7979 VOID CORRECTED

Form 1099-B

2016

Cat. No. 14411V

Proceeds From 

Broker and 

Barter Exchange 

Transactions

Copy A

For 

Internal Revenue 

Service Center 

File with Form 1096.

Department of the Treasury - Internal Revenue Service

OMB No. 1545-0715

For Privacy Act 

and Paperwork 

Reduction Act 

Notice, see the 

2016 General

Instructions for

Certain 

Information

Returns.

PAYER'S name, street address, city or town, state or province, 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, state or province, country, and ZIP or foreign postal code

Account number (see instructions) 2nd TIN not.

CUSIP number FATCA filing 

requirement

Applicable check box on Form 8949

1a Description of property (Example 100 sh. XYZ Co.)

1b Date acquired 1c Date sold or disposed

1d Proceeds

$

1e Cost or other basis

$

1f Accrued market discount

$

1g Wash sale loss disallowed

$

2 Short-term gain or loss

Long-term gain or loss

Ordinary

3 Check if basis reported to 

IRS

4 Federal income tax withheld

$

5 Check if noncovered 

security

6 Reported to IRS:

Gross proceeds

Net proceeds

7 Check if loss is not allowed 

based on amount in 1d

8 Profit or (loss) realized in 

2016 on closed contracts

$

9 Unrealized profit or (loss) on 

open contracts—12/31/2015

$

10 Unrealized profit or (loss) on 

open contracts—12/31/2016

$

11 Aggregate profit or (loss) 

on contracts

$

12 Check if proceeds from 

collectibles

13 Bartering

$

14 State name 15 State identification no. 16 State tax withheld

$

$

Form 1099-B www.irs.gov/form1099b

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

Form 1099-B

2016

Proceeds From 

Broker and 

Barter Exchange 

Transactions

Copy 1

For State Tax 

Department

Department of the Treasury - Internal Revenue Service

PAYER'S name, street address, city or town, state or province, country, ZIP OMB No. 1545-0715

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, state or province, country, and ZIP or foreign postal code

Account number (see instructions)

CUSIP number FATCA filing 

requirement

Applicable check box on Form 8949

1a Description of property (Example 100 sh. XYZ Co.)

1b Date acquired 1c Date sold or disposed

1d Proceeds

$

1e Cost or other basis

$

1f Accrued market discount

$

1g Wash sale loss disallowed

$

2 Short-term gain or loss

Long-term gain or loss

Ordinary

3 If checked, basis reported 

to IRS

4 Federal income tax withheld

$

5 If checked, noncovered 

security

6 Reported to IRS:

Gross proceeds

Net proceeds

7 If checked, loss is not allowed 

based on amount in 1d

8 Profit or (loss) realized in 

2016 on closed contracts

$

9 Unrealized profit or (loss) on 

open contracts—12/31/2015

$

10 Unrealized profit or (loss) on 

open contracts—12/31/2016

$

11 Aggregate profit or (loss) 

on contracts

$

12 Check if proceeds from 

collectibles

13 Bartering

$

14 State name 15 State identification no. 16 State tax withheld

$

$

Form 1099-B www.irs.gov/form1099b
 CORRECTED (if checked)

Form 1099-B

2016

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 

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.

PAYER'S name, street address, city or town, state or province, country, ZIP OMB No. 1545-0715

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, state or province, country, and ZIP or foreign postal code

Account number (see instructions)

CUSIP number FATCA filing 

requirement

Applicable check box on Form 8949

1a Description of property (Example 100 sh. XYZ Co.)

1b Date acquired 1c Date sold or disposed

1d Proceeds

$

1e Cost or other basis

$

1f Accrued market discount

$

1g Wash sale loss disallowed

$

2 Short-term gain or loss

Long-term gain or loss

Ordinary

3 If checked, basis reported 

to IRS

4 Federal income tax withheld

$

5 If checked, noncovered 

security

6 Reported to IRS:

Gross proceeds

Net proceeds

7 If checked, loss is not allowed 

based on amount in 1d

8 Profit or (loss) realized in 

2016 on closed contracts

$

9 Unrealized profit or (loss) on 

open contracts—12/31/2015

$

10 Unrealized profit or (loss) on 

open contracts—12/31/2016

$

11 Aggregate profit or (loss) 

on contracts

$

12 Check if proceeds from 

collectibles

13 Bartering

$

14 State name 15 State identification no. 16 State tax withheld

$

$

Form 1099-B (Keep for your records) www.irs.gov/form1099b
Instructions for Recipient

Brokers and barter exchanges must report proceeds from (and in some 

cases, basis for) transactions to you and the IRS on Form 1099-B. 

Reporting is also required when your broker knows or has reason to 

know that a corporation in which you own stock has had a reportable 

change in control or capital structure. You may be required to 

recognize gain from the receipt of cash, stock, or other property that 

was exchanged for the corporation’s stock. If your broker reported this 

type of transaction to you, the corporation is identified in box 1a.

Recipient's identification number. For your protection, this form 

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

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

taxpayer identification number (ATIN), or employer identification 

number (EIN). However, the issuer has reported your complete 

identification number to the IRS.

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

payer assigned to distinguish your account.

CUSIP number. Shows the CUSIP (Committee on Uniform Security 

Identification Procedures) number or other applicable identifying 

number.

FATCA filing requirement. If the FATCA filing requirement box is 

checked, the payer is reporting on this Form 1099 to satisfy its 

chapter 4 account reporting requirement. You also may have a filing 

requirement. See the Instructions for Form 8938.

Applicable check box on Form 8949. Indicates where to report this 

transaction on Form 8949 and Schedule D, and which check box is 

applicable. See the instructions for your Schedule D and/or Form 

8949.

Box 1a. Shows a brief description of the item or service for which 

amounts are being reported. For regulated futures contracts and

forward contracts, “RFC” or other appropriate description may be 

shown. For Section 1256 option contracts, “Section 1256 option” or 

other appropriate description may be shown. For a corporation that 

had a reportable change in control or capital structure, this box may 

show the class of stock as C (common), P (preferred), or O (other).

Box 1b. This box may be blank if box 5 is checked or if the securities 

sold were acquired on a variety of dates. For short sales, the date 

shown is the date you acquired the security delivered to close the 

short sale.

Box 1c. Shows the trade date of the sale or exchange. For short 

sales, the date shown is the date the security was delivered to close 

the short sale. For aggregate reporting in boxes 8 through 11, no entry 

will be present.

Box 1d. Shows the cash proceeds, reduced by any commissions or 

transfer taxes related to the sale, for transactions involving stocks,

debt, commodities, forward contracts, non-Section 1256 option 

contracts, or securities futures contracts. May show the proceeds 

from the disposition of your interest(s) in a widely held fixed

investment trust. May also show the aggregate amount of cash and 

the fair market value of any stock or other property received in a 

reportable change in control or capital structure arising from the 

corporate transfer of property to a foreign corporation. Losses on 

forward contracts or non-Section 1256 option contracts are shown in 

parentheses. This box does not include proceeds from regulated 

futures contracts or Section 1256 option contracts. Report this 

amount on Form 8949 or on Schedule D (whichever is applicable) as 

explained in the Instructions for Schedule D. 

Box 1e. Shows the cost or other basis of securities sold. If the 

securities were acquired through the exercise of a non-compensatory 

option granted or acquired on or after January 1, 2014, the basis has 

been adjusted to reflect your option premium. If the securities were 

acquired through the exercise of a non-compensatory option granted 

or acquired before January 1, 2014, your broker is permitted, but not 

required, to adjust the basis to reflect your option premium. If the 

securities were acquired through the exercise of a compensatory 

option, the basis has not been adjusted to include any amount related 

to the option that was reported to you on a Form W-2. If box 5 is 

checked, box 1e may be blank. See the Instructions for Form 8949, 

Instructions for Schedule D, or Pub. 550 for details.

(Instructions continued on the back of Copy 2.)
 CORRECTED (if checked)

Form 1099-B

2016

Proceeds From 

Broker and 

Barter Exchange 

Transactions

Copy 2

To be filed with 

recipient's state 

income tax return, 

when required.

Department of the Treasury - Internal Revenue Service

PAYER'S name, street address, city or town, state or province, country, ZIP OMB No. 1545-0715

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, state or province, country, and ZIP or foreign postal code

Account number (see instructions)

CUSIP number FATCA filing 

requirement

Applicable check box on Form 8949

1a Description of property (Example 100 sh. XYZ Co.)

1b Date acquired 1c Date sold or disposed

1d Proceeds

$

1e Cost or other basis

$

1f Accrued market discount

$

1g Wash sale loss disallowed

$

2 Short-term gain or loss

Long-term gain or loss

Ordinary

3 If checked, basis reported 

to IRS

4 Federal income tax withheld

$

5 If checked, noncovered 

security

6 Reported to IRS:

Gross proceeds

Net proceeds

7 If checked, loss is not allowed 

based on amount in 1d

8 Profit or (loss) realized in 

2016 on closed contracts

$

9 Unrealized profit or (loss) on 

open contracts—12/31/2015

$

10 Unrealized profit or (loss) on 

open contracts—12/31/2016

$

11 Aggregate profit or (loss) 

on contracts

$

12 Check if proceeds from 

collectibles

13 Bartering

$

14 State name 15 State identification no. 16 State tax withheld

$

$

Form 1099-B www.irs.gov/form1099b
Instructions for Recipient (Continued)

Box 1f. Shows the amount of accrued market discount. For details on 

market discount, see Schedule D (Form 1040) instructions, 

Instructions for Form 8949, and Pub. 550. If box 5 is checked, box 1f 

may be blank.

Box 1g. Shows the amount of nondeductible loss in a wash sale 

transaction. For details on wash sales, see Schedule D (Form 1040) 

instructions, Instructions for Form 8949, and Pub. 550. If box 5 is 

checked, box 1g may be blank. 

Box 2. The short-term and long-term boxes pertain to short-term gain 

or loss and long-term gain or loss. If the Ordinary box is checked, your 

security may be subject to special rules. For example, gain on a 

contingent payment debt instrument subject to the noncontingent 

bond method generally is treated as ordinary interest income rather 

than as capital gain. Please see the Instructions for Form 8949, 

Pub. 550, or Pub. 1212 for more details on whether there are any 

special rules or adjustments that might apply to your security. If box 5 

is checked, box 2 may be blank.

Box 3. If checked, the basis in box 1e has been reported to the IRS 

and one or more of the check boxes in box 2 must be checked. If box 

3 is checked on Form(s) 1099-B and NO adjustment is required, see 

the instructions for your Schedule D as you may be able to report your 

transaction directly on Schedule D. If the Ordinary check box in box 2 

is checked, an adjustment may be required.

Box 4. Shows backup withholding. Generally, a payer must backup 

withhold if you did not furnish your taxpayer identification number to 

the payer. See Form W-9 for information on backup withholding. 

Include this amount on your income tax return as tax withheld.

Box 5. If checked, the securities sold were noncovered securities and 

boxes 1b, 1e, 1f, 1g, and 2 may be blank. Generally, a noncovered 

security means: stock purchased before 2011, stock in most mutual

funds purchased before 2012, stock purchased in or transferred to a 

dividend reinvestment plan before 2012, debt acquired before 2014, 

options granted or acquired before 2014, and securities futures 

contracts entered into before 2014.

Box 6. If the exercise of a non-compensatory option resulted in a sale 

of a security, indicates whether the amount in box 1d was adjusted for 

premium. 

Box 7. If checked, you cannot take a loss on your tax return based on 

gross proceeds from a reportable change in control or capital 

structure reported in box 1d. See the Form 8949 and Schedule D 

instructions. The broker should advise you of any losses on a separate 

statement.

Regulated Futures Contracts, Foreign Currency Contracts, and 

Section 1256 Option Contracts (Boxes 8 Through 11):

Box 8. Shows the profit or (loss) realized on regulated futures, foreign

currency, or Section 1256 option contracts closed during 2016.

Box 9. Shows any year-end adjustment to the profit or (loss) shown in 

box 8 due to open contracts on December 31, 2015.

Box 10. Shows the unrealized profit or (loss) on open contracts held in 

your account on December 31, 2016. These are considered closed 

out as of that date. This will become an adjustment reported as 

unrealized profit or (loss) on open contracts-–12/31/2016 in 2017.

Box 11. Boxes 8, 9, and 10 are all used to figure the aggregate profit 

or (loss) on regulated futures, foreign currency, or Section 1256 option 

contracts for the year. Include this amount on your 2016 Form 6781.

Box 12. If checked, proceeds are from a transaction involving 

collectibles.

Box 13. Shows the cash you received, the fair market value of any 

property or services you received, and the fair market value of any 

trade credits or scrip credited to your account by a barter exchange. 

See Pub. 525.

Boxes 14–16. Shows state(s)/local income tax information.

Future developments. For the latest information about any 

developments related to Form 1099-B and its instructions, such as 

legislation enacted after they were published, go to www.irs.gov/

form1099b. 
 VOID CORRECTED

Form 1099-B

2016

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 

2016 General

Instructions for

Certain 

Information

Returns.

PAYER'S name, street address, city or town, state or province, 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, state or province, country, and ZIP or foreign postal code

Account number (see instructions) 2nd TIN not.

CUSIP number FATCA filing 

requirement

Applicable check box on Form 8949

1a Description of property (Example 100 sh. XYZ Co.)

1b Date acquired 1c Date sold or disposed

1d Proceeds

$

1e Cost or other basis

$

1f Accrued market discount

$

1g Wash sale loss disallowed

$

2 Short-term gain or loss

Long-term gain or loss

Ordinary

3 Check if basis reported to 

IRS

4 Federal income tax withheld

$

5 Check if noncovered 

security

6 Reported to IRS:

Gross proceeds

Net proceeds

7 Check if loss is not allowed 

based on amount in 1d

8 Profit or (loss) realized in 

2016 on closed contracts

$

9 Unrealized profit or (loss) on 

open contracts—12/31/2015

$

10 Unrealized profit or (loss) on 

open contracts—12/31/2016

$

11 Aggregate profit or (loss) 

on contracts

$

12 Check if proceeds from 

collectibles

13 Bartering

$

14 State name 15 State identification no. 16 State tax withheld

$

$

Form 1099-B www.irs.gov/form1099b
Instructions for Payer

To complete Form 1099-B, use: 

• the 2016 General Instructions for Certain 

Information Returns, and

• the 2016 Instructions for Form 1099-B.

To order these instructions and additional forms, go 

to www.irs.gov/form1099b.

Caution: Because paper forms are scanned during

processing, you cannot file with the IRS Forms 1096,

1097, 1098, 1099, 3921, 3922, or 5498 that you print

from the IRS website.

Due dates. Furnish Copy B of this form to the recipient 

by February 15, 2017.

File Copy A of this form with the IRS by February 28, 

2017. If you file electronically, the due date is March 31, 

2017. To file electronically, you must have software that

generates a file according to the specifications in Pub. 

1220, Specifications for Electronic Filing of Forms 1097, 

1098, 1099, 3921, 3922, 5498, and W-2G. The IRS does 

not provide a fill-in form option.

Foreign recipient. If the recipient of the proceeds is a

nonresident alien, you may have to withhold federal

income tax and file Form 1042-S, Foreign Person’s U.S. 

Source Income Subject to Withholding. See the

Instructions for Form 1042-S and Pub. 515, Withholding 

of Tax on Nonresident Aliens and Foreign Entities.

Need help? If you have questions about reporting on

Form 1099-B, call the information reporting customer

service site toll free at 1-866-455-7438 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).