2 Stocks, bonds, etc. Reported

to IRS

Gross proceeds

$ Gross proceeds less commissions 

PAYER’S federal identification number RECIPIENT’S identification number 3 Bartering 4 Federal income tax withheld

$ $

RECIPIENT’S name No. of shares exchanged 5

Street address (including apt. no.) Description 7

City, state, and ZIP code

Account number (see instructions) 2nd TIN not.

Form 1099-B Department of the Treasury - Internal R



Cat. No. 14411V

Form 1099-B

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

Intern

Ser

File wit

F

a

N

Ins

Certai

8

$

Profit or (loss) realized in

2010

9 Unrealized profit or (loss) on

open contracts—12/31/2009

10 Unrealized profit or (loss) on

open contracts–12/31/2010

11 Aggregate profit or (loss)

$

$ $

Classes of stock

exchanged

6

CORPORATION’S name

12 Check the box if recipient cannot take a loss on their tax

return based on the amount in box 2
Fo

This 

in

being 

I

Se

required 

a neglig

other 

impos

incom

the IRS 

2 Stocks, bonds, etc. Reported

to IRS

Gross proceeds

$ Gross proceeds less commissions 

PAYER’S federal identification number RECIPIENT’S identification number 3 Bartering 4 Federal income tax withheld

$ $

RECIPIENT’S name No. of shares exchanged 5

Street address (including apt. no.) Description 7

City, state, and ZIP code

Account number (see instructions)

Form 1099-B Department of the Treasury - Internal R



(keep for your records)

Form 1099-B

8

$

Profit or (loss) realized in

2010

9 Unrealized profit or (loss) on

open contracts—12/31/2009

10 Unrealized profit or (loss) on

open contracts–12/31/2010

11 Aggregate profit or (loss)

$

$ $

Classes of stock

exchanged

6

CORPORATION’S name

12 If the box is checked, the recipient cannot take a loss on

their tax return based on the amount in box 2
this type of transaction to you, the corporation is identified in the

box below your name and address on Form 1099-B.

Box 7. Shows a brief description of the item or service 

proceeds or bartering income is being reported. For reg

futures contracts and forward contracts, “RFC” or other 

description may be shown.

Box 1a. Shows the trade date of the transaction. For aggregate

reporting, no entry will be present.

Box 1b. For broker transactions, may show the CUSIP (Committee

on Uniform Security Identification Procedures) number of the item

reported. Box 8. Shows the profit or (loss) realized on regulated f

Box 2. Shows the aggregate cash proceeds from transactions foreign currency contracts closed during 2010. involving stocks, bonds, other debt obligations, commodities, or

forward 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 change in control or substantial

change in capital structure arising from the corporate transfer of

property to a foreign corporation. Losses on forward contracts are

shown in parentheses. This box does not include proceeds from

regulated futures contracts. The broker must indicate whether gross

proceeds or gross proceeds less commissions and option premiums

were reported to the IRS. Report this amount on Schedule D (Form

1040), Capital Gains and Losses. But, for changes in control or

substantial changes in capital structure, see box 12.

Box 9. Shows any year-end adjustment to the profit or 

in box 8 due to open contracts on December 31, 2009.

Box 10. Shows the unrealized profit or (loss) on open c

in your account on December 31, 2010. These are cons

as of that date. This will become an adjustment reporte

2011.

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

profit or (loss) on regulated futures or foreign currency c

the year. Include this amount on your 2010 Form 6781.

Taxpayer Identification Number and Certification, for inf

backup withholding. Include this amount on your incom

as tax withheld.

Regulated Futures Contracts:

Box 5. Shows the number of shares of the corporation’

you held which were exchanged in the change in contro

substantial change in capital structure.

Box 6. Shows the class or classes of the corporation’s 

were exchanged in the change in control or substantial 

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

payer assigned to distinguish your account.

Box 12. If checked, you cannot take a loss on your tax 

on gross proceeds from an acquisition of control or sub

change in capital structure reported in box 2. Do not re

on Schedule D (Form 1040). The broker should advise y

losses on a separate statement.

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), or adoption

taxpayer identification number (ATIN). However, the issuer has

reported your complete identification number to the IRS and, where

applicable, to state and/or local governments.
F

a

N

Ins

Certai

2 Stocks, bonds, etc. Reported

to IRS

Gross proceeds

$ Gross proceeds less commissions 

PAYER’S federal identification number RECIPIENT’S identification number 3 Bartering 4 Federal income tax withheld

$ $

RECIPIENT’S name No. of shares exchanged 5

Street address (including apt. no.) Description 7

City, state, and ZIP code

2nd TIN not.

Form 1099-B Department of the Treasury - Internal R



Form 1099-B

8

$

Profit or (loss) realized in

2010

9 Unrealized profit or (loss) on

open contracts—12/31/2009

10 Unrealized profit or (loss) on

open contracts–12/31/2010

11 Aggregate profit or (loss)

$

$ $

Classes of stock

exchanged

6

CORPORATION’S name

12 Check the box if recipient cannot take a loss on their tax

return based on the amount in box 2

Account number (see instructions)
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

recipient by February 15, 2011.

Caution: Because paper forms are scanned during

processing, you cannot file with the IRS Forms 1096,

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

the IRS website.

Foreign recipient. If the recipient of the pro

nonresident alien, you may have to withhold 

income tax and file Form 1042-S, Foreign Pe

U.S. Source Income Subject to Withholding. 

Instructions for Form 1042-S and Pub. 515,

Withholding of Tax on Nonresident Aliens an

Entities.

Need help? If you have questions about rep

Form 1099-B, call the information reporting c

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

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

call 304-579-4827 (not toll free). The hours o

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

4:30 p.m., Eastern time.

File Copy A of this form with the IRS by 

February 28, 2011. If you file electronically, the due

date is March 31, 2011. To file electronically, you must