Statement for

Recipients of 1979
Ty ‘int 2
pwcrs | Miscellaneous

name, address,
ZIP code, and Income

Federal Copy C
identifying
umber For Payer
Recipient's identifying number 1 Rents 2 Royalties 3 Prizes and awards

‘Type or print RECIPIENT'S name, address, and ZIP code below.

4 Other fixed or determinable income
a, Amount b. Source

Form 1099-MISC

Department of the Treasury—Internal Revenue Service

Statement for
Recipients of
‘Type or print

PAYER'S Miscellaneous

name, address,
ZIP code, and Income

Federal Copy C
identifying
number. For Payer
Recipient's identifying number 1 Rents 2 Royalties ‘3 Prizes and awards

‘Type or print RECIPIENT'S name, address, and ZIP code below.

Other fixed or determinable income
a, Amount b. Souree

Form 1099-MISC

Department of the Treasury—Internal Revenue Service

Statement for
Recipients of

. me .
pares’ | Miscellaneous
ni , adds a

air code, ana’ | Hcome

Federal Copy c

identifying For Payer

Recipient's identifying number 1 Rents

2 Royalties 3 Prizes and awards

‘Type or print RECIPIENT'S name, address, and ZIP code below.

4 Other fixed or determinable income
‘a. Amount b, Source

Form 1099—MISC

Department of the Treasury—Internal Revenue Service


Instructions to Payee

The amounts shown on this form represent payments Boxes 3 and 4.—On Form 1040 on the appropriate

to you (or on your behalf) in the course of the payer's line for “Other income.” This includes prizes, awards,

trace or business. tt is the only required notice for tax or any other amount paid to you (or on your behalf) but

purposes you will receive on these payments. not in connection with a trade or business carried on
Report these amounts as follows: by you

Boxes 1 and 2.--On Form 1040 on the appropriate
schedule for Rent and Royalty Income.

Instructions to Payee

The amounts shown on this form represent payments Boxes 3 and 4.—On Form 1040 on the appropriate
to you (or on your behalf) in the course of the payer's line for “Other income.” This includes prizes, awards,
trade or business. tt is the only required notice for tax or any other amount paid fo you (or on your behalf) but
purposes you will receive on these payments not in connection with a trade or business carried on

Report these amounts as follows: by you.

Bexes 1 and 2.—On Form 1040 on the appropriate
schedule for Rent and Royalty Income.

Instructions to Payee

mounts shown on this form represent payments Boxes 3 and 4.—On Form 1040 on the appropriate
(or on your behalf) in the course of the payer's line for “Other income.” This includes prizes, awarc's,
irade or business. fi is the only required notice for tax or any other amount paid to you (or on your behalf) bur
purposes you will receive on these payments. not in connection with a trade or business carried on

Report these amounts as follows: by you.

Bexes 1 ane 2.--On Form 1040 on the appropriate
le for Rent and Royalty Income.





For Official Use Only |

Statement for
Recipients of

7 :
pee | Miscellaneous
name, address, Income

ZIP code, and

Faderal Copy A
icontifing For Internal Revenue
— ° Service Center
Recipient's identifying number 1 Rents 2 Royalties 3 Prizes and awards
3
-
Type or print RECIPIENT'S name, address, and ZIP code below (Name must aline with | 4 Other fixed or determinable income
arrow). a. Amount i b, Source
Name >

Far, atactons on completing TW Yor, see “Tratvetions for Ferm

Form 1099—MISC

Department of the Treasury—Internal Revenue Service

Statement for
For Official Use Only Recipients of
Type or print .
pees’ | Miscellaneous
name, address,
ZIP code, and Income
Federal Copy A
identifying For internal Revenue
number, Service Center
Recipient's identifying number 1 Rents 2 Royalties 3 Prizes and awards
sO
—
Type of print RECIPIENT'S name, address, and ZIP code below (Name must aline with ff 4 Other fixed or determinable income |
arrow). a. Amount b. Source
sos r
i
i
For instructions on completing this form, see “Instructions for Form
1096,""
Form 1099—MISC Department of the Treasury—laternal Revenue Service
Statement for
For Official Use Only Recipients of
Type or print j
pares Miscellaneous
name, address,
ZIP code, and Income
Federal Copy A
identitying For Internal Revenue
umber. i
m Service Center
Recipient's identifying number 1 Rents 2R 3 Prizes and awards
50
—
Type or print RECIPIENT'S name, address, and ZIP code below (Name must aline with P 4 Other fixed or determinable income
arrow). a. Amount bd. Source
a |

1 Ea sracicns oF completing This Term, S00 “Tastrucions for Form

Form 1099—MISC

Department of the Treasury—Internal Revenue Service




Statement for
Recipients of 7

ares" | Miscellaneous
name, address, I ncome

ZIP code, and

Federal

identifying Copy B

number. For Recipient
Recipient's Identifying number 1 Rents 2 Royalties 3 Prizes and awards

‘Type or print RECIPIENT'S name, address, and ZIP code below.

‘4 Other fixed or determinable income
a, Amount b. Source

If this form shows two or more recipients, the recipient
whose Federal identifying number is shown is urged to file @
Form 1087-MISC with the Internal Revenue Service for each
of the other recipients and provide each with a copy. However,
a husband or wife is not required to file a Form 1087-MISC to
show payments for the other.

"This Information 1s being furnished to the Internal Revenue Service.

Form 1099—MISC See Back of This Copy for Reporting Instructions Department of the Treasury—Internal Revenue Service

Statement for
Recipients of 7

Type or print | Miscellaneous

name, address,
ZIP code, and Income

Federal Cc
t . opy B
identifying eae
number. For Recipient
Recipient's identifying number 1 Rents 2 Royalties 3 Prizes and awards

Type or print RECIPIENT'S name, address, and ZIP code below.

4% Other fixed or determinable income
a, Amount b. Source

If this form shows two or more recipients, the recipient
whose Federal identifying number is shown is urged to file a
Form 1087-MISC with the Internal Revenue Service for each
of the other recipients and provide each with a copy. However,
a husband or wife is not required to file a Form 1087-MISC to
show payments for the other.

This Information is being furnished to the Internal Revenue Service.

Form 1099—MISC ‘See Back of This Copy for Reporting Instructions Department of the Treasury—Internal Revenue Service

Statement for
Recipients of

Tyee ovprint_ | Miscellaneous
name, address, Income

ZIP code, and
Federal
identifying Copy B
number. For Recipient
1 Rents 2 Royalties 3 Prizes and awards

‘Type or print RECIPIENT'S name, address, and ZIP code below.

4 Other fixed or determinable income
a, Amount b. Source

If this form shows two or more recipients, the recipient
whose Federal identifying number is shown is urged to file 2
Form 1087-MISC with the Internal Revenue Service for each
of the other recipients and provide each with a copy. However,
a husband or wife is not required to file a Form 1087-MISC to
show payments for the other.

This tnformation is being furnished to the Internal Revenue Service,

Form 1099-MISC ‘See Back of This Copy for Reporting Instructions Department of the Treasury—Internal Revenue Service