Type or print
PAYER’S
name, address,

Statement for
Recipients of

1977

Original Issue

ZiP code, and | Discount
Federal
identifying Copy C
number. For Payer
Record owner's identifying number | 1 Total original issue discount | 2 Ratable monthly portion 3 Issue price of obligation 4 Stated redemption price at

in 1977 for all holders

maturity

‘Type or print RECORD OWNER’S name, address, and ZIP code below.

Form 1099-OID Ye 6PO + 1976218-097

96-2109817

Department of the Treasury—Internal Revenue Service

Type or print
PAYER'S
name, address,
ZIP code, and
Federal
Identifying
number.

Statement for
Recipients of

1977

Original Issue
Discount

Copy C
For Payer

Record owner's Identifying number | 1 Total original issue discount

2 Ratable monthly portion
in 1977 for all holders

3 Issue price of obligation

4 Stated redemption price at
maturity

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

Form 1099-OID

FORO 1976210077 ae noonir

Department of the Treasury—Internal Revenue Service

‘Type or print
PAYER’'S
name, address,
ZIP code, and
Federal
Identifying
number.

Statement for
Recipients of

1977

Original Issue
Discount

Copy C
For Payer

Record owner's dantfying number | 1 Total, original Issue discount | 2 Ratable monthly portion

in 1977 for all holders

3 Issue price of obligation

4 Stated redemption price at
maturity

‘Type or print RECORD OWNER’S name, address, and ZIP code below.

Form 1099-OID

‘Fr GPO + 1976~218-097 36-7109817

Department of the Treasury—internal Revenue Service




| For Official Use Only |

Type or print

Statement for
Recipients of

1977

Original Issue

PAYER'S. if
name, address, | Discount
ZIP code, and
Federal Copy A
identifying For Internal Revenue
slumber. Service Center
Record owner's identifying number J 1 Total original issue discount J 2 Ratable monthly portion 3 Issue price of obligation 4 Stated redemption price at
in 1977 for all holders maturity
9% 1]
Type or print RECORD OWNER’S name, address, and ZIP code below. (Name must aline with
arrow.)
‘Name >|
For instructions on completing this form, see
J “Instructions for Form 1096.”
Form 1099-OID Fe GPO 1 1976—218-097 ‘36-2100817 Department of the Treasury—Internal Revenue Service
| Statement for
For Official Use Only Recipients of
Ty int Sot
neers | Original Issue
name, address, | Discount
ZIP code, and
Federal Copy A
identifying For Internal Revenue
fumber. Service Center
Record owner’s Identifying number J 1 Total original issue discount § 2 Ratable monthly portion 3 Issue price of obligation 4 Stated redemption price at
in 1977 for all hotders, maturity
a)
‘Type or print RECORD OWNER'S name, address, and ZIP code below. (Name must aline with
arrow.)
Name >|
For instructions on completing this form, see
“Instructions for Form 1096.""
Form 1099-OID He GPO 1 1976—218-097 36-2109817 Department of the Treasury—Internal Revenue Service
; | Statement for
For Official Use Only Recipients of
tr int aot
pars - | Original Issue
name, address, | Discount
ZIP code, and
Federal Copy A
identifying For Internal Revenue
number. Service Center
Record owner's Identifying number [J 1 Total original issue discount § 2 Ratable monthly portion |’ Issue price of obligation 4 Stated redemption price at
in 1977 for all holders maturity
6
‘Type or print RECORD OWNER'S name, address, and ZIP code below. (Name must aline with
arrow.)
Name >|

“Instructions for Form 1096.”

[im instructions on completing this form, see

‘Ye GPO s 1976—218-097

Form 1099-OID

36-2109817

Department of the Treasury—Internal Revenue Service




Statement for
Recipients of

1977

Type or print -:
PAYER'S Original Issue
name, address, .
ZIP code, and’ | Discount
Federal
identifying Copy B
number. For Record Owner

Record owner's idantifying number | 1 Total original issue discount | 2 Ratable monthly portion 3 Issue price of obligation ‘4 Stated redemption price at

in 1977 for all holders maturity

Type or print RECORD OWNER’S name, address, and ZIP code below.

If this form shows two or more record owners, the
record owner whose Federal identifying number is
shown should file a Form 1087—OID with the Internal
Revenue Service for each of the other record owners
and provide each with a copy. However, a husband
or wife is not required to file a Form 1087—OID to
show payments for the other.

This information is being furnished to the Internal
Revenue Service.

Form 1099-OID

oro
WOO 1976-718097  annionen

Department of the Treasury—Internal Revenue Service

Statement for
Recipients of 1977
Type or print
PAYER'S Original Issue
name, address, .
ziP code, and | Discount
Federal
Identifying Copy B
number. For Record Owner

Record owner's Identifying number | 1 Total original issue discount | 2 Ratable monthly portion

In 1977 for all holders

3 Issue price of obligation “4 Stated redemption price at
‘maturity

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

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

This information is being furnished to the Internal
Revenue Service.

Form 1099-OID

HO 676216057 anargneiy

Department of the Treasury—Internal Revenue Service

1977

Statement for

Recipients of
Type or print ws
PAYER'S Original Issue
name, address, .
Zip code, and | Discount
Federal
Identifying Copy B
number. For Record Owner
Record owner's identifying number | 1 Total original issue discount | 2 Ratable monthly portion 3 Issue price of obligation ‘4 Stated redemption price at
In 1977 for all holders maturity

‘Type or print RECORD OWNER’S name, address, and ZIP code below.

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

This information is being furnished to the Internal
Revenue Service.

Form 1099-O1D

OPO + 1975—218-097 36-2109017

Department of the Treasury—Internal Revenue Service