VOID CORRECTED

CREDITOR’S name, street address, city, state, and ZIP code OMB No. 1545-1424

Cancellation

of Debt

CREDITOR’S federal identification number DEBTOR’S identification number 1 Date canceled 2 Amount of debt canceled

$

3 Interest if included in box 2

5

DEBTOR’S name

Street address (including apt. no.) Debt description

City, state, and ZIP code

Account number (see instructions)

Form 1099-C Department of the Treasury - Internal Revenue Service

8585

Cat. No. 26280W

6

$

4

Form 1099-C

Check for bankruptcy 7 Fair market value of property

$

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

Copy A

For

Internal Revenue

Service Center

File with Form 1096.

For Privacy Act

and Paperwork

Reduction Act

Notice, see the

2007 General

Instructions for

Forms 1099, 1098,

5498, and W-2G.

2007
CORRECTED (if checked)

CREDITOR’S name, street address, city, state, and ZIP code OMB No. 1545-1424

Cancellation

of Debt

CREDITOR’S federal identification number DEBTOR’S identification number 1 Date canceled 2 Amount of debt canceled

$

3 Interest if included in box 2

5

DEBTOR’S name

Street address (including apt. no.) Debt description

City, state, and ZIP code

Account number (see instructions)

Form 1099-C Department of the Treasury - Internal Revenue Service

Copy B

For Debtor

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.

(keep for your records)

4

$

Form 1099-C

6 7 Bankruptcy (if checked) Fair market value of property

$

2007
Instructions for Debtor

If a federal government agency, certain agencies connected with the

Federal Government, financial institution, credit union, or an

organization having a significant trade or business of lending money

(such as a finance or credit card company) cancels or forgives a

debt you owe of $600 or more, this form must be provided to you.

Generally, if you are an individual, you must include all canceled

amounts, even if less than $600, on the “Other income” line of Form

1040. If you are a corporation, partnership, or other entity, report the

canceled debt on your tax return. See the instructions for your tax

return.

However, some canceled debts are not includible, or fully

includible, in your income, such as certain student loans (see Pub.

525), certain debts reduced by the seller after purchase (see Pub.

334), qualified farm debt (see Pub. 225), qualified real property

business debt (see Pub. 334), or debts canceled in bankruptcy (see

Pub. 908). Do not report a canceled debt as income if you did not

deduct it but would have been able to do so on your tax return if

you had paid it. Also, do not include canceled debts in your income

to the extent you were insolvent. If you exclude a canceled debt

from your income because it was canceled in a bankruptcy case or

during insolvency, or because the debt is qualified farm debt or

qualified real property business debt, file Form 982, Reduction of Tax

Attributes Due to Discharge of Indebtedness (and Section 1082

Basis Adjustment).

Box 1. Shows the date the debt was canceled.

Box 2. Shows the amount of debt canceled.

Box 6. If the box is marked, the creditor has indicated the debt was

canceled in a bankruptcy proceeding.

Box 5. Shows a description of the debt. If box 7 is completed, box 5

shows a description of the property.

Box 3. Shows interest if included in the canceled debt in box 2. See

Pub. 525, Taxable and Nontaxable Income, to see if you must

include the interest in gross income.

Box 7. If, in the same calendar year, a foreclosure or abandonment

of property occurred in connection with the cancellation of the debt,

the fair market value (FMV) of the property will be shown, or you will

receive a separate Form 1099-A, Acquisition or Abandonment of

Secured Property. Generally, the gross foreclosure bid price is

considered to be the FMV. For an abandonment or voluntary

conveyance in lieu of foreclosure, the FMV is generally the appraised

value of the property. You may have income or loss because of the

acquisition or abandonment. See Pub. 544, Sales and Other

Dispositions of Assets, for information about foreclosures and

abandonments.

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

creditor assigned to distinguish your account.
VOID CORRECTED

CREDITOR’S name, street address, city, state, and ZIP code OMB No. 1545-1424

Cancellation

of Debt

CREDITOR’S federal identification number DEBTOR’S identification number 1 Date canceled 2 Amount of debt canceled

$

3 Interest if included in box 2

5

DEBTOR’S name

Street address (including apt. no.) Debt description

City, state, and ZIP code

Account number (see instructions)

Form 1099-C Department of the Treasury - Internal Revenue Service

$

4

Form 1099-C

6 7 Check for bankruptcy Fair market value of property

$

For Creditor

For Privacy Act

and Paperwork

Reduction Act

Notice, see the

2007 General

Instructions for

Forms 1099,

1098, 5498,

and W-2G.

Copy C

2007
Instructions for Creditors

General and specific form instructions are provided as

separate products. The products you should use to

complete Form 1099-C are the 2007 General

Instructions for Forms 1099, 1098, 5498, and W-2G,

and the 2007 Instructions for Forms 1099-A and

1099-C. A chart in the general instructions gives a

quick guide to which form must be filed to report a

particular payment. To order these instructions and

additional forms, visit the IRS website at www.irs.gov

or call 1-800-TAX-FORM (1-800-829-3676).

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

by January 31, 2008.

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

2008. If you file electronically, the due date is March

31, 2008. To file electronically, you must have software

that generates a file according to the specifications in

Pub. 1220, Specifications for Filing Forms 1098, 1099,

5498, and W-2G Electronically or Magnetically. IRS

does not provide a fill-in form option.

Caution: Because paper forms are scanned during

processing, you cannot file Forms 1096, 1098, 1099, or

5498 that you download and print from the IRS

website.

Need help? If you have questions about reporting on

Form 1099-C, call the information reporting customer

service site toll free at 1-866-455-7438 or

304-263-8700 (not toll free). For TTY/TDD equipment,

call 304-267-3367 (not toll free). The hours of operation

are Monday through Friday from 8:30 a.m. to 4:30 p.m.

Eastern time. The service site can also be reached by

email at mccirp@irs.gov.