWEEN FRONT & MIDDLE PANEL TO OPEN
                                                                                         FOLD, CREASE AND TEAR ALONG PERFORATION REMOVE THESE EDGES FIRST  4
                 TXE 1099NEC-B                   FOLD, CREASE AND TEAR ALONG PERFORATION  REMOVE THESE EDGES FIRST  9138934  PAYER’S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.  a b Cash tips  c TTOC  Nonemployee
                                                                                                            OMB No. 1545-0116
                             REMOVE THESE EDGES FIRST FOLD, CREASE AND TEAR ALONG PERFORATION  REMOVE THESE EDGES FIRST FOLD, CREASE AND TEAR ALONG PERFORATION  TXE 1099NEC           3 Excess golden parachute payments  with recipient’s
                                                                                                            Compensation
                                                                                                            (Rev. December 2026)
                                                                                                            For calendar year
                                                                                                    d Overtime Compensation
                                                                                                             Copy 2
                                                                                                            To be filed
                                                                                                            state income
                                                                                                            tax return,
                                                                                           RECIPIENT'S name, street address (including apt. no.), city or town, state or province, country, and ZIP or foreign
                                                                                 Schedule 1-A (Form 1040). If the occupation code 000 is used, and no other code is  postal code  when required
                                                                                 included in box 1c, your cash tips are not qualified tips; do not use the amount reported
                                                                                 in box 1b for the deduction for qualified tips.
                                        Schedule 1-A (Form 1040). If the occupation code 000 is used, and no other code is  Box 1d. Shows the total amount of qualified overtime compensation. This amount has
                                                                                 determining the qualified overtime compensation deduction in Part III of Schedule 1-A
                              Instructions for Recipient  included in box 1c, your cash tips are not qualified tips; do not use the amount reported  been included in the amount reported in box 1a. Use the amount in box 1d when
                                        in box 1b for the deduction for qualified tips.
                                                                        You received this form instead of Form W-2 because the payer did not consider you an
                              You received this form instead of Form W-2 because the payer did not consider you an  Box 1d. Shows the total amount of qualified overtime compensation. This amount has  Instructions for Recipient  Note: If you are receiving payments on which no income, social security, and Medicare  Form  1099-NEC  www.irs.gov/Form 1099NEC
                                        been included in the amount reported in box 1a. Use the amount in box 1d when
                                                                        If you believe you are an employee and cannot get the payer to correct this form, report
                               employee and did not withhold income tax or social security and Medicare taxes.  determining the qualified overtime compensation deduction in Part III of Schedule 1-A  employee and did not withhold income tax or social security and Medicare taxes.  taxes are withheld, you should make estimated tax payments. See Form 1040-ES (or  5  Department of the Treasury - Internal Revenue Service
                                                                                 instructions. Corporations, fiduciaries, and partnerships must report these amounts on the
                                                                                 (Form 1040).
                               If you believe you are an employee and cannot get the payer to correct this form, report
                               the amount shown in box 1 on the line for “Wages, salaries, tips, etc.” of Form 1040,  Note: If you are receiving payments on which no income, social security, and Medicare  the amount shown in box 1 on the line for “Wages, salaries, tips, etc.” of Form 1040,  Form 1040-ES (NR)). Individuals must report these amounts as explained in these box 1  a a  OMB No. 1545-0116
                               1040-SR, or 1040-NR. You must also complete Form 8919 and attach it to your return.
                                        (Form 1040).
                                                                        For more information, see Pub. 1779, Independent Contractor or Employee.
                               For more information, see Pub. 1779, Independent Contractor or Employee.  taxes are withheld, you should make estimated tax payments. See Form 1040-ES (or  5  1040-SR, or 1040-NR. You must also complete Form 8919 and attach it to your return.  Box 2. If checked, consumer products totaling $5,000 or more were sold to you for resale  PAYER’S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.  Nonemployee
                                                                        If you are not an employee but the amount in box 1 is not self-employment (SE) income
                                                                                  appropriate lines of their tax returns.
                                        Form 1040-ES (NR)). Individuals must report these amounts as explained in these box 1
                               If you are not an employee but the amount in box 1 is not self-employment (SE) income
                               (for example, it is income from a sporadic activity or a hobby), report the amount shown in  instructions. Corporations, fiduciaries, and partnerships must report these amounts on the  (for example, it is income from a sporadic activity or a hobby), report the amount shown in  on a buy-sell, a deposit-commission, or another basis. Generally, report any income from  b Cash tips  c TTOC c TTOC  Compensation
                                        appropriate lines of their tax returns.
                                                                                  your sale of these products on Schedule C (Form 1040).
                                                                                                    b Cash tips
                                                                        Recipient’s taxpayer identification number (TIN). For your protection, this form may
                                                                                                           (Rev. December 2026)
                               box 1 on the “Other income” line (on Schedule 1 (Form 1040)).
                                        on a buy-sell, a deposit-commission, or another basis. Generally, report any income from
                               Recipient’s taxpayer identification number (TIN). For your protection, this form may  Box 2. If checked, consumer products totaling $5,000 or more were sold to you for resale  box 1 on the “Other income” line (on Schedule 1 (Form 1040)).  Box 3. Shows your total compensation of excess golden parachute payments subject to a  d Overtime Compensation  For calendar year
                                                                                  20% excise tax. See your tax return instructions for where to report.
                                                                                  you did not give your TIN to the payer. See Form W-9, Request for Taxpayer Identification
                                                                        taxpayer identification number (ITIN), adoption taxpayer identification number (ATIN), or
                               show only the last four digits of your TIN (social security number (SSN), individual
                                                                        employer identification number (EIN)). However, the issuer has reported your complete TIN
                                                                                                    d Overtime Compensation
                               taxpayer identification number (ITIN), adoption taxpayer identification number (ATIN), or  your sale of these products on Schedule C (Form 1040).  show only the last four digits of your TIN (social security number (SSN), individual  Box 4. Shows backup withholding. A payer must backup withhold on certain payments if  Copy B
                                        Box 3. Shows your total compensation of excess golden parachute payments subject to a
                               employer identification number (EIN)). However, the issuer has reported your complete TIN
                               to the IRS.  20% excise tax. See your tax return instructions for where to report.  Number and Certification, for information on backup  withholding. Include this amount on  For Recipient
                               Account number. May show an account or other unique number the payer assigned to  Box 4. Shows backup withholding. A payer must backup withhold on certain payments if  3 Excess golden parachute payments
                                                                                  Boxes 5–7. State income tax withheld reporting boxes.
                                                                                  1099-NEC and its instructions, such as legislation enacted after they were published, go
                                        Number and Certification, for information on backup  withholding. Include this amount on
                               Box 1a. Shows your total nonemployee compensation. If the amount in this box is SE  your income tax return as tax withheld.  Box 1a. Shows your total nonemployee compensation. If the amount in this box is SE  Future developments. For the latest information about developments related to Form  furnished to the IRS. If
                               distinguish your account.  you did not give your TIN to the payer. See Form W-9, Request for Taxpayer Identification  Account number. May show an account or other unique number the payer assigned to  your income tax return as tax withheld.  information and is being
                                                                         income, report it on Schedule C or F (Form 1040) if a sole proprietor or on Form 1065 and
                                                                        to the IRS.
                                                                                                           This is important tax
                                                                         Schedule K-1 (Form 1065) if a partnership, and the recipient/partner completes Schedule
                               income, report it on Schedule C or F (Form 1040) if a sole proprietor or on Form 1065 and  Boxes 5–7. State income tax withheld reporting boxes.  distinguish your account.  Free File Program. Go to www.irs.gov/FreeFile to see if you qualify for no-cost online  you are required to file a
                               Schedule K-1 (Form 1065) if a partnership, and the recipient/partner completes Schedule
                                                                                  federal tax preparation, e-filing, and direct deposit or payment options.
                                                                                                           return, a negligence
                                        1099-NEC and its instructions, such as legislation enacted after they were published, go
                               SE (Form 1040).
                               Box 1b. Shows the total amount of cash tips. “Cash tips” include tips received in cash or  Future developments. For the latest information about developments related to Form  Box 1b. Shows the total amount of cash tips. “Cash tips” include tips received in cash or  to www.irs.gov/Form1099NEC.  RECIPIENT'S name, street address (including apt. no.), city or town, state or province, country, and ZIP or foreign  Federal income tax withheld  imposed on you if this
                                                                         charged. This amount has been included in the amount reported in box 1a. Use the
                                                                                                            penalty or other
                                                                         amount in box 1b when determining the qualified tip deduction in Part II of Schedule 1-A
                                                                                           postal code
                               charged. This amount has been included in the amount reported in box 1a. Use the  Free File Program. Go to www.irs.gov/FreeFile to see if you qualify for no-cost online  SE (Form 1040).  the IRS determines that
                                                                                                            sanction may be
                               amount in box 1b when determining the qualified tip deduction in Part II of Schedule 1-A
                                        to www.irs.gov/Form1099NEC.
                                                                                                           income is taxable and
                                                                         Box 1c. Shows up to two Treasury Tipped Occupation Code(s) (TTOC) for your tipped
                               Box 1c. Shows up to two Treasury Tipped Occupation Code(s) (TTOC) for your tipped  federal tax preparation, e-filing, and direct deposit or payment options.  (Form 1040).  it has not been
                                                                         occupation(s). Use this code(s) in determining the deduction for qualified tips in Part II of
                               (Form 1040).
                               occupation(s). Use this code(s) in determining the deduction for qualified tips in Part II of
                                                                                                            reported.
                                                                                           Form  1099-NEC  $
                                                                                               (keep for your records)  www.irs.gov/Form 1099NEC
                                                                                                       Department of the Treasury - Internal Revenue Service
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                      TXE 1099NEC-B                                               TXE 1099NEC
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                                                                           9138945  PAYER’S name, street address, city or town, state or province, country,  ZIP or foreign postal code, and telephone no.  1 Unemployment compensation
                                                                                            FOLD, CREASE AND TEAR ALONG PERFORATION
                       REMOVE SIDE EDGES FIRST
                     SLIDE FINGER BETWEEN FRONT & MIDDLE PANEL TO OPEN              $   OMB No. 1545-0120                                                                            • Accepted by the USPS
                                       CORRECTED (if checked)  OMB No. 1545-0112  Interest  PAYER’S TIN   2 State or local income tax   Form  1099-G
                                            (Rev. January 2024)
                               PAYER’S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.
                                                                                     refunds, credits, or offsets
                Instructions for Recipient (continued)  Box 13. For a tax-exempt covered security, shows the amount of premium amortization allo-  Payer’s RTN (optional)  Form 1099-INT  Income Copy 2  TXE 1099G          RECIPIENT’S name, Street address (including apt. no.), City or town, state or province, country,  ZIP or foreign postal code  $ 3 Box 2 amount is for tax year  4 Federal income tax withheld  REMOVE THESE EDGES FIRST  Government   FOLD, CREASE AND TEAR ALONG PERFORATION  REMOVE THESE EDGES FIRST
                                                                                             Certain
                                            For calendar year
                                                                                RECIPIENT’S TIN
                                                                                        (Rev. December 2026)
                              A
                Box 11. For a taxable covered security (other than a U.S. Treasury obligation), shows the
                                        1 Interest income
                                                                                        For calendar year
                amount of premium amortization allocable to the interest payment(s), unless you notified the
                         cable to the interest payment(s). If an amount is reported in this box, see Pub. 550 to deter-
                         mine the net amount of tax-exempt interest reportable on Form 1040 or 1040-SR. If an
                payer in writing in accordance with Regulations section 1.6045-1(n)(5) that you did not want
                         amount is not reported in this box for a tax-exempt covered security acquired at a premium,
                                                                                            Payments
                to amortize bond premium under section 171. If an amount is reported in this box, see the
                         the payer has reported a net amount of interest in box 8 or 9, whichever is applicable. If the
                                        $
                Instructions for Schedule B (Form 1040) to determine the net amount of interest includible in
              REMOVE THESE EDGES FIRST FOLD, CREASE AND TEAR ALONG PERFORATION  income on Form 1040 or 1040-SR with respect to the security. If an amount is not reported in  amount in box 13 is greater than the amount of interest paid on the tax-exempt covered  FOLD, CREASE AND TEAR ALONG PERFORATION  REMOVE THESE EDGES FIRST  RECIPIENT’S TIN   2 Early withdrawal penalty  5 Investment expenses  income tax return,  Form 1099-G  $  7 Agriculture payments  10 Family leave benefits  recipient’s state    • Delivered to the Correct Addressee
                                        3 Interest on U.S. Savings Bonds and Treasury obligations
                               9139047
                                                                                        $
                this box for a taxable covered security acquired at a premium and the payer is reporting pre-
                                                                                    5 RTAA payments
                         security, the excess is a nondeductible loss. See Regulations section 1.171-2(a)(4)(ii).
                                        $
                                                                                    $
                mium amortization, the payer has reported a net amount of interest in box 1. If the amount in
                         Box 14. Shows CUSIP number(s) for tax-exempt bond(s) on which tax-exempt interest was
                                                To be filed with
                         paid, or tax credit bond(s) on which taxable interest was paid or tax credit was allowed, to
                                                recipient’s state
                box 11 is greater than the amount of interest paid on the covered security, see Regulations
                                                                                             Copy 2
                                                                                        6 Taxable grants
                                                                                       $
                                        4 Federal income tax withheld
                                        $
                         you during the calendar year. If blank, no CUSIP number was issued for the bond(s).
                section 1.171-2(a)(4).
                                                                                           To be filed with
                         Boxes 15–17. State tax withheld reporting boxes.
                Box 12. For a U.S. Treasury obligation that is a covered security, shows the amount of premi-
                                            7 Foreign country or U.S. territory
                                                when required.
                                                                                    $
                                            $
                         Nominees. If this form includes amounts belonging to another person(s), you are considered
                um amortization allocable to the interest payment(s), unless you notified the payer in writing
                                                                                       8 Check if box 2 is
                                PAYER’S TIN
                                RECIPIENT’S name, Street address (including apt. no.), City or town, state or province, country, and ZIP or foreign postal code
                                        $
                         a nominee recipient. Complete a Form 1099-INT for each of the other owners showing the
                in accordance with Regulations section 1.6045-1(n)(5) that you did not want to amortize bond
                                                                                       income
                         income allocable to each. File Copy A of the form with the IRS. Furnish Copy B to each
                                        6 Foreign tax paid
                                                                                        trade or business
                premium under section 171. If an amount is reported in this box, see the Instructions for
                                                                           Account number (see instructions)
                                                                                    9 Market gain
                                            Specified private activity bond interest
                                                                                            income tax
                Schedule B (Form 1040) to determine the net amount of interest includible in income on Form
                                            9
                         owner. List yourself as the “payer” and the other owner(s) as the “recipient.” File Form(s)
                                                                                            return, when
                         1099-INT with Form 1096 with the Internal Revenue Service Center for your area. On Form
                1040 or 1040-SR with respect to the U.S. Treasury obligation. If an amount is not reported in
                                        $
                         1096, list yourself as the “filer.” A spouse is not required to file a nominee return to show
                this box for a U.S. Treasury obligation that is a covered security acquired at a premium and
                the payer is reporting premium amortization, the payer has reported a net amount of interest
                         amounts owned by the other spouse.
                                            13 Bond premium on tax-exempt bond
                                                                                    11a  State 11b State identification no.
                                         Market discount
                in box 3. If the amount in box 12 is greater than the amount of interest paid on the U.S.
                         Future developments. For the latest information about developments related to Form 1099-
                                            $
                Treasury obligation, see Regulations section 1.171-2(a)(4).
                         INT and its instructions, such as legislation enacted after they were published, go to
                                         $
                         www.irs.gov/Form1099INT.  TXE 1099INT                       8 $ 10 Tax-exempt interest  $ 11 Bond premium  State tax withheld  www.irs.gov/Form1099G  $ $ $ 12 State income tax withheld  required.    • Mailed at the Lowest Possible Rate!
                                            $
                         Free File Program. Go to www.irs.gov/FreeFile to see if you qualify for no-cost online feder-  12 Bond premium on Treasury obligations  State 16  State identification no. 17 $
                         al tax preparation, e-filing, and direct deposit or payment options.  $  Tax-exempt and tax credit  15  $  Instructions for Recipient
                                      FATCA filing  14  bond CUSIP no.  Department of the Treasury - Internal Revenue Service  PAYER’S name, street address, city or town, state or province, country,  ZIP or foreign postal code, and telephone no.  1 Unemployment compensation  Department of the Treasury - Internal Revenue Service Recipient’s taxpayer identification number (TIN). For your protection, this form may  to the payer. See Form W-9 for information on backup withholding. Include this amount on
                                      requirement
                                                                                                      your income tax return as tax withheld.
                                                                                  CORRECTED  (if checked)
                                                                                             show only the last four digits of your TIN (SSN, ITIN, ATIN, or EIN). However, the issuer has
                                                                                                      Include on the “Other income” line of Schedule 1 (Form 1040).
                                Account number (see instructions)  www.irs.gov/Form1099INT  OMB No. 1545-0112  $  OMB No. 1545-0120  reported your complete TIN to the IRS.  Box 5. Shows reemployment trade adjustment assistance (RTAA) payments you received.
                                                                                             Account number. May show an account or other unique number the payer has assigned to
                                                                                                      Box 6. Shows taxable grants you received from a federal, state, or local government.
                                                                                             distinguish your account.
                                                                                             Caution: Identity Theft (IDT). If you suspect that you are a victim of IDT, do not report the
                                                                                                      Box 7. Shows your taxable Department of Agriculture payments. If the payer shown is
                                Form 1099-INT  CORRECTED (if checked)  Interest  PAYER’S TIN   2 State or local income tax   Form  1099-G  incorrect amount shown in box 1 of Form(s) 1099-G on your tax return. Go to  payment, as a nominee, that is taxable to you. This may represent the entire agricultural
                                                                                                      anyone other than the Department of Agriculture, it means the payer has received a
                                                                                             www.irs.gov/idtheftunemployment for more information.
                                PAYER’S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.
               Instructions for Recipient  may deduct this amount to figure your adjusted gross income on your income tax return.  Payer’s RTN (optional)  Form 1099-INT  Income  refunds, credits, or offsets  (Rev. December 2026)  Certain  Box 1. Shows the total unemployment compensation (UC) paid to you in the calendar year  subsidy payment received on your behalf by the nominee, or it may be your pro rata share
                                             (Rev. January 2024)
                                                                                                      of the original payment. See Pub. 225 and the Schedule F (Form 1040) instructions for
               The information provided may be different for covered and noncovered securities. For a  See the Instructions for Form 1040 to see where to take the deduction.  RECIPIENT’S TIN   $  Government  reported. Combine the box 1 amounts from all Forms 1099-G and report the total as  information about where to report this income. Partnerships, see Form 8825 for how to
               description of covered securities, see the Instructions for Form 8949. For a taxable covered  Box 3. Shows interest on U.S. Savings Bonds, Treasury bills, Treasury bonds, and Treasury  For calendar year  For calendar year  income on the UC line of your tax return. Except as explained below, this is your taxable  7
               security acquired at a premium, unless you notified the payer in writing in accordance with  notes. This may or may not all be taxable. See Pub. 550. This interest is exempt from state  1 Interest income  Copy B  Payments  amount. If you made contributions to a governmental UC program and received a payment  report.
               Regulations section 1.6045-1(n)(5) that you did not want to amortize the premium under sec-  and local income taxes. This interest is not included in box 1. See the instructions above for  RECIPIENT’S name, Street address (including apt. no.), City or town, state or province, country,  ZIP or foreign postal code  3 Box 2 amount is for tax year  Box 8. If this box is checked, the amount in box 2 is attributable to an income tax that
               tion 171, or for a tax-exempt covered security acquired at a premium, your payer must gen-  a taxable covered security acquired at a premium.  $  For Recipient  from that program, the payer must issue a separate Form 1099-G to report this amount to  applies exclusively to income from a trade or business and is not a tax of general
                                                                                             you. If you itemize deductions, you may deduct your contributions on Schedule A (Form
               erally report either (1) a net amount of interest that reflects the offset of the amount of interest  Box 4. Shows backup withholding. Generally, a payer must backup withhold if you did not  This is important tax  4 Federal income tax withheld  1040) as taxes paid. If you do not itemize, only include in income the amount that is in  application. If taxable, report the amount in box 2 on Schedule C or F (Form 1040), as
               paid to you by the amount of premium amortization allocable to the payment(s), or (2) a gross  furnish your TIN or you did not furnish the correct TIN to the payer. See Form W-9. Include  2 Early withdrawal penalty  $  excess of your contributions.  appropriate.
               amount for both the interest paid to you and the premium amortization allocable to the pay-  this amount on your income tax return as tax withheld.  3 Interest on U.S. Savings Bonds and Treasury obligations  information and is  5 RTAA payments
               ment(s). If you did notify your payer that you did not want to amortize the premium on a tax-  Box 5. Any amount shown is your share of investment expenses of a single-class REMIC.  $  being furnished to the  $  6 Taxable grants  Copy B  Box 2. Shows refunds, credits, or offsets of state or local income tax you received. It may  Box 9. Shows market gain on CCC loans whether repaid using cash or CCC certificates.
                                                                                             be taxable to you if you deducted the state or local income tax paid on Schedule A (Form
                                                                                                      See the Schedule F (Form 1040) instructions.
               able covered security, then your payer will only report the gross amount of interest paid to  This amount is included in box 1. Note: This amount is not deductible.  5 Investment expenses  IRS. If you are  For Recipient  Boxes 10. Shows the amount paid to you from a governmental paid family leave program.
               you. For a noncovered security acquired at a premium, your payer is only required to report  Box 6. Shows foreign tax paid. You may be able to claim this tax as a deduction or a credit  $  7 Agriculture payments  $  1040). Even if you did not receive the amount shown, for example, because (a) it was
               the gross amount of interest paid to you.  on your Form 1040 or 1040-SR. See your tax return instructions.  RECIPIENT’S TIN   4 Federal income tax withheld  required to file a return,  credited to your state or local estimated tax, (b) it was offset against federal or state debts,  If you made contributions to a governmental paid family leave program and received total
               Recipient’s taxpayer identification number (TIN). For your protection, this form may show  Box 7. Shows the country or U.S. territory to which the foreign tax was paid.  B  $  a negligence penalty or  $  This is important tax   (c) it was offset against other offsets, or (d) you made a charitable contribution from your  payments that meets or exceeds the applicable reporting threshold from that program, the
                                                                                          information and is
               only the last four digits of your TIN (social security number (SSN), individual taxpayer identifi-  Box 8. Shows tax-exempt interest paid to you during the calendar year by the payer. See PAYER’S TIN   $  7 Foreign country or U.S. territory  other sanction may be  Account number (see instructions)  8 If checked, box 2 is   being furnished to the   refund, it is still taxable if it was deducted. If you received interest on this amount, you may  payer must issue a Form 1099-G to report the amount paid to you. If you itemize
                                                                                      income
               cation number (ITIN), adoption taxpayer identification number (ATIN), or employer identifica-  how to report this amount in the Instructions for Form 1040. This amount may be subject to  imposed on you if this  9 Market gain  trade or business   IRS. If you are required   receive Form 1099-INT for the interest. Regardless of whether the interest is reported to  deductions, you may report your contributions on Schedule A (Form 1040) as state or local
               tion number (EIN)). However, the issuer has reported your complete TIN to the IRS.  backup withholding. See Box 4 above. See the instructions above for a tax-exempt covered RECIPIENT’S name, Street address (including apt. no.), City or town, state or province, country, and ZIP or foreign postal code  6 Foreign tax paid  $  you, report it as interest income on your tax return. See your tax return instructions.  taxes paid.
               FATCA filing requirement. If the FATCA filing requirement box is checked, the payer is  security acquired at a premium.  $  9 Specified private activity bond interest  income is taxable and  Form 1099-G  to file a return, a   Box 3. Identifies the tax year for which the box 2 refunds, credits, or offsets shown were  Boxes 11a–12. State income tax withheld reporting boxes.
               reporting on this Form 1099 to satisfy its chapter 4 account reporting requirement. You may  Box 9. Shows tax-exempt interest subject to the alternative minimum tax. This amount is  8  Tax-exempt interest  $  the IRS determines that  10 Family leave benefits  negligence penalty or   made.  Future developments. For the latest information about developments related to Form
                                                                                      $
               also have a filing requirement. See the Instructions for Form 8938.  included in box 8. See the Instructions for Form 6251. See the instructions above for a tax-  11 Bond premium  it has not been reported.  11a  State 11b State identification no.  other sanction may be   Box 4. Shows backup withholding or withholding you requested on unemployment  1099-G and its instructions, such as legislation enacted after they were published, go to
               Account number. May show an account or other unique number the payer assigned to dis-  exempt covered security acquired at a premium.  $  (keep for your records)  imposed on you if this   www.irs.gov/Form1099G.
               tinguish your account.  Box 10. For a taxable or tax-exempt covered security, if you made an election under section  10  Market discount  $  compensation, Commodity Credit Corporation (CCC) loans, or certain crop disaster
               Payer’s Routing Transit Number (RTN). A payer may include the RTN to identify the bank or  1278(b) to include market discount in income as it accrues and you notified your payer of  $  13 Bond premium on tax-exempt bond  State tax withheld  12 State income tax withheld  the IRS determines that   payments.  Free File Program. Go to www.irs.gov/FreeFile to see if you qualify for no-cost online
                                                                                      $
                                                                                          income is taxable and
                                                                                             Generally, a payer must backup withhold on certain payments if you did not give your TIN
                                                                                                      federal tax preparation, e-filing, and direct deposit or payment options.
                                                                                      $
               financial institution where your account is held.  the election in writing in accordance with Regulations section 1.6045-1(n)(5), shows the mar-  12 Bond premium on Treasury obligations  $  www.irs.gov/Form1099G  it has not been
               Box 1. Shows taxable interest paid to you during the calendar year by the payer. This does  ket discount that accrued on the debt instrument during the year while held by you, unless it  15  State 16  State identification no. 17 $
               not include interest shown in box 3. May also show the total amount of the credits from clean  $  $  reported.
               renewable energy bonds, new clean renewable energy bonds, qualified energy conservation  was reported on Form 1099-OID. For a taxable or tax-exempt covered security acquired on
                                       requirement
               bonds, qualified zone academy bonds, qualified school construction bonds, and build  or after January 1, 2015, accrued market discount will be calculated on a constant yield  FATCA filing  14 Tax-exempt and tax credit  Department of the Treasury - Internal Revenue Service  Department of the Treasury - Internal Revenue Service
                                          bond CUSIP no.
                         basis unless you notified your payer in writing in accordance with Regulations section
               America bonds that must be included in your interest income. These amounts were treated  1.6045-1(n)(5) that you did not want to make a constant yield election for market discount
               as paid to you during the calendar year on the credit allowance dates (March 15, June 15,
               September 15, and December 15). For more information, see Form 8912. See the instruc-  under section 1276(b). Report the accrued market discount on your income tax return as  www.irs.gov/Form1099INT
               tions above for a taxable covered security acquired at a premium.  directed in the Instructions for Form 1040. Market discount on a tax-exempt security is  Account number (see instructions)
                         includible in taxable income as interest income.
               Box 2. Shows interest or principal forfeited because of early withdrawal of time savings. You  (Continued on the back of Copy 2.)  (keep for your records)
                                 Form 1099-INT                                    FIRST-CLASS MAIL
                                                                                  IMPORTANT: TAX RETURN
                                                                                  DOCUMENT ENCLOSED
                                          FIRST-CLASS MAIL              SEE OTHER SIDE FOR OPENING INSTRUCTIONS
                                          IMPORTANT: TAX RETURN
                                          DOCUMENT ENCLOSED  OPENING INSTRUCTIONS  SEE OTHER SIDE FOR
                                 SEE OTHER SIDE FOR  OPENING INSTRUCTIONS                   OPENING INSTRUCTIONS  SEE OTHER SIDE FOR
                        TXE 1099INT                                                 TXE 1099G
                  11” Printed Z-Fold - 2 Around                              11” Printed Z-Fold - 2 Around
           Copies B, 2, Back w/Instructions - Simplex                 Copies B, 2, Back w/Instructions - Simplex
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