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Form 1099-A

(Rev. January 2022)

Cat. No. 14412G

Acquisition or 

Abandonment of 

Secured Property

Copy A

For 

Internal Revenue 

Service Center

Department of the Treasury - Internal Revenue Service

File with Form 1096. 

OMB No. 1545-0877

For Privacy Act 

and Paperwork 

Reduction Act 

Notice, see the 

current General 

Instructions for 

Certain

Information 

Returns.

For calendar year 

20

8080 VOID CORRECTED

LENDER’S name, street address, city or town, state or province, country, ZIP or 

foreign postal code, and telephone no.

LENDER’S TIN BORROWER’S TIN

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 Date of lender’s acquisition or 

knowledge of abandonment

2 Balance of principal 

outstanding

$

3 4 Fair market value of property

$

5 Check if the borrower was personally liable for repayment of 

the debt . . . . . . . . . . . . ▶

6 Description of property

Form 1099-A (Rev. 1-2022) www.irs.gov/Form1099A

Do Not Cut or Separate Forms on This Page — Do Not Cut or Separate Forms on This Page
 

Form 1099-A

(Rev. January 2022)

Acquisition or 

Abandonment of 

Secured Property

Copy B

For Borrower

Department of the Treasury - Internal Revenue Service

This is important tax 

information and is being 

furnished to the IRS. 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.

OMB No. 1545-0877

For calendar year 

20

CORRECTED (if checked)

LENDER’S name, street address, city or town, state or province, country, ZIP or 

foreign postal code, and telephone no.

LENDER’S TIN BORROWER’S TIN

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 Date of lender’s acquisition or 

knowledge of abandonment

2 Balance of principal 

outstanding

$

3 4 Fair market value of property

$

5 If checked, the borrower was personally liable for repayment 

of the debt . . . . . . . . . . . ▶

6 Description of property

Form 1099-A (Rev. 1-2022) (keep for your records) www.irs.gov/Form1099A
Instructions for Borrower

Certain lenders who acquire an interest in property that was security for a loan 

or who have reason to know that such property has been abandoned must 

provide you with this statement. You may have reportable income or loss 

because of such acquisition or abandonment. Gain or loss from an acquisition is 

generally measured by the difference between your adjusted basis in the 

property and the amount of your debt canceled in exchange for the property or, 

if greater, the sale proceeds. If you abandoned the property, you may have 

income from the discharge of indebtedness in the amount of the unpaid balance 

of your canceled debt. The tax consequences of abandoning property depend 

on whether or not you were personally liable for the debt. Losses on acquisitions 

or abandonments of property held for personal use are not deductible. See Pub. 

4681 for information about your tax consequences.

Property means any real property (such as a personal residence), any 

intangible property, and tangible personal property that is held for investment or 

used in a trade or business.

If you borrowed money on this property with someone else, each of you 

should receive this statement.

Borrower’s taxpayer identification number (TIN). For your protection, this 

form may show only the last four digits of your TIN (social security number 

(SSN), individual taxpayer identification number (ITIN), adoption taxpayer 

identification number (ATIN), or employer identification number (EIN)). However, 

the issuer has reported your complete TIN to the IRS.

Account number. May show an account or other unique number the lender 

assigned to distinguish your account.

Box 1. For a lender’s acquisition of property that was security for a loan, the 

date shown is generally the earlier of the date title was transferred to the lender 

or the date possession and the burdens and benefits of ownership were 

transferred to the lender. This may be the date of a foreclosure or execution sale 

or the date your right of redemption or objection expired. For an abandonment, 

the date shown is the date on which the lender first knew or had reason to know 

that the property was abandoned or the date of a foreclosure, execution, or 

similar sale.

Box 2. Shows the debt (principal only) owed to the lender on the loan when the 

interest in the property was acquired by the lender or on the date the lender first 

knew or had reason to know that the property was abandoned.

Box 3. Reserved for future use.

Box 4. Shows the fair market value of the property. If the amount in box 4 is less 

than the amount in box 2, and your debt is canceled, you may have cancellation 

of debt income. If the property was your main home, see Pub. 523 to figure any 

taxable gain or ordinary income.

Box 5. Shows whether you were personally liable for repayment of the debt 

when the debt was created or, if modified, when it was last modified.

Box 6. Shows the description of the property acquired by the lender or 

abandoned by you. If “CCC” is shown, the form indicates the amount of any 

Commodity Credit Corporation loan outstanding when you forfeited your 

commodity. 

Future developments. For the latest information about developments related to 

Form 1099-A and its instructions, such as legislation enacted after they were 

published, go to www.irs.gov/Form1099A.

Free File Program. Go to www.irs.gov/FreeFile to see if you qualify for no-cost 

online federal tax preparation, e-filing, and direct deposit or payment options.
 

Form 1099-A

(Rev. January 2022)

Acquisition or 

Abandonment of 

Secured Property

Copy C

For Lender

Department of the Treasury - Internal Revenue Service

OMB No. 1545-0877

For Privacy Act 

and Paperwork 

Reduction Act 

Notice, see the 

current General 

Instructions for 

Certain 

Information 

Returns.

For calendar year 

20

VOID CORRECTED

LENDER’S name, street address, city or town, state or province, country, ZIP or 

foreign postal code, and telephone no.

LENDER’S TIN BORROWER’S TIN

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 Date of lender’s acquisition or 

knowledge of abandonment

2 Balance of principal 

outstanding

$

3 4 Fair market value of property

$

5 Check if the borrower was personally liable for repayment of 

the debt . . . . . . . . . . . . ▶

6 Description of property

Form 1099-A (Rev. 1-2022) www.irs.gov/Form1099A
Instructions for Lender

To complete Form 1099-A, use:

• The current General Instructions for Certain Information 

Returns, and

• The current Instructions for Forms 1099-A and 1099-C.

To order these instructions and additional forms, go to 

www.irs.gov/EmployerForms.

Caution: Because paper forms are scanned during 

processing, you cannot file certain Forms 1096, 1097, 1098, 

1099, 3921, or 5498 that you print from the IRS website.

Filing and furnishing. For filing and furnishing instructions, 

including due dates, and to request filing or furnishing 

extensions, see the current General Instructions for Certain 

Information Returns.

Need help? If you have questions about reporting on Form 

1099-A, call the information reporting customer service site 

toll free at 866-455-7438 or 304-263-8700 (not toll free). 

Persons with a hearing or speech disability with access to 

TTY/TDD equipment can call 304-579-4827 (not toll free).