8 9 laser CuT sHeeTs laser CuT sHeeTs all lasers 50 sHeets/pack – WHere noTeD: bulk packaGinG 500 sHeets/pack all lasers 50 sHeets/pack – WHere noTeD: bulk packaGinG 500 sHeets/pack __ __ __ __ MANUFACTURED IN U.S.A. ON OCR LASER BOND PAPER USING HEAT RESISTANT INKS DETACH BEFORE MAILING LIC 5122 _ _ _ _ __ Department of the Treasury - Internal Revenue Service Form 1099-INT www.irs.gov/form1099int RECIPIENT'S name, street address, city or town, province or state, country, and ZIP or foreign postal code Form 1099-INT 2018 Interest Income Copy C For Payer OMB No. 1545-0112 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 Account number (see instructions) 2nd TIN not. Payer's RTN (optional) 1 Interest income $ 2 Early withdrawal penalty $ 3 Interest on U.S. Savings Bonds and Treas. obligations $ 4 Federal income tax withheld $ 5 Investment expenses $ 6 Foreign tax paid $ 7 Foreign country or U.S. possession 8 Tax-exempt interest $ 9 Specified private activity bond interest $ 10 Tax-exempt bond CUSIP no. 11 State 12 State identification no. 13 State tax withheld $ $ Department of the Treasury - Internal Revenue Service Form 1099-INT www.irs.gov/form1099int RECIPIENT'S name, street address, city or town, province or state, country, and ZIP or foreign postal code Form 1099-INT 2018 Interest Income Copy C For Payer OMB No. 1545-0112 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 Account number (see instructions) 2nd TIN not. Payer's RTN (optional) 1 Interest income $ 2 Early withdrawal penalty $ 3 Interest on U.S. Savings Bonds and Treas. obligations $ 4 Federal income tax withheld $ 5 Investment expenses $ 6 Foreign tax paid $ 7 Foreign country or U.S. possession 8 Tax-exempt interest $ 9 Specified private activity bond interest $ 10 Tax-exempt bond CUSIP no. 11 State 12 State identification no. 13 State tax withheld $ $ or State Copy or State Copy __ __ __ __ MANUFACTURED IN U.S.A. ON OCR LASER BOND PAPER USING HEAT RESISTANT INKS DETACH BEFORE MAILING LIB 5121 __ Department of the Treasury - Internal Revenue Service Form 1099-INT (keep for your records) www.irs.gov/form1099int Form 1099-INT 2018 Interest 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. OMB No. 1545-0112 CORRECTED (if checked) 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 Account number (see instructions) Payer's RTN (optional) 1 Interest income $ 2 Early withdrawal penalty $ 3 Interest on U.S. Savings Bonds and Treas. obligations $ 4 Federal income tax withheld $ 5 Investment expenses $ 6 Foreign tax paid $ 7 Foreign country or U.S. possession 8 Tax-exempt interest $ 9 Specified private activity bond interest $ 10 Tax-exempt bond CUSIP no. 11 State 12 State identification no. 13 State tax withheld $ $ Department of the Treasury - Internal Revenue Service Form 1099-INT (keep for your records) www.irs.gov/form1099int Form 1099-INT 2018 Interest 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. OMB No. 1545-0112 CORRECTED (if checked) 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 Account number (see instructions) Payer's RTN (optional) 1 Interest income $ 2 Early withdrawal penalty $ 3 Interest on U.S. Savings Bonds and Treas. obligations $ 4 Federal income tax withheld $ 5 Investment expenses $ 6 Foreign tax paid $ 7 Foreign country or U.S. possession 8 Tax-exempt interest $ 9 Specified private activity bond interest $ 10 Tax-exempt bond CUSIP no. 11 State 12 State identification no. 13 State tax withheld $ $ RECIPIENT'S name, street address, city or town, province or state, country, and ZIP or foreign postal code RECIPIENT'S name, street address, city or town, province or state, country, and ZIP or foreign postal code __ 12 11 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 $ 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 $ $ 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 2 To be filed with recipient’s state income tax return, when required. $ 18 Section 409A income 15b Section 409A deferrals 15a $ $ RECIPIENT’S name, address, and ZIP code 12 11 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 $ 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 $ $ 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 2 To be filed with recipient’s state income tax return, when required. $ 18 Section 409A income 15b Section 409A deferrals 15a $ $ RECIPIENT’S name, address, and ZIP code •• _ _ _ _ __ _ _ _ _ MANUFACTURED IN U.S.A. ON OCR LASER BOND PAPER USING HEAT RESISTANT INKS __ Nondividend distributions Unrecap. Sec. 1250 gain CORRECTED VOID OMB No. 1545-0110 Total ordinary dividends 1a PAYER’S name, street address, city, state, ZIP code, and telephone no. 1b Qualified dividends Total capital gain distr. 2a RECIPIENT’S identification number PAYER’S federal identification number 2b Form 1099-DIV Dividends and Distributions Department of the Treasury - Internal Revenue Service Form 1099-DIV $ $ $ $ $ $ $ $ 2nd TIN not. 3 5 Investment expenses 9 8 4 Federal income tax withheld Collectibles (28%) gain Section 1202 gain d 2 c 2 6 Foreign tax paid $ $ RECIPIENT’S name, address, city and ZIP code or State Copy Account number (see instructions) $ $ Noncash liquidation distributions Cash liquidation distributions Copy C For Privacy Act and Paperwork Reduction Act Notice, see the 2016 General Instructions for Certain Information Returns. For Payer Nondividend distributions Unrecap. Sec. 1250 gain CORRECTED VOID OMB No. 1545-0110 Total ordinary dividends 1a PAYER’S name, street address, city, state, ZIP code, and telephone no. 1b Qualified dividends Total capital gain distr. 2a RECIPIENT’S identification number PAYER’S federal identification number 2b Form 1099-DIV Dividends and Distributions Form 1099-DIV $ $ $ $ $ $ $ $ 2nd TIN not. 3 5 Investment expenses 9 8 4 Federal income tax withheld Collectibles (28%) gain Section 1202 gain d 2 c 2 6 Foreign tax paid $ $ RECIPIENT’S name, address, city and ZIP code or State Copy Account number (see instructions) $ $ Noncash liquidation distributions Cash liquidation distributions Copy C For Privacy Act and Paperwork Reduction Act Notice, see the 2016 General Instructions for Certain Information Returns. For Payer Department of the Treasury - Internal Revenue Service LDC 5132 DETACH BEFORE MAILING 7 Foreign country or U.S. possession 7 Foreign country or U.S. possession 18 18 __ MANUFACTURED IN U.S.A. ON OCR LASER BOND PAPER USING HEAT RESISTANT INKS DETACH BEFORE MAILING LCC 5139 Form 1099-C 2018 Cancellation of Debt Copy C For Creditor Department of the Treasury - Internal Revenue Service OMB No. 1545-1424 For Privacy Act and Paperwork Reduction Act Notice, see the 2017 General Instructions for Certain Information Returns. VOID CORRECTED CREDITOR'S name, street address, city, state, ZIP code, and telephone no. CREDITOR'S federal identification number Account number (see instructions) 1 2 Amount of debt discharged $ 3 Interest if included in box 2 $ 4 Debt description 5 Check here if the debtor was personally liable for repayment of the debt . . . . . . . 6 7 Fair market value of property $ Form 1099-C DEBTOR’S name, address, city, and ZIP code or State Copy Form 1099-C 2018 Cancellation of Debt Copy C For Creditor Department of the Treasury - Internal Revenue Service OMB No. 1545-1424 For Privacy Act and Paperwork Reductio n Act Notice, see the 2017 General Instructions for Certain Information Returns. VOID CORRECTED CREDITOR'S name, street address, city, state, ZIP code, and telephone no. CREDITOR'S federal identification number Account number (see instructions) 1 2 Amount of debt discharged $ 3 Interest if included in box 2 $ 4 Debt description 5 Check here if the debtor was personally liable for repayment of the debt . . . . . . . 6 7 Fair market value of property $ Form 1099-C DEBTOR’S name, address, city, and ZIP code or State Copy Form 1099-C 2018 Cancellation of Debt Copy C For Creditor Department of the Treasury - Internal Revenue Service OMB No. 1545-1424 For Privacy Act and Paperwork Reduction Act Notice, see the 2017 General Instructions for Certain Information Returns. VOID CORRECTED CREDITOR'S name, street address, city, state, ZIP code, and telephone no. CREDITOR'S federal identification number Account number (see instructions) 1 2 Amount of debt discharged $ 3 Interest if included in box 2 $ 4 Debt description 5 Check here if the debtor was personally liable for repayment of the debt . . . . . . . 6 7 Fair market value of property $ Form 1099-C DEBTOR’S name, address, city, and ZIP code or State Copy Form 1098 2018 Mortgage Interest Statement Copy C For Recipient/ Lender or State Copy Department of the Treasury - Internal Revenue Service OMB No. 1545-0901 For Privacy Act and Paperwork Reduction Act Notice, see the 2017 General Instructions for Certain Information Returns. VOID CORRECTED RECIPIENT'S/LENDER'S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no. RECIPIENT'S/LENDER'S federal PAYER'S/BORROWER'S taxpayer Account number (see instructions) 1 Mortgage interest received from payer(s)/borrower(s) $ 2 Outstanding mortgage principal as of 1/1/2017 $ 3 Mortgage origination date 4 Refund of overpaid interest $ 5 Mortgage insurance premiums $ 6 Points paid on purchase of principal residence $ 7 Is address of property securing mortgage same as PAYER'S/BORROWER'S address? If “Yes,” check box . . . . . . . . . If “No,” enter address of property securing mortgage below 8 Address of property securing mortgage (see instructions) 9 If property securing mortgage has no address, provide description of the property (see instructions) 10 Number of mortgaged properties 11 Other Form 1098 www.irs.gov/form1098 L18C 5152 PAYER'S/BORROWER'S name, street address, city or town, state or province, country, and ZIP or foreign postal code Form 1098 2018 Mortgage Interest Statement Copy C For Recipient/ Lender or State Copy Department of the Treasury - Internal Revenue Service OMB No. 1545-0901 For Privacy Act and Paperwork Reduction Act Notice, see the 2017 General Instructions for Certain Information Returns. VOID CORRECTED RECIPIENT'S/LENDER'S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no. RECIPIENT'S/LENDER'S federal PAYER'S/BORROWER'S taxpayer Account number (see instructions) 1 Mortgage interest received from payer(s)/borrower(s) $ 2 Outstanding mortgage principal as of 1/1/2017 $ 3 Mortgage origination date 4 Refund of overpaid interest $ 5 Mortgage insurance premiums $ 6 Points paid on purchase of principal residence $ 7 Is address of property securing mortgage same as PAYER'S/BORROWER'S address? If “Yes,” check box . . . . . . . . . If “No,” enter address of property securing mortgage below 8 Address of property securing mortgage (see instructions) 9 If property securing mortgage has no address, provide description of the property (see instructions) 10 Number of mortgaged properties 11 Other Form 1098 www.irs.gov/form1098 PAYER'S/BORROWER'S name, street address, city or town, state or province, country, and ZIP or foreign postal code • DETACH BEFORE MAILING __ __ __ __ __ _ _ _ _ __ CORRECTED VOID FILER’S name, street address, city, state, ZIP code, and telephone number Tuition Statement 3 STUDENT’S social security number FILER’S federal identification no. 2 9 Service Provider/Acct. No. (see instr.) STUDENT’S name, address, city and ZIP code Department of the Treasury - Internal Revenue Service Form 1098-T 10 Form 1098-T OMB No. 1545-1574 Ins. contract reimb./refund Check if you have changed your reporting method for 2015 Amounts billed for qualified tuition and related expenses Payments received for qualified tuition and related expenses 1 $ $ Copy C For Filer For Privacy Act and Paperwork Reduction Act Notice, see the 2016 General Instructions for Forms 1099, 1098, 3921, 3922, 5498, and W-2G. 4 Adjustments made for a prior year 6 Adjustments to scholarships or grants for a prior year $ 5 Scholarships or grants $ Check this box if the amount in box 1 or 2 includes amounts for an academic period beginning January - March 2016 8 Check if at least half-time student Check if a graduate student $ $ 7 2018 or State Copy __ _ _ _ _ __ __ __ __ __ 8383 __ _ _ _ _ __ CORRECTED VOID FILER’S name, street address, city, state, ZIP code, and telephone number Tuition Statement 3 STUDENT’S social security number FILER’S federal identification no. 2 9 Service Provider/Acct. No. (see instr.) STUDENT’S name, address, city and ZIP code Department of the Treasury - Internal Revenue Service Form 1098-T 10 Form 1098-T OMB No. 1545-1574 Ins. contract reimb./refund Check if you have changed your reporting method for 2015 Amounts billed for qualified tuition and related expenses Payments received for qualified tuition and related expenses 1 $ $ Copy C For Filer For Privacy Act and Paperwork Reduction Act Notice, see the 2016 General Instructions for Forms 1099, 1098, 3921, 3922, 5498, and W-2G. 4 Adjustments made for a prior year 6 Adjustments to scholarships or grants for a prior year $ 5 Scholarships or grants $ Check this box if the amount in box 1 or 2 includes amounts for an academic period beginning January - March 2016 8 Check if at least half-time student Check if a graduate student $ $ 7 2018 or State Copy __ 8383 __ _ _ _ _ __ CORRECTED VOID FILER’S name, street address, city, state, ZIP code, and telephone number Tuition Statement 3 STUDENT’S social security number FILER’S federal identification no. 2 9 Service Provider/Acct. No. (see instr.) STUDENT’S name, address, city and ZIP code Department of the Treasury - Internal Revenue Service Form 1098-T 10 Form 1098-T OMB No. 1545-1574 Ins. contract reimb./refund Check if you have changed your reporting method for 2015 Amounts billed for qualified tuition and related expenses Payments received for qualified tuition and related expenses 1 $ $ Copy C For Filer For Privacy Act and Paperwork Reduction Act Notice, see the 2016 General Instructions for Forms 1099, 1098, 3921, 3922, 5498, and W-2G. 4 Adjustments made for a prior year 6 Adjustments to scholarships or grants for a prior year $ 5 Scholarships or grants $ Check this box if the amount in box 1 or 2 includes amounts for an academic period beginning January - March 2016 8 Check if at least half-time student Check if a graduate student $ $ 7 2018 or State Copy __ 8383 Form 1098 2018 Mortgage Interest Statement Copy B For Payer/ Borrower Department of the Treasury - Internal Revenue Service The information in boxes 1 through 10 is important tax information and is being furnished to the Internal Revenue Service. If you are negligence penalty or other sanction may be imposed on you if the IRS determines that an underpayment of tax results because you overstated a deduction for this mortgage interest or for these points, reported in boxes 1 and 6; or because you didn't report the refund of interest (box 4); or because you claimed a non-deductible item. OMB No. 1545-0901 CORRECTED (if checked) RECIPIENT'S/LENDER'S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no. RECIPIENT'S/LENDER'S federal PAYER'S/BORROWER'S taxpayer Account number (see instructions) *Caution: The amount shown may not be fully deductible by you. Limits based on the loan amount and the cost and value of the secured property may apply. Also, you may only deduct interest to the extent it was incurred by you, actually paid by you, and not reimbursed by another person. 1 Mortgage interest received from payer(s)/borrower(s)* $ 2 Outstanding mortgage principal as of 1/1/2017 $ 3 Mortgage origination date 4 Refund of overpaid interest $ 5 Mortgage insurance premiums $ 6 Points paid on purchase of principal residence $ 7 Is address of property securing mortgage same as PAYER'S/BORROWER'S address? If “Yes,” box is checked . . . . . . . . If “No,” see box 8 or 9, below 8 Address of property securing mortgage 9 If property securing mortgage has no address, below is the description of the property 10 Number of mortgaged properties 11 Other Form 1098 (Keep for your records) www.irs.gov/form1098 L18B 5151 PAYER'S/BORROWER'S name, street address, city or town, state or province, country, and ZIP or foreign postal code Form 1098 2018 Mortgage Interest Statement Copy B For Payer/ Borrower Department of the Treasury - Internal Revenue Service The information in boxes 1 through 10 is important tax information and is being furnished to the Internal Revenue Service. If you are negligence penalty or other sanction may be imposed on you if the IRS determines that an underpayment of tax results because you overstated a deduction for this mortgage interest or for these points, reported in boxes 1 and 6; or because you didn't report the refund of interest (box 4); or because you claimed a non-deductible item. OMB No. 1545-0901 CORRECTED (if checked) RECIPIENT'S/LENDER'S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no. RECIPIENT'S/LENDER'S federal PAYER'S/BORROWER'S taxpayer Account number (see instructions) *Caution: The amount shown may not be fully deductible by you. Limits based on the loan amount and the cost and value of the secured property may apply. Also, you may only deduct interest to the extent it was incurred by you, actually paid by you, and not reimbursed by another person. 1 Mortgage interest received from payer(s)/borrower(s)* $ 2 Outstanding mortgage principal as of 1/1/2017 $ 3 Mortgage origination date 4 Refund of overpaid interest $ 5 Mortgage insurance premiums $ 6 Points paid on purchase of principal residence $ 7 Is address of property securing mortgage same as PAYER'S/BORROWER'S address? If “Yes,” box is checked . . . . . . . . If “No,” see box 8 or 9, below 8 Address of property securing mortgage 9 If property securing mortgage has no address, below is the description of the property 10 Number of mortgaged properties 11 Other Form 1098 (Keep for your records) www.irs.gov/form1098 PAYER'S/BORROWER'S name, street address, city or town, state or province, country, and ZIP or foreign postal code • DETACH BEFORE MAILING __ __ __ __ __ __ __ _ _ _ _ 2010 FORM L18TB CORRECTED Tuition Statement (keep for your records) Copy B For Student This is important tax information and is being furnished to the Internal Revenue Service. FILER’S name, street address, city, state, ZIP code, and telephone number 3 STUDENT’S social security number FILER’S federal identification no. 2 9 Service Provider/Acct. No. (see instr.) STUDENT’S name, address, city and ZIP code Department of the Treasury - Internal Revenue Service Form 1098-T 10 Form 1098-T OMB No. 1545-1574 Ins. contract reimb./refund If this box is checked, your educational institution has changed its reporting method for 2015 Amounts billed for qualified tuition and related expenses Payments received for qualified tuition and related expenses 1 $ $ 4 Adjustments made for a prior year 6 Adjustments to scholarships or grants for a prior year $ 7 $ 5 Scholarships or grants $ Checked if the amount in box 1 or 2 includes amounts for an academic period beginning January - March 2016 8 Checked if at least half-time student Checked if a graduate student $ 18 CORRECTED Tuition Statement (keep for your records) Copy B For Student This is important tax information and is being furnished to the Internal Revenue Service. FILER’S name, street address, city, state, ZIP code, and telephone number 3 STUDENT’S social security number FILER’S federal identification no. 2 9 Service Provider/Acct. No. (see instr.) STUDENT’S name, address, city and ZIP code Department of the Treasury - Internal Revenue Service Form 1098-T 10 Form 1098-T OMB No. 1545-1574 Ins. contract reimb./refund If this box is checked, your educational institution has changed its reporting method for 2015 Amounts billed for qualified tuition and related expenses Payments received for qualified tuition and related expenses 1 $ $ 4 Adjustments made for a prior year 6 Adjustments to scholarships or grants for a prior year $ 7 $ 5 Scholarships or grants $ Checked if the amount in box 1 or 2 includes amounts for an academic period beginning January - March 2016 8 Checked if at least half-time student Checked if a graduate student $ 18 CORRECTED Tuition Statement (keep for your records) Copy B For Student This is important tax information and is being furnished to the Internal Revenue Service. FILER’S name, street address, city, state, ZIP code, and telephone number 3 STUDENT’S social security number FILER’S federal identification no. 2 9 Service Provider/Acct. No. (see instr.) STUDENT’S name Department of the Treasury - Internal Revenue Service Form 1098-T 10 Form 1098-T OMB No. 1545-1574 Ins. contract reimb./refund If this box is checked, your educational institution has changed its reporting method for 2015 Amounts billed for qualified tuition and related expenses Payments received for qualified tuition and related expenses 1 $ $ 4 Adjustments made for a prior year 6 Adjustments to scholarships or grants for a prior year $ 7 $ 5 Scholarships or grants $ Checked if the amount in box 1 or 2 includes amounts for an academic period beginning January - March 2016 8 Checked if at least half-time student Checked if a graduate student $ 18 , address, city and ZIP code __ __ __ __ __ 8383 8383 8383 __ __ __ __ __ 8383 8383 8383 __ __ __ CORRECTED VOID FILER’S name, street address, city, state, ZIP code, and telephone number Tuition Statement 3 STUDENT’S social security number FILER’S federal identification no. Street address (including apt. no.) 2 City, state, and ZIP code 9 Service Provider/Acct. No. (see instr.) STUDENT’S name Department of the Treasury - Internal Revenue Service Form 1098-T 10 Form 1098-T OMB No. 1545-1574 Ins. contract reimb./refund Do Not Cut or Separate Forms on This Page — Do Not Cut or Separate Forms on This Page Check if you have changed your reporting method for 2009 Amounts billed for qualified tuition and related expenses Payments received for qualified tuition and related expenses 1 $ $ Copy A For Internal Revenue Service Center File with Form 1096. For Privacy Act and Paperwork Reduction Act Notice, see the 2016 General Instructions for Forms 1099, 1098, 3921, 3922, 5498, and W-2G. 4 Adjustments made for a prior year 6 Adjustments to scholarships or grants for a prior year $ 7 5 Scholarships or grants $ Check this box if the amount in box 1 or 2 includes amounts for an academic period beginning January - March 2016 8 Check if at least half-time student Check if a graduate student $ $ 18 41-1628061 __ __ __ CORRECTED VOID FILER’S name, street address, city, state, ZIP code, and telephone number Tuition Statement 3 STUDENT’S social security number FILER’S federal identification no. Street address (including apt. no.) 2 City, state, and ZIP code 9 Service Provider/Acct. No. (see instr.) STUDENT’S name Department of the Treasury - Internal Revenue Service Form 1098-T 10 Form 1098-T OMB No. 1545-1574 Ins. contract reimb./refund Do Not Cut or Separate Forms on This Page — Do Not Cut or Separate Forms on This Page Check if you have changed your reporting method for 2009 Amounts billed for qualified tuition and related expenses Payments received for qualified tuition and related expenses 1 $ $ Copy A For Internal Revenue Service Center File with Form 1096. For Privacy Act and Paperwork Reduction Act Notice, see the 2016 General Instructions for Forms 1099, 1098, 3921, 3922, 5498, and W-2G. 4 Adjustments made for a prior year 6 Adjustments to scholarships or grants for a prior year $ 7 5 Scholarships or grants $ Check this box if the amount in box 1 or 2 includes amounts for an academic period beginning January - March 2016 8 Check if at least half-time student Check if a graduate student $ $ 18 41-1628061 __ __ __ CORRECTED VOID FILER’S name, street address, city, state, ZIP code, and telephone number Tuition Statement 3 STUDENT’S social security number FILER’S federal identification no. Street address (including apt. no.) 2 City, state, and ZIP code 9 Service Provider/Acct. No. (see instr.) STUDENT’S name Department of the Treasury - Internal Revenue Service Form 1098-T 10 Form 1098-T OMB No. 1545-1574 Ins. contract reimb./refund Do Not Cut or Separate Forms on This Page — Do Not Cut or Separate Forms on This Page Check if you have changed your reporting method for 2009 Amounts billed for qualified tuition and related expenses Payments received for qualified tuition and related expenses 1 $ $ Copy A For Internal Revenue Service Center File with Form 1096. For Privacy Act and Paperwork Reduction Act Notice, see the 2016 General Instructions for Forms 1099, 1098, 3921, 3922, 5498, and W-2G. 4 Adjustments made for a prior year 6 Adjustments to scholarships or grants for a prior year $ 7 5 Scholarships or grants $ Check this box if the amount in box 1 or 2 includes amounts for an academic period beginning January - March 2016 8 Check if at least half-time student Check if a graduate student $ $ 18 41-1628061 DETACH BEFORE MAILING Form 1098 2018 Mortgage Interest Statement Copy A For Internal Revenue Service Center File with Form 1096. Department of the Treasury - Internal Revenue Service OMB No. 1545-0901 For Privacy Act and Paperwork Reduction Act Notice, see the 2017 General Instructions for Certain Information Returns. VOID CORRECTED RECIPIENT'S/LENDER'S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no. RECIPIENT'S/LENDER'S federal PAYER'S/BORROWER'S taxpayer PAYER'S/BORROWER'S name Street address (including apt. no.) City or town, state or province, country, and ZIP or foreign postal code Account number (see instructions) 1 Mortgage interest received from payer(s)/borrower(s) $ 2 Outstanding mortgage principal as of 1/1/2017 $ 3 Mortgage origination date 4 Refund of overpaid interest $ 5 Mortgage insurance premiums $ 6 Points paid on purchase of principal residence $ 7 Is address of property securing mortgage same as PAYER'S/BORROWER'S address? If “Yes,” check box . . . . . . . . . If “No,” enter address of property securing mortgage below 8 Address of property securing mortgage (see instructions) 9 If property securing mortgage has no address, provide description of the property (see instructions) 10 Number of mortgaged properties 11 Other Form 1098 www.irs.gov/form1098 41-0852411 Form 1098 2018 Mortgage Interest Statement Copy A For Internal Revenue Service Center File with Form 1096. Department of the Treasury - Internal Revenue Service OMB No. 1545-0901 For Privacy Act and Paperwork Reduction Act Notice, see the 2017 General Instructions for Certain Information Returns. VOID CORRECTED RECIPIENT'S/LENDER'S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no. RECIPIENT'S/LENDER'S federal PAYER'S/BORROWER'S taxpayer PAYER'S/BORROWER'S name Street address (including apt. no.) City or town, state or province, country, and ZIP or foreign postal code Account number (see instructions) 1 Mortgage interest received from payer(s)/borrower(s) $ 2 Outstanding mortgage principal as of 1/1/2017 $ 3 Mortgage origination date 4 Refund of overpaid interest $ 5 Mortgage insurance premiums $ 6 Points paid on purchase of principal residence $ 7 Is address of property securing mortgage same as PAYER'S/BORROWER'S address? If “Yes,” check box . . . . . . . . . If “No,” enter address of property securing mortgage below 8 Address of property securing mortgage (see instructions) 9 If property securing mortgage has no address, provide description of the property (see instructions) 10 Number of mortgaged properties 11 Other Form 1098 www.irs.gov/form1098 41-0852411 L18A 5150 41-0852411 8181 8181 MANUFACTURED ON OCR LASER BOND PAPER USING HEAT RESISTANT INKS _ __ _ __ __ __ __ __ MANUFACTURED IN U.S.A. ON OCR LASER BOND PAPER USING HEAT RESISTANT INKS DETACH BEFORE MAILING L58C 5172 CORRECTED VOID IRA Contribution Information Department of the Treasury - Internal Revenue Service Form 5498 Copy C For Privacy Act and Paperwork Reduction Act Notice, see the 2016 General Instructions for Certain Information Returns. For Trustee or Issuer SIMPLE contributions OMB No. 1545-0747 IRA contributions (other than amounts in boxes 2-4, 8-10, 13a, and 14a) 1 TRUSTEE’S or ISSUER’S name, street address, city, state, and ZIP code $ 2 Rollover contributions $ Recharacterized contributions Roth IRA conversion amount 3 PARTICIPANT’S social security number TRUSTEE’S or ISSUER’S federal identification no. 5 Fair market value of account 6 Life insurance cost included in box 1 $ $ PARTICIPANT’S name, address, city, and ZIP code SEP contributions 8 7 $ 9 Year 13b Postponed contribution 13a $ 14a Repayments 4 $ $ Form 5498 11 Account number (see instructions) IRA SEP SIMPLE Roth IRA Check if RMD for 2012 RMD amount Code $ Roth IRA contributions 10 12a RMD date 12b $ 13c 18 Code 14b $ $ CORRECTED VOID IRA Contribution Information Department of the Treasury - Internal Revenue Service Form 5498 Copy C For Privacy Act and Paperwork Reduction Act Notice, see the 2016 General Instructions for Certain Information Returns. For Trustee or Issuer SIMPLE contributions OMB No. 1545-0747 IRA contributions (other than amounts in boxes 2-4, 8-10, 13a, and 14a) 1 TRUSTEE’S or ISSUER’S name, street address, city, state, and ZIP code $ 2 Rollover contributions $ Recharacterized contributions Roth IRA conversion amount 3 PARTICIPANT’S social security number TRUSTEE’S or ISSUER’S federal identification no. 5 Fair market value of account 6 Life insurance cost included in box 1 $ $ PARTICIPANT’S name, address, city, and ZIP code SEP contributions 8 7 $ 9 Year 13b Postponed contribution 13a $ 14a Repayments 4 $ $ Form 5498 11 Account number (see instructions) IRA SEP SIMPLE Roth IRA Check if RMD for 2012 RMD amount Code $ Roth IRA contributions 10 12a RMD date 12b $ 13c 18 Code 14b $ $ _ __ _ __ __ __ __ __ MANUFACTURED IN U.S.A. ON OCR LASER BOND PAPER USING HEAT RESISTANT INKS DETACH BEFORE MAILING L58B 5171 (keep for your records) Copy B For Participant (if checked) This information is being furnished to the Internal Revenue Service. CORRECTED IRA Contribution Information Department of the Treasury - Internal Revenue Service Form 5498 SIMPLE contributions OMB No. 1545-0747 IRA contributions (other than amounts in boxes 2-4, 8-10, 13a, and 14a) 1 TRUSTEE’S or ISSUER’S name, street address, city, state, and ZIP code $ 2 Rollover contributions $ Recharacterized contributions Roth IRA conversion amount 3 PARTICIPANT’S social security number TRUSTEE’S or ISSUER’S federal identification no. 5 Fair market value of account 6 Life insurance cost included in box 1 $ $ PARTICIPANT’S name, address, city, and ZIP code SEP contributions 8 7 $ 9 Year 13b Postponed contribution 13a $ 14a Repayments 4 $ $ Form 5498 11 Account number (see instructions) IRA SEP SIMPLE Roth IRA If checked, required minimum distribution for 2012. RMD amount Code $ Roth IRA contributions 10 12a RMD date 12b $ 13c 18 Code 14b $ $ (keep for your records) Copy B For Participant (if checked) This information is being furnished to the Internal Revenue Service. CORRECTED IRA Contribution Information Department of the Treasury - Internal Revenue Service Form 5498 SIMPLE contributions OMB No. 1545-0747 IRA contributions (other than amounts in boxes 2-4, 8-10, 13a, and 14a) 1 TRUSTEE’S or ISSUER’S name, street address, city, state, and ZIP code $ 2 Rollover contributions $ Recharacterized contributions Roth IRA conversion amount 3 PARTICIPANT’S social security number TRUSTEE’S or ISSUER’S federal identification no. 5 Fair market value of account 6 Life insurance cost included in box 1 $ $ PARTICIPANT’S name, address, city, and ZIP code SEP contributions 8 7 $ 9 Year 13b Postponed contribution 13a $ 14a Repayments 4 $ $ Form 5498 11 Account number (see instructions) IRA SEP SIMPLE Roth IRA If checked, required minimum distribution for 2012. RMD amount Code $ Roth IRA contributions 10 12a RMD date 12b $ 13c 18 Code 14b $ $ __ __ 2828 2828 MANUFACTURED IN U.S.A. ON OCR LASER BOND PAPER USING HEAT RESISTANT INKS __ __ __ __ __ DETACH BEFORE MAILING L58A 5170 CORRECTED VOID IRA Contribution Information SIMPLE contributions OMB No. 1545-0747 IRA contributions (other than amounts in boxes 2-4, 8-10, 13a, and 14a) 1 TRUSTEE’S or ISSUER’S name, street address, city, state, and ZIP code $ 2 Rollover contributions $ Recharacterized contributions Roth IRA conversion amount 3 PARTICIPANT’S social security number TRUSTEE’S or ISSUER’S federal identification no. 5 Fair market value of account 6 Life insurance cost included in box 1 $ $ PARTICIPANT’S name SEP contributions 8 7 $ 9 Street address (including apt. no.) Year 13b Postponed contribution 13a City, state, and ZIP code $ 14a Repayments 4 $ $ Form 5498 Department of the Treasury - Internal Revenue Service Form 5498 Copy A File with Form 1096. For Privacy Act and Paperwork Reduction Act Notice, see the 2016 General Instructions for Certain Information Returns. For Internal Revenue Service Center Do Not Cut or Separate Forms on This Page — Do Not Cut or Separate Forms on This Page 11 Account number (see instructions) IRA SEP SIMPLE Roth IRA Check if RMD for 2012 RMD amount Code $ Roth IRA contributions 10 12a RMD date 12b $ 13c 18 Code 14b $ $ 41-0852411 CORRECTED VOID IRA Contribution Information SIMPLE contributions OMB No. 1545-0747 IRA contributions (other than amounts in boxes 2-4, 8-10, 13a, and 14a) 1 TRUSTEE’S or ISSUER’S name, street address, city, state, and ZIP code $ 2 Rollover contributions $ Recharacterized contributions Roth IRA conversion amount 3 PARTICIPANT’S social security number TRUSTEE’S or ISSUER’S federal identification no. 5 Fair market value of account 6 Life insurance cost included in box 1 $ $ PARTICIPANT’S name SEP contributions 8 7 $ 9 Street address (including apt. no.) Year 13b Postponed contribution 13a City, state, and ZIP code $ 14a Repayments 4 $ $ Form 5498 Department of the Treasury - Internal Revenue Service Form 5498 Copy A File with Form 1096. For Privacy Act and Paperwork Reduction Act Notice, see the 2016 General Instructions for Certain Information Returns. For Internal Revenue Service Center 11 Account number (see instructions) IRA SEP SIMPLE Roth IRA Check if RMD for 2012 RMD amount Code $ Roth IRA contributions 10 12a RMD date 12b $ 13c 18 Code 14b $ $ 41-0852411 __ __ __ __ __ __ MANUFACTURED IN U.S.A. ON OCR LASER BOND PAPER USING HEAT RESISTANT INKS DETACH BEFORE MAILING LAC 5148 CORRECTED VOID OMB No. 1545-0877 LENDER’S name, street address, city, state, ZIP code, and telephone no. Acquisition or Abandonment of Secured Property Balance of principal outstanding 2 1 Date of lender’s acquisition or knowledge of abandonment BORROWER’S identification number LENDER’S federal identification number $ Fair market value of property 4 3 BORROWER’S name, address, city, and ZIP code $ 5 Description of property 6 Account number (see instructions) Form 1099-A Department of the Treasury - Internal Revenue Service Copy C Form 1099-A For Lender or State Copy For Privacy Act and Paperwork Reduction Act Notice, see the 2017 General Instructions for Certain Information Returns. 18 Check here if the borrower was personally liable for repayment of the debt __ CORRECTED VOID OMB No. 1545-0877 LENDER’S name, street address, city, state, ZIP code, and telephone no. Acquisition or Abandonment of Secured Property Balance of principal outstanding 2 1 Date of lender’s acquisition or knowledge of abandonment BORROWER’S identification number LENDER’S federal identification number $ Fair market value of property 4 3 BORROWER’S name, address, city, and ZIP code $ 5 Description of property 6 Account number (see instructions) Form 1099-A Department of the Treasury - Internal Revenue Service Copy C Form 1099-A For Lender or State Copy For Privacy Act and Paperwork Reduction Act Notice, see the 2017 General Instructions for Certain Information Returns. 18 Check here if the borrower was personally liable for repayment of the debt CORRECTED VOID OMB No. 1545-0877 LENDER’S name, street address, city, state, ZIP code, and telephone no. Acquisition or Abandonment of Secured Property Balance of principal outstanding 2 1 Date of lender’s acquisition or knowledge of abandonment BORROWER’S identification number LENDER’S federal identification number $ Fair market value of property 4 3 BORROWER’S name, address, city, and ZIP code $ 5 Description of property 6 Account number (see instructions) Form 1099-A Department of the Treasury - Internal Revenue Service Copy C Form 1099-A For Lender or State Copy For Privacy Act and Paperwork Reduction Act Notice, see the 2017 General Instructions for Certain Information Returns. 18 Check here if the borrower was personally liable for repayment of the debt __ __ __ __ __ __ __ __ MANUFACTURED IN U.S.A. ON OCR LASER BOND PAPER USING HEAT RESISTANT INKS DETACH BEFORE MAILING LAB 5147 CORRECTED (if checked) OMB No. 1545-0877 LENDER’S name, street address, city, state, ZIP code, and telephone no. Acquisition or Abandonment of Secured Property Balance of principal outstanding 2 1 Date of lender’s acquisition or knowledge of abandonment BORROWER’S identification number LENDER’S federal identification number $ Fair market value of property 4 3 BORROWER’S name, address, city, and ZIP code $ 5 Description of property 6 Account number (see instructions) Form 1099-A Department of the Treasury - Internal Revenue Service (keep for your records) Copy B 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 taxable income results from this transaction and the IRS determines that it has not been reported. For Borrower Form 1099-A 18 If checked, the borrower was personally liable for repayment of the debt CORRECTED (if checked) OMB No. 1545-0877 LENDER’S name, street address, city, state, ZIP code, and telephone no. Acquisition or Abandonment of Secured Property Balance of principal outstanding 2 1 Date of lender’s acquisition or knowledge of abandonment BORROWER’S identification number LENDER’S federal identification number $ Fair market value of property 4 3 BORROWER’S name, address, city, and ZIP code $ 5 Description of property 6 Account number (see instructions) Form 1099-A Department of the Treasury - Internal Revenue Service (keep for your records) Copy B 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 taxable income results from this transaction and the IRS determines that it has not been reported. For Borrower Form 1099-A 18 If checked, the borrower was personally liable for repayment of the debt CORRECTED (if checked) OMB No. 1545-0877 LENDER’S name, street address, city, state, ZIP code, and telephone no. Acquisition or Abandonment of Secured Property Balance of principal outstanding 2 1 Date of lender’s acquisition or knowledge of abandonment BORROWER’S identification number LENDER’S federal identification number $ Fair market value of property 4 3 BORROWER’S name, address, city, and ZIP code $ 5 Description of property 6 Account number (see instructions) Form 1099-A Department of the Treasury - Internal Revenue Service (keep for your records) Copy B 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 taxable income results from this transaction and the IRS determines that it has not been reported. For Borrower Form 1099-A 18 If checked, the borrower was personally liable for repayment of the debt MANUFACTURED IN U.S.A. ON OCR LASER BOND PAPER USING HEAT RESISTANT INKS DETACH BEFORE MAILING LBC 5155 RECIPIENT’S name, address, city, and ZIP code or State Copy Form 1099-B 2018 Proceeds From Broker and Barter Exchange Transactions Copy C For Payer Department of the Treasury - Internal Revenue Service OMB No. 1545-0715 For Privacy Act and Paperwork Reduction Act Notice, see the 2017 General Instructions for Certain Information Returns. VOID CORRECTED PAYER'S name, street address, city, state, ZIP code, and telephone no. Account number (see instructions) 2nd TIN not. CUSIP number 1a Date of sale or exchange 1b Date of acquisition 1c Type of gain or loss Short-term Long-term 1d Stock or other symbol 1e Quantity sold 2a Stocks, bonds, etc. $ Reported to IRS } Gross proceeds Gross proceeds less commissions and option premiums 2b Check if loss not allowed based on amount in box 2a 3 Cost or other basis $ 4 Federal income tax withheld $ 5 Wash sale loss disallowed $ 6 Check if: a Noncovered security b Basis reported to IRS 7 Bartering $ 8 Description 9 2012 on closed contracts $ 10 open contracts—12/31/2011 $ 11 open contracts—12/31/2012 $ 12 contracts $ 13 State 14 15 State tax withheld $ Form 1099-B RECIPIENT’S name, address, city, and ZIP code or State Copy Form 1099-B 2018 Proceeds From Broker and Barter Exchange Transactions Copy C For Payer Department of the Treasury - Internal Revenue Service OMB No. 1545-0715 For Privacy Act and Paperwork Reduction Act Notice, see the 2017 General Instructions for Certain Information Returns. VOID CORRECTED PAYER'S name, street address, city, state, ZIP code, and telephone no. Account number (see instructions) 2nd TIN not. CUSIP number 1a Date of sale or exchange 1b Date of acquisition 1c Type of gain or loss Short-term Long-term 1d Stock or other symbol 1e Quantity sold 2a Stocks, bonds, etc. $ Reported to IRS } Gross proceeds Gross proceeds less commissions and option premiums 2b Check if loss not allowed based on amount in box 2a 3 Cost or other basis $ 4 Federal income tax withheld $ 5 Wash sale loss disallowed $ 6 Check if: a Noncovered security b Basis reported to IRS 7 Bartering $ 8 Description 9 2012 on closed contracts $ 10 open contracts—12/31/2011 $ 11 open contracts—12/31/2012 $ 12 contracts $ 13 State 14 15 State tax withheld $ Form 1099-B MANUFACTURED IN U.S.A. ON OCR LASER BOND PAPER USING HEAT RESISTANT INKS DETACH BEFORE MAILING LBB 5154 RECIPIENT’S name, address, city, and ZIP code Form 1099-B 2018 Proceeds From Broker and Barter Exchange Transactions Copy B For Recipient Department of the Treasury - Internal Revenue Service This is important tax information and is being furnished to the Internal Revenue Service. If you are 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. OMB No. 1545-0715 CORRECTED (if checked) PAYER'S name, street address, city, state, ZIP code, and telephone no. Account number (see instructions) 2nd TIN not. CUSIP number 1a Date of sale or exchange 1b Date of acquisition 1c Type of gain or loss Short-term Long-term 1d Stock or other symbol 1e Quantity sold 2a Stocks, bonds, etc. $ Reported to IRS } Sales price Sales price less commissions and option premiums 2b If box checked, loss based on amount in 2a is not allowed 3 Cost or other basis $ 4 Federal income tax withheld $ 5 Wash sale loss disallowed $ 6 Checked if: a Noncovered security b Basis reported to IRS 7 Bartering $ 8 Description 9 2012 on closed contracts $ 10 open contracts—12/31/2011 $ 11 open contracts—12/31/2012 $ 12 contracts $ 13 State 14 15 State tax withheld $ Form 1099-B (keep for your records) RECIPIENT’S name, address, city, and ZIP code Form 1099-B 2018 Proceeds From Broker and Barter Exchange Transactions Copy B For Recipient Department of the Treasury - Internal Revenue Service This is important tax information and is being furnished to the Internal Revenue Service. If you are 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. OMB No. 1545-0715 CORRECTED (if checked) PAYER'S name, street address, city, state, ZIP code, and telephone no. Account number (see instructions) 2nd TIN not. CUSIP number 1a Date of sale or exchange 1b Date of acquisition 1c Type of gain or loss Short-term Long-term 1d Stock or other symbol 1e Quantity sold 2a Stocks, bonds, etc. $ Reported to IRS } Sales price Sales price less commissions and option premiums 2b If box checked, loss based on amount in 2a is not allowed 3 Cost or other basis $ 4 Federal income tax withheld $ 5 Wash sale loss disallowed $ 6 Checked if: a Noncovered security b Basis reported to IRS 7 Bartering $ 8 Description 9 2012 on closed contracts $ 10 open contracts—12/31/2011 $ 11 open contracts—12/31/2012 $ 12 contracts $ 13 State 14 15 State tax withheld $ Form 1099-B (keep for your records) MANUFACTURED IN U.S.A. ON OCR LASER BOND PAPER USING HEAT RESISTANT INKS 7979 7979 DETACH BEFORE MAILING 5153 LBA 41-0852411 Form 1099-B 2018 Proceeds From Broker and Barter Exchange Transactions Copy A For Internal Revenue Service Center Department of the Treasury - Internal Revenue Service File with Form 1096. For Privacy Act and Paperwork Reduction Act Notice, see the 2016 General Instructions for Certain Information Returns. OMB No. 1545-0715 VOID CORRECTED PAYER'S name, street address, city, state, ZIP code, and telephone no. RECIPIENT'S name Street address (including apt. no.) City, state, and ZIP code Account number (see instructions) 2nd TIN not. CUSIP number 1a Date of sale or exchange 1b Date of acquisition 1c Type of gain or loss Short-term Long-term 1d Stock or other symbol 1e Quantity sold 2a Stocks, bonds, etc. $ Reported to IRS } Gross proceeds Gross proceeds less commissions and option premiums 2b Check if loss not allowed based on amount in box 2a 3 Cost or other basis $ 4 Federal income tax withheld $ 5 Wash sale loss disallowed $ 6 Check if: a Noncovered security b Basis reported to IRS 7 Bartering $ 8 Description 9 2012 on closed contracts $ 10 open contracts—12/31/2011 $ 11 open contracts—12/31/2012 $ 12 contracts $ 13 State 14 15 State tax withheld $ Form 1099-B Do Not Cut or Separate Forms on This Page — Do Not Cut or Separate Forms on This Page 41-0852411 Form 1099-B 2018 Proceeds From Broker and Barter Exchange Transactions Copy A For Internal Revenue Service Center Department of the Treasury - Internal Revenue Service File with Form 1096. For Privacy Act and Paperwork Reduction Act Notice, see the 2016 General Instructions for Certain Information Returns. OMB No. 1545-0715 VOID CORRECTED PAYER'S name, street address, city, state, ZIP code, and telephone no. RECIPIENT'S name Street address (including apt. no.) City, state, and ZIP code Account number (see instructions) 2nd TIN not. CUSIP number 1a Date of sale or exchange 1b Date of acquisition 1c Type of gain or loss Short-term Long-term 1d Stock or other symbol 1e Quantity sold 2a Stocks, bonds, etc. $ Reported to IRS } Gross proceeds Gross proceeds less commissions and option premiums 2b Check if loss not allowed based on amount in box 2a 3 Cost or other basis $ 4 Federal income tax withheld $ 5 Wash sale loss disallowed $ 6 Check if: a Noncovered security b Basis reported to IRS 7 Bartering $ 8 Description 9 2012 on closed contracts $ 10 open contracts—12/31/2011 $ 11 open contracts—12/31/2012 $ 12 contracts $ 13 State 14 15 State tax withheld $ Form 1099-B __ 8080 8080 8080 MANUFACTURED IN U.S.A. ON OCR LASER BOND PAPER USING HEAT RESISTANT INKS __ 41-0852411 DETACH BEFORE MAILING LAA 5146 CORRECTED VOID OMB No. 1545-0877 LENDER’S name, street address, city, state, ZIP code, and telephone no. Acquisition or Abandonment of Secured Property Balance of principal outstanding 2 1 Date of lender’s acquisition or knowledge of abandonment BORROWER’S identification number LENDER’S federal identification number $ Fair market value of property 4 3 BORROWER’S name $ 5 Check here if the borrower was personally liable for repayment of the debt Street address (including apt. no.) City, state, and ZIP code Description of property 6 Account number (see instructions) Form 1099-A Department of the Treasury - Internal Revenue Service Copy A For Privacy Act and Paperwork Reduction Act Notice, see the 2017 General Instructions for Certain Information Returns. File with Form 1096. For Internal Revenue Service Center Form 1099-A Do Not Cut or Separate Forms on This Page — Do Not Cut or Separate Forms on This Page 18 41-0852411 CORRECTED VOID OMB No. 1545-0877 LENDER’S name, street address, city, state, ZIP code, and telephone no. Acquisition or Abandonment of Secured Property Balance of principal outstanding 2 1 Date of lender’s acquisition or knowledge of abandonment BORROWER’S identification number LENDER’S federal identification number $ Fair market value of property 4 3 BORROWER’S name $ 5 Check here if the borrower was personally liable for repayment of the debt Street address (including apt. no.) City, state, and ZIP code Description of property 6 Account number (see instructions) Form 1099-A Department of the Treasury - Internal Revenue Service Copy A For Privacy Act and Paperwork Reduction Act Notice, see the 2017 General Instructions for Certain Information Returns. File with Form 1096. For Internal Revenue Service Center Form 1099-A Do Not Cut or Separate Forms on This Page — Do Not Cut or Separate Forms on This Page 18 41-0852411 CORRECTED VOID OMB No. 1545-0877 LENDER’S name, street address, city, state, ZIP code, and telephone no. Acquisition or Abandonment of Secured Property Balance of principal outstanding 2 1 Date of lender’s acquisition or knowledge of abandonment BORROWER’S identification number LENDER’S federal identification number $ Fair market value of property 4 3 BORROWER’S name $ 5 Check here if the borrower was personally liable for repayment of the debt Street address (including apt. no.) City, state, and ZIP code Description of property 6 Account number (see instructions) Form 1099-A Department of the Treasury - Internal Revenue Service Copy A For Privacy Act and Paperwork Reduction Act Notice, see the 2017 General Instructions for Certain Information Returns. File with Form 1096. For Internal Revenue Service Center Form 1099-A 18 MANUFACTURED IN U.S.A. ON OCR LASER BOND PAPER USING HEAT RESISTANT INKS DETACH BEFORE MAILING LCB 5138 Form 1099-C 2018 Cancellation of Debt Copy B For Debtor Department of the Treasury - Internal Revenue Service This is important tax information and is being furnished to the Internal Revenue Service. 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