28 29 1099 Forms 1099 Forms 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 2 21 22 23 24 25 26 27 28 29 30 _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 9595 9595 _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ S S E L N O B R A C C S I M - 9 9 0 1 T P 5 5 M - C T M R O F S S E L N O B R A C C S I M - 9 9 0 1 T P 5 5 M - C T M R O F Nonemployee compensation CORRECTED VOID OMB No. 1545-0115 Rents 1 PAYER’S name, street address, city, state, ZIP code, and telephone no. $ 2 Royalties $ Federal income tax withheld Other income 3 RECIPIENT’S identification number PAYER’S Federal identification number 5 Fishing boat proceeds 6 Medical and health care payments RECIPIENT’S name Substitute payments in lieu of dividends or interest 8 7 $ $ 9 Street address (including apt. no.) 10 Crop insurance proceeds City, state, and ZIP code Gross proceeds paid to an attorney 14 Excess golden parachute payments 13 Account number (see instructions) $ 16 State tax withheld 17 State/Payer’s state no. $ 18 State income $ $ 4 Payer made direct sales of $5,000 or more of consumer products to a buyer (recipient) for resale Form 1099-MISC Miscellaneous Income $ 2nd TIN not. Department of the Treasury - Internal Revenue Service Form 1099-MISC Copy A File with Form 1096. For Privacy Act and Paperwork Reduction Act Notice, see the 2016 General Instructions for Forms 1099, 1098, 5498, and W-2G. For Internal Revenue Service Center Do Not Cut or Separate Forms on This Page — Do Not Cut or Separate Forms on This Page 12 11 18 Section 409A income 15b Section 409A deferrals 15a $ $ $ $ $ $ $ $ Nonemployee compensation CORRECTED VOID OMB No. 1545-0115 Rents 1 PAYER’S name, street address, city, state, ZIP code, and telephone no. $ 2 Royalties $ Federal income tax withheld Other income 3 RECIPIENT’S identification number PAYER’S Federal identification number 5 Fishing boat proceeds 6 Medical and health care payments RECIPIENT’S name Substitute payments in lieu of dividends or interest 8 7 $ $ 9 Street address (including apt. no.) 10 Crop insurance proceeds City, state, and ZIP code Gross proceeds paid to an attorney 14 Excess golden parachute payments 13 Account number (see instructions) $ 16 State tax withheld 17 State/Payer’s state no. $ 18 State income $ $ 4 Payer made direct sales of $5,000 or more of consumer products to a buyer (recipient) for resale Form 1099-MISC Miscellaneous Income $ 2nd TIN not. Department of the Treasury - Internal Revenue Service Form 1099-MISC Copy A File with Form 1096. For Privacy Act and Paperwork Reduction Act Notice, see the 2016 General Instructions for Forms 1099, 1098, 5498, and W-2G. For Internal Revenue Service Center 12 11 18 Section 409A income 15b Section 409A deferrals 15a $ $ $ $ $ $ $ $ 41-1628061 41-1628061 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 2 21 22 23 24 25 26 27 28 29 30 RECIPIENT’S name Street address (including apt. no.) City, state, and ZIP code Copy A For Internal Revenue Service Center File with Form 1096. 41-1628061 Do Not Cut or Separate Forms on This Page — Do Not Cut or Separate Forms on This Page For Privacy Act and Paperwork Reduction Act Notice, see the 2016 General Instructions for Forms 1099, 1098, 5498, and W-2G. RECIPIENT’S name Street address (including apt. no.) City, state, and ZIP code Copy A For Internal Revenue Service Center File with Form 1096. 41-1628061 For Privacy Act and Paperwork Reduction Act Notice, see the 2016 General Instructions for Forms 1099, 1098, 5498, and W-2G. Department of the Treasury - Internal Revenue Service Department of the Treasury - Internal Revenue Service Form Form 1099-MISC 1099-MISC CORRECTED CORRECTED RECIPIENT’S identification RECIPIENT’S identification number number Account number (see instructions) Account number (see instructions) PAYER’S Federal identification PAYER’S Federal identification number number Rents Rents 1 1 $ $ 2 2 Royalties Royalties $ $ $ $ Fishing boat proceeds Fishing boat proceeds 5 5 6 6 Medical and health care payments Medical and health care payments $ $ 7 7 8 8 Substitute payments in lieu of Substitute payments in lieu of dividends or interest dividends or interest Nonemployee compensation Nonemployee compensation $ $ $ $ 9 9 $ $ Excess golden parachute Excess golden parachute payments payments $ $ State tax withheld State tax withheld $ $ $ $ State income State income $ $ $ $ Payer made direct sales of Payer made direct sales of $5,000 or more of consumer $5,000 or more of consumer products to a buyer products to a buyer (recipient) for resale (recipient) for resale 10 10 3 3 Other income Other income $ $ 4 4 Federal income tax withheld Federal income tax withheld $ $ Crop insurance proceeds Crop insurance proceeds 12 12 14 14 Gross proceeds paid to Gross proceeds paid to an attorney an attorney 17 17 State/Payer’s state no. State/Payer’s state no. 11 11 13 13 16 16 18 18 $ $ 15a 15a R E L I A M C S I M 9 9 0 1 T P 5 5 M - M T M R O F OMB No. 1545-0115 OMB No. 1545-0115 Miscellaneous Miscellaneous Income Income Form Form 1099-MISC 1099-MISC PAYER’S name, street address, city, state, ZIP code, and telephone no. PAYER’S name, street address, city, state, ZIP code, and telephone no. 18 18 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 R E L I A M C S I M 9 9 0 1 T P 5 5 M - M T M R O F 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 1A 11 1B 555 9595 9595 15b 15b $ $ Section 409A income Section 409A income Section 409A deferrals Section 409A deferrals $ $ VOID 2nd TIN not. 2nd TIN not. VOID 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 2 21 22 23 24 25 26 27 28 29 30 9696 9696 MANUFACTURED ON OCR LASER BOND PAPER USING HEAT RESISTANT INKS DETACH BEFORE MAILING LOA 5163 41-0852411 Department of the Treasury - Internal Revenue Service www.irs.gov/form1099oid Form 1099-OID 2018 Original Issue Discount Copy A For Internal Revenue Service Center File with Form 1096. OMB No. 1545-0117 For Privacy Act and Paperwork Reduction Act Notice, see the 2016 General Instructions for Certain Information Returns. VOID CORRECTED PAYER’S name, street address, city or town, province or state, country, ZIP or foreign postal code, and telephone no. PAYER’S federal identification number RECIPIENT’S identification number RECIPIENT’S name Street address (including apt. no.) City or town, province or state, country, and ZIP or foreign postal code Account number (see instructions) 2nd TIN not. 1 Original issue discount for 2014 $ 2 Other periodic interest $ 3 Early withdrawal penalty $ 4 Federal income tax withheld $ 5 Foreign tax paid $ 6 Foreign country or U.S. possession 7 Description 8 Original issue discount on U.S. Treasury obligations $ 9 Investment expenses $ 10 State 11 State identification no. 12 State tax withheld $ $ Form 1099-OID 41-0852411 Department of the Treasury - Internal Revenue Service www.irs.gov/form1099oid Form 1099-OID 2018 Original Issue Discount Copy A For Internal Revenue Service Center File with Form 1096. OMB No. 1545-0117 For Privacy Act and Paperwork Reduction Act Notice, see the 2016 General Instructions for Certain Information Returns. VOID CORRECTED PAYER’S name, street address, city or town, province or state, country, ZIP or foreign postal code, and telephone no. PAYER’S federal identification number RECIPIENT’S identification number RECIPIENT’S name Street address (including apt. no.) City or town, province or state, country, and ZIP or foreign postal code Account number (see instructions) 2nd TIN not. 1 Original issue discount for 2014 $ 2 Other periodic interest $ 3 Early withdrawal penalty $ 4 Federal income tax withheld $ 5 Foreign tax paid $ 6 Foreign country or U.S. possession 7 Description 8 Original issue discount on U.S. Treasury obligations $ 9 Investment expenses $ 10 State 11 State identification no. 12 State tax withheld $ $ Form 1099-OID Do Not Cut or Separate Forms on This Page — Do Not Cut or Separate Forms on This Page 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 2 21 22 23 24 25 26 27 28 29 30 __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __ __ __ D N O B C S I M - 9 9 0 1 T P 1 1 M - T M R O F D N O B C S I M - 9 9 0 1 T P 1 1 M - T M R O F 11 12 (keep for your records) Nonemployee compensation CORRECTED (if checked) Rents 1 PAYER’S name, street address, city, state, ZIP code, and telephone no. $ 2 Royalties $ Other income 3 RECIPIENT’S identification number PAYER’S Federal identification number 5 Fishing boat proceeds 6 Medical and health care payments $ $ Substitute payments in lieu of dividends or interest 8 7 $ $ 9 10 Crop insurance proceeds Gross proceeds paid to an attorney 14 Excess golden parachute payments 13 Account number (see instructions) $ 16 State tax withheld 17 State/Payer’s state no. $ Department of the Treasury - Internal Revenue Service 18 State income $ $ 4 $ $ Payer made direct sales of $5,000 or more of consumer products to a buyer (recipient) for resale Form 1099-MISC $ Copy B For Recipient This is important tax information and is being furnished to the Internal Revenue Service. If you are required to file a return, a negligence penalty or other sanction may be imposed on you if this income is taxable and the IRS determines that it has not been reported. Federal income tax withheld Section 409A income 15b Section 409A deferrals 15a $ $ $ $ RECIPIENT’S name, address, and ZIP code 11 12 (keep for your records) Nonemployee compensation CORRECTED (if checked) OMB No. 1545-0115 Rents 1 PAYER’S name, street address, city, state, ZIP code, and telephone no. $ 2 Royalties $ Other income 3 RECIPIENT’S identification number PAYER’S Federal identification number 5 Fishing boat proceeds 6 Medical and health care payments $ $ Substitute payments in lieu of dividends or interest 8 7 $ $ 9 10 Crop insurance proceeds Gross proceeds paid to an attorney 14 Excess golden parachute payments 13 Account number (see instructions) $ 16 State tax withheld 17 State/Payer’s state no. $ Department of the Treasury - Internal Revenue Service 18 State income $ $ 4 $ $ Payer made direct sales of $5,000 or more of consumer products to a buyer (recipient) for resale Form 1099-MISC Form 1099-MISC Miscellaneous Income $ Copy B For Recipient This is important tax information and is being furnished to the Internal Revenue Service. If you are required to file a return, a negligence penalty or other sanction may be imposed on you if this income is taxable and the IRS determines that it has not been reported. Federal income tax withheld 18 Section 409A income 15b Section 409A deferrals 15a $ $ $ $ RECIPIENT’S name, address, and ZIP code OMB No. 1545-0115 Miscellaneous Income Form 1099-MISC 18 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 2 21 22 23 24 25 26 27 28 29 30 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 2 21 22 23 24 25 26 27 28 29 30 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 2 21 22 23 24 25 26 27 28 29 30 41-1628061 Employee contributions /Designated Roth contributions or insurance premiums CORRECTED VOID Gross distribution 1 PAYER’S name, street address, city, state, and ZIP code $ 2a Taxable amount $ Total distribution Taxable amount not determined 2b Copy A RECIPIENT’S identification number PAYER’S federal identification number 3 Capital gain (included in box 2a) 4 Federal income tax withheld For Internal Revenue Service Center $ $ RECIPIENT’S name Net unrealized appreciation in employer’s securities 6 5 For Privacy Act and Paperwork Reduction Act Notice, see the 2016 General Instructions for Forms 1099, 1098, 5498, and W-2G. $ $ IRA/ SEP/ SIMPLE Distribution code(s) 7 Street address (including apt. no.) 8 Other % Your percentage of total distribution 9a City, state, and ZIP code % State/Payer’s state no. 11 State tax withheld 10 1st year of desig. Roth contrib. $ 13 Local tax withheld 14 Name of locality $ Department of the Treasury — Internal Revenue Service Form 1099-R File with Form 1096. 12 15 State distribution Local distribution $ $ $ $ $ 9b Total employee contributions $ Account number (see instructions) $ $ 9898 Distributions From Pensions, Annuities, Retirement or Profit-Sharing Plans, IRA's, Insurance Contracts etc. OMB No. 1545-0119 Form 1099-R 18 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 2 21 22 23 24 25 26 27 28 29 30 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 2 21 22 23 24 25 26 27 28 29 30 Department of the Treasury - Internal Revenue Service Form 1099-R VOID CORRECTED PAYER’S name, street address, city, state, and ZIP code RECIPIENT’S identification number RECIPIENT’S name, street address (including apt. no.), city, state, and ZIP code Account number (optional) PAYER’S Federal identification number Copy 1 For State, City, or Local Tax Department or Copy D For Payer Gross distribution 1 4 6 $ 2a Taxable amount $ 2b Taxable amount not determined Total distribution $ Capital gain (included in box 2a) 3 Federal income tax withheld $ 5 Net unrealized appreciation in employer’s securities Employee contributions or insurance premiums $ $ 7 Distribution code 8 Other $ IRA/ SEP/ SIMPLE 9a Your percentage of total distribution 9b Total employee contributions $ 10 State tax withheld $ $ Local tax withheld 13 $ $ 11 State/Payer’s state no. 14 Name of locality 12 State distribution $ $ 15 Local distribution $ $ For Privacy Act and Paperwork Reduction Act Notice, see the 2016 General Instructions for Forms 1099, 1098, 5498, and W-2G. % % Distributions From Pensions, Annuities, Retirement or Profit-Sharing Plans, IRA's, Insurance Contracts etc. OMB No. 1545-0119 Form 1099-R 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 2 21 22 23 24 25 26 27 28 29 30 SW19 DW19 Use Envelope DW19 or SW19 2018 18 18 18 2018 2018 version not released at time of printing FORM 1099 MISC “Miscellaneous” The 1099 MISC is used to report rents, royalties, prizes and awards, fishing boat proceeds, fees, commissions paid to non-employees, and health care payments. An extra State Copy may be added to make a 5-part form when payer has withheld state tax from recipient. FORM 1099 OID Used for nominees return for original issue discounts (applies to holder of bonds, debentures, certificates of deposits, etc.). FIRST CLASS POSTAL INDICIA Eliminate Excess Eliminate Handling Manual Posting A Postal Indicia (for all 1099 mailers) can be applied as a custom imprint at our plant (contact your salesperson for charges and closing dates) or computer generated into the reverse box on part 1. In either case, postal permits eliminate postal metering and extra handling. FIRST CLASS POSTAL INDICIA Our Peel-Apart Mailer construction provides you with the advantages of convenience, low-cost and excellent legibility. The Ply‑saver feature enables you to utilize the back of the outgoing envelope as an information ply. continuous continuous electronic filing dated Self-mailers FORM 1099 MISC TC-M3, TC-M4, TC-M5 PTM-M3, PTM-M4 T-M1 TC-04 tm-m3m POD-M3M continuous FORM NUMBERS Form T-M1 1-Part Carbonless Form TC-M3 3-Part Form TC-M4 4-Part MAILER FORM NUMBERS Form PTM-M3 3-Part Peel-Apart Form PTM-M4 4-Part Peel-Apart Electronic Form TM-M3M 3-Part Open Date Form POD-M3M 3-Part continuous FORM NUMBERS Form TC-04 4-Part FORM 1099 PATR This form is used for reporting income for patrons of cooperatives. FORM 1099 R File Form 1099-R, Distributions From Pensions, Annuities, Retirement of Profit-Sharing Plans, IRA’s, Insurance Contracts, etc., for each person to whom you have made any designated distribution from profit-sharing or retirement plans, IRA’s, annuities, pensions, etc., whether or not you withheld Federal income tax. Form 1099 r Non-Mailers Mailers TC-p4 TC-r4 / tc-r6 tm-mr3 / tm-mr4 TC-mr4 continuous FORM NUMBERS Carbonless Form TC-r4 4-Part Form TC-r6 6-Part Electronic Filing Form TC-Mr4 4-Part MAILER FORM NUMBERS Electronic Filing Form TM-Mr3 3-Part Form TM-Mr4 4-Part continuous FORM NUMBERS Carbonless Form TC-p4 4-Part Available Self Seal Self DW19S 18 Available Self Seal Self DWMRS Available Self Seal Self DWMRS Available Self Seal Self DWMRS SWMR DWMR Use Envelope DWMR or SWMR SWMR DWMR Use Envelope DWMR or SWMR SWMR DWMR Use Envelope DWMR or SWMR Available Self Seal Self DWMRS Available Self Seal Self DWMRS SWMR DWMR Use Envelope DWMR or SWMR SWMR DWMR Use Envelope DWMR or SWMR