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(CORRECTED

PAYER’S name, street address, city, state. and ZIP code 1 Rents. OMB No. 1545-0115.
$ 1989 Miscellaneous
2 Royalties Income
Statement for
$ Recipients of
PAYER’S Federal identification number | RECIPIENT'S identification number 3 Prizes and awards 4 Federal income tax withheld
$ $ Copy C
RECIPIENT'S name (first, middle, last) 5 Fishing boat proceeds ‘6 Medical and health care payments For Payer
$ $
For Paperwork
7 Nonemployee compensation | 8 Substitute payments in lieu of Reduction Act
Street address dividends or interest Notice and
$ $ instructions for
completing this
City, state, and ZIP code 9 Payer made direct sales of $5,000 or more of consumer ; form, see
oducts to a buyer (recipient) for resale > instructions for
Labs Her (recipient) D Forms 1099,
‘Account number (optional) (0 Crop insurance proceeds ] y 1098, 5498, 1096,
$ U / and W-2G.

Form 1099-MISC

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(J CORRECTED

Department of the Treasury - Internal Revenue Service

PAYER'S name, street address, city, state. and ZIP code 1 Rents OMB No. 1545-0115
$ 1989 Miscellaneous
2 Royalties Income
Statement for
$ Recipients of
PAYER'S Federal identification number | RECIPIENT'S identification number 3 Prizes and awards 4 Federal income tax withheld
$ $ Copy C
RECIPIENT'S name (first, middle, last) 5 Fishing boat proceeds 6 Medical and health care payments For Payer
$ $
For Paperwork
7 Nonempioyee compensation | 8 Substitute payments in lieu of Reduction Act
street address dividends or interest Notice and
$ $ instructions for
completing this
City, state, and ZIP code ‘9 Payer made direct sales of $5,000 or more of consumer form, see
products to a buyer (recipient) for resale *T instructions or
Account number (optional) fe Crop insurance proceeds 1098, 5498, 1096,
$ and W-2G.

Form 1099-MISC

Department of the Treasury - Internal Revenue Service

[LJ voiD —[_] CORRECTED
PAYER’S name, street address, city, state. and ZIP code 1 Rents ‘OMB No. 1545-0115
$ 1989 Miscellaneous
2 Royalties Income
Statement for
$ Recipients of
PAYER’S Federal identification number | RECIPIENT'S identification number | 3 Prizes and awards “4 Federal income tax withheld
s $ Copy C
RECIPIENT'S name (first, middle, last) : Fishing boat proceeds § Medical and health care payments For Payer
For Paperwork
7 Nonemployee compensation | 8 Substitute payments in lieu of Reduction Act
Street address dividends or interest Notice and
$ $ instructions for
completing this,
City, state, and ZIP code 9 Payer made direct sales of $5,000 or more of consumer form, see
products toa buyer (recipient) for resale . >f retro.
Account number (optional) }10 Crop insurance proceeds 1098, 5498, 1096,
$ and W-2G

Form 1099-MISC

Department of the Treasury - Internal Revenue Service


Instructions for Recipient

The amount(s) shown on this form may or may not be taxable to you. If the
amount(s) is taxable and you are an individual, report it on your tax return
as explained below. (Other taxpayers, such as fiduciaries or partnerships,
report the amount(s) on corresponding lines of your tax return.)

Boxes 1 and 2.—Report on Schedule E (Form 1040); or Schedule C if you
provide services that are primarily for your customer's convenience, such
as regular cleaning, changing linen, or maid service.

Box 3.—Report on the line for ‘Other income” on Form 1040. If it is
yeaen” business income, report this amount on Schedule C or F (Form

Box 4,—Any amount listed in this box represents backup withholding. For

example, persons not furnishing their taxpayer identification number to

the payer become subject to backup withholding at a 20% rate on certain

payments. See Form W-9, Request for Taxpayer Identification Number

and Certification, for information on backup withholding. Include this on

your income tax return as tax withheld.

Box 5.—An amount in this box means the fishing boat operator considers

you self-employed. Report this amount on Schedule C (Form 1040). See
ublication 595, Tax Guide for Commercial Fishermen.

Box 6.—Report on Schedule C (Form 1040), .

Box 7.—Generally, these amounts are considered income from self-

employment. Report them as part of your trade or business income on

Schedule C or F (Form 1040). If you are not self-employed, amounts paid

Instructions for Recipient

‘The amount(s) shown on this form may or ynay not be taxable to you. If the
amount(s) Is taxable and you are an individual, report It on your tax return

as explained below. (Other taxpayers, such as fiduciaries or partnerships,

report the amount(s) on corresponding lines of your tax return.)

ort on Schedule E (Form 1040), or Schedule C if you
provide services that are primarily for your customer's convenience, such
88 regular cleaning, changing linen, or mald service.

Box 3.—Report on the line for ‘Other Income’ on Form 1040, If it Is
year" business Income, report this amount on Schedule C or F (Form

Box 4,—Any amount listed in this box represents backup withholding. For
example, persons not furnishing their taxpayer Identification number to
the payer become subject to backup withholding at a 20% rate on certain
payments. See Form W-9, Request for Taxpayer Identification Number
and Certification, for information on backup withholding. Include this on
your income tax return as tax withheld.

Box 5.—An amount in this box means the fishing boat operator considers
you self-employed. Report this amount on Schedule C (Form 1040). See
Publication 595, Tax Guide for Commercial Fishermen.

Box 6.—Report on Schedule C (Form 1040).

Box 7.—Generally, these amounts are considered income from self-
‘employment. Report them as part of your trade or business income on
Schedule C or F (Form 1040). If you are not self-employed, amounts paid

Instructions for Recipient

The amount(s) shown on this form may or may not be taxable to you. If the
amount(s) is taxable and you are an individual, report it on your tax return
as explained below. (Other taxpayers, such as fiduciaries or partnerships,
report the amount(s) on corresponding lines of your tax return.)

Boxes 1 and 2.—Report on Schedule E (Form 1040); or Schedule C if you
provide services that are primarily for your customer's convenience, such
as regular cleaning, changing linen, or maid service.

Box 3.—Report on the line for ‘Other income” on Form 1040. Ifit is
trade or business income, report this amount on Schedule C or F (Form

Box 4,—Any amount listed in this box represents backup withholding. For
example, persons not furnishing their taxpayer identification number to
the payer become subject to backup withholding at a 20% rate on certain
payments. See Form W-9, Request for Taxpayer Identification Number
and Certification, for information on backup withholding. Include this on
your income tax return as tax withheld.

Box 5.—An amount in this box means the fishing boat operator considers
you self-employed. Report this amount on Schedule C (Form 1040). See
Publication 595, Tax Guide for Commercial Fishermen.

Box 6.—Report on Schedule C (Form 1040).

Box 7.—Generally, these amounts are considered income from self-
employment. Report them as part of your trade or business income on
Schedule C or F (Form 1040). If you are not self-employed, amounts paid

to you for services rendered are generally reported on Form 1040 on the

line for ‘Wages, salaries, tips, etc."

if there are two amounts shown in this box, one may be labeled “EPP.”

This represents excess golden parachute payments. You must pay a 20%

excise tax on this amount. See your Form 1040 instructions under ‘‘Other

Taxes.”’ The unlabeled amount is your total compensation.

Box 8.—Report as ‘‘Other income” on your tax return. The amount shown

is substitute payments in lieu of dividends or tax-exempt interest received

by your broker on your behalf after transfer of your securities for use ina
short sale.

Box 9.—An entry in the checkbox means sales to you of consumer
roducts on a buy-sell, deposit-commission, or any other basis for resale
ave amounted to $5,000 or more. The person filing this return does not

have to show a dollar amount in this box. Any income from your sale of

these products should generally be reported on Schedule C (Form 1040).

Box 10,—Report on the line for “Crop insurance proceeds” on Schedule F

(Form 1040).

‘The amounts shown on this form (except Boxes 4 and 8) may be subject to

self-employment (social security) tax computed on Schedule SE (Form

1040). See Publication 533, Self-Employment Tax, for more information

on amounts considered self-employment income. Since no income or social

security taxes will be withheld by the payer. ou may be required to make
estimated tax payments. See Form 1! OES, Estimated Tax for Individuals,

41,8, GOVERNMENT PRINTING OFFICH: 1989~246~265

to you for services rend

line tor Wages, salaries, tips

e two amounts shown In this box, one may be labeled “EPP.,'"
ents golden parachute payments, You must pay a 20%

nerally reported on Form 1040 on the

on thi int. See your Form 1040 instructions under "Other
‘he unlabeled amount is your total compensation.
Box 8,-—-Report as ‘Other Income"’ on your tax return. The amount shown
Is substitute payments in lleu of dividends or tax-exempt Interest received
by your broker on your behalf after transfer of your securities for use in @
short sale.
Box 9.—An entry in the checkbox means sales to you of consumer
Products ona buy-sell, deposit-commission, or any other basis for resale
ave amounted to $5,000 or more. The person filing this return does not
have to show a dollar amount in this box. Any income from your sale of
these products should generally be reported on Schedule C (Form 1040).
Box 10.—Report on the line for “Crop insurance proceeds” on Schedule F
(Form 1040).
‘The amounts shown on this form (except Boxes 4 and 8) may be subject to
self-employment (social security) tax computed on Schedule SE (Form
1040). See Publication 533, Self-Employment Tax, for more information
on amounts considered self-employment income. Since no income or social
security taxes will be withheld by the payer, you may be required to make
estimated tax payments. See Form 1040-ES, Estimated Tax for Individuals.

*U.S, GOVERNMENT PRINTING OFFICE: 1989-246-265

to you for services rendered are generally reported on Form 1040 on the
line for “Wages, salaries, tips, etc."

If there are two amounts shown in this box, one may be labeled ““EPP."”
This represents excess golden parachute payments. You must pay a 20%
excise tax on this amount. See your Form 1040 instructions under “Other
Taxes." The unlabeled amount is your total compensation.

Box 8.—Report as ‘Other income” on your tax return. The amount shown
is substitute payments in lieu of dividends or tax-exempt interest received
by your broker on your behalf after transfer of your securities for use in a
short sale.

Box 9.—An entry in the checkbox means sales to you of consumer
products on a buy-sell, deposit-commission, or any other basis for resale
have amounted to $5,000 or more. The person filing this return does not
have to show a dollar amount in this box. Any income from your sale of
these products should generally be reported on Schedule C (Form 1040).
Box 10.—Report on the line for “Crop insurance proceeds” on Schedule F
(Form 1040).

The amounts shown on this form (except Boxes 4 and 8) may be subject to
self-employment (social security) tax computed on Schedule SE (Form
1040). See Publication 533, Self-Employment Tax, for more information
on amounts considered self-employment income. Since no income or social
security taxes will be withheld by the payer, you may be required to make
estimated tax payments. See Form 1040-ES, Estimated Tax for Individuals.

*U.S. GOVERNMENT PRINTING OFFICE: 1989-246-265


9595 [I voID = =[-JCORRECTED For Official Use Only
Type or machine print PAYER’S name, street address, city, state, and ZIP code | 1 Rents OMB No. 1545-0115
‘ 1989
2 Royalties
Statement for
$ Recipients of

Miscellaneous
Income

PAYER'S Federal identification number | RECIPIENT'S identification number

3 Prizes and awards 4 Federal income tax withheld

Copy A

For Internal

‘Type or machine print RECIPIENT'S name (first, middle, last)

5 Fishing boat proceeds 6 Medical and health care payments

$

Revenue
Service Center

7 Nonemployee compensation | 8 Substitute payments in lieu of

Street address

dividends or interest

$ $

For Paperwork
Reduction Act
Notice and
instructions for

City, state, and ZIP code

9 Payer made direct sales of $5,000 or more of consumer
products to a buyer (recipient) for resale

‘Account number (optional)

(0 Crop insurance proceeds

$

Form 1099-MISC

Department of the Treasury

Do NOT Cut or Separate Forms on This Page

completing this
form, see
Instructions for

“Internal Revenue Service

Form 1099-MISC

Department of the Treasury -

Do NOT Cut or Separate Forms on This Page

9595 [1 VvoID = [CORRECTED For Official Use Only
Type or machine print PAYER'S name, street address, city, state, and ZIP code 1 Rents OMB No. 1545-0115
$ 1989 Miscellaneous
2 Royalties Income
Statement for
$ Recipients of
PAYER’S Federal identification number | RECIPIENT'S identification number _ | 3 Prizes and awards ‘4 Federal income tax withheld Copy A
$ For Internal
‘Type or machine print RECIPIENT'S name (first, middle, last) 5 Fishing boat proceeds © Medical and health care payments Revenue
$ $ Service Center
7 Nonemployee compensation | 8 Substitute payments in lieu of For aperwork
3 dividends or interest eduction
treet address Notice and
$ $ instructions for
— completing this
City, state, and ZIP code 9 Payer made direct sales of $5,000 or more of consumer form, see
products to a buyer (recipient) for resale > Instructions for
‘Account number (optional) 10 Crop insurance proceeds 1098, a 109¢,
and W-

Internal Revenue Service

9595 C1 voID =[_JCORRECTED _ForOfticial Use Only
‘Type or machine print PAYER’S name, street address, city, state, and IPcode | 1 Rents ‘OMB No. 1545-0115
$ 1989 Miscellaneous
2 Royalties Income
Statement for
$ Recipients of
PAYER’S Federal identification number | RECIPIENT'S identification number | 3 Prizes and awards 4 Federal income tax withheld Copy A
$ For Internal
‘Type or machine print RECIPIENT'S name (first, middle, last) 5 Fishing boat proceeds Medical and healthcare payments Revenue
$ $ Service Center
7 Nonemployee compensation | 8 Substitute payments in lieu of For Paperwork
dividends or interest eduction
‘Street address Notice and
$ $ instructions for
completing this

City, state, and ZIP code

9 Payer made direct sales of $5,000 or more of consumer
products to a buyer (recipient) for resale

‘Account number (optional)

]10 Crop insurance proceeds

$

Form 1099-MISC

Department of the Treasury -

form, see

Instructions for

Forms 1099,

1098, 5498, 1096,
and W-

Internal Revenue Service




(CORRECTED (if

checked)

PAYER'S name, street address, city, state, and ZIP code 1 Rents OMB No. 1545-0115

$ 1989 Miscellaneous
2 Royalties Income

Statement for

$ Recipients of
PAYER'S Federal identification number | RECIPIENT'S identification number 3 Prizes and awards 4 Federal income tax withheld Copy B
$ For Recipient
RECIPIENT'S name (first, middle, last) 5 Fishing boat proceeds 6 Medical and health care payments This is important tax
$ $ information and is

Street address

City, state, and ZIP code

7 Nonemployee compensation

being ‘furnished to the
internal Revenue
Service. if you are
required to file a

'8 Substitute payments in lieu of
dividends or interest

$ $ return, a negligence
penalty or other
9 Payer made direct sales of $5,000 or more of consumer sanction will be

products to a buyer (recipient)

‘Account number (optional)

f10 Crop insurance proceeds

$

Form 1099-MISC

(1 CORRECTED (if

imposed on you if this

income is taxable and
the IRS determines
that it has not been

reporte

for resale >

Department of the Treasury - Internal Revenue Service

checked)

PAYER’S name, street address, city, state, and ZIP code 7 Rents ‘OMB No. 1545-0115,
$ 1989 Miscellaneous
2 Royalties Income
Statement for
$ Recipients of
PAYER’S Federal identification number] RECIPIENT'S identification number | 3 Prizes and awards 4 Federal income tax withheld Copy B
$ $ For Recipient
RECIPIENT'S name (first, middle, last) 5 Fishing boat proceeds 6 Medical and health care payments | This is important tax
information and is
$ $ being furnished to the

Street address

City, state, and ZIP code

7 Nonemployee compensation

$

internal Revenue
Service. If you are
required to file a
$ return, a negligence
penalty or other

‘8 Substitute payments in lieu of
dividends or interest

‘9 Payer made direct sales of $5,
products to a buyer (recipient)

sanction will be
imposed on you if this
income is taxable and

000 or more of consumer
forresale . . 2 2 >

‘Account number (optional)

10 Crop insurance proceeds

$

the IRS determines
that it has not been
UL feported.

Form 1099-MISC

(1 CORRECTED (if

Department of the Treasury - Internal Revenue Service

checked)

PAYER’S name, street address, city, state, and ZIP code 7 Rents ‘OMB No. 1545-0115
$ 1989 Miscellaneous
2 Royalties Income
Statement for
$ Recipients of
PAYER'S Federal identification number | RECIPIENT'S identification number 3 Prizes and awards 4 Federal income tax withheld Copy B
$ $ For Recipient
RECIPIENT'S name (first, middle, last) 5 Fishing boat proceeds % Medical and healtheare payments | This is important tax
information and is
$ $ being furnished to the

Street address

City, state, and ZIP code

7 Nonemployee compensation

$

internal Revenue
Service. If you are
required to filea
$ return, a negligence
penalty or other

‘8 Substitute payments in lieu of
div;dends or interest

9 Payer made direct sales of $5,
products to a buyer (recipient)

sanction will be
imposed on you if this
income is taxable and

000 or more of consumer

for resale

‘Account number (optional)

j10 Crop insurance proceeds

$

the IRS determines
thatit has not been
reported.

Form 1099-MISC

Department of the Treasury - Internal Revenue Service