([]voip ~— [_} CORRECTED
PAYER'S name, street address, city, state, and ZIP code 1 Rents OMB No.1545-0115
1985 Miscellaneous
2 Royalties Income
Statement for
Recipients of
PAYER’S Federal identification number | RECIPIENT'S identification number 3 Prizes and awards 4 Federal income tax withheld
Copy C
RECIPIENT'S name (first, middle, last) 5 Fishing boat proceeds 6 Medical and health care payments For Payer

Street address

City, state, and ZIP code

For Paperwork

N

Nonemployee compensation

Reduction Act
Notice and
instructions for
completing this

8 Substitute payments in lieu of
dividends or interest

©

products to a buyer (recipient) for resale

Payer made direct sales of $5,000 or more of consumer

form, see
Instructions for
Form 1099 Series,

>]

Account number (optional)

1098, 5498, and
1096.

Form 1099-MISC

Department of the Treasury - Internal Revenue Service

Street address

City, state, and ZIP code

[Clvoip =[-] CORRECTED
PAYER’S name, street address, city, state, and ZIP code 1 Rents OMB No.1545-0115
1985 Miscellaneous
2 Royalties Income
Statement for
Recipients of
PAYER'’S Federal identification number | RECIPIENT'S identification number 3 Prizes and awards 4 Federal income tax withheld
Copy C
RECIPIENT'S name (first, middle, last) 5 Fishing boat proceeds 6 Medical and health care payments For Payer
For Paperwork
7 Nonemployee compensation | 8 Substitute payments in lieu of Reduction Act
dividends or interest Notice and

instructions for
completing this

©

Payer made direct sales of $5,000 or more of consumer
products to a buyer (recipient) for resale >

form, see
Instructions for
Form 1099 Series,

Account number (optional)

1098, 5498, and
10!

Form 1099-MISC

(_]voiD —_[_] CORRECTED

Department of the Treasury - Internal Revenue Service

Street address

City, state, and ZIP code

PAYER’S name, street address, city, state, and ZIP code 1 Rents OMB No. 1545-0115
1985 Miscellaneous
2 Royalties Income
Statement for
Recipients of
PAYER'S Federal identification number | RECIPIENT'S identification number 3 Prizes and awards 4 Federal income tax withheld
Copy C
RECIPIENT'S name (first, middle, last) 5 Fishing boat proceeds 6 Medical and health care payments For Payer

For Paperwork

7 Nonemployee compensation

Reduction Act
Notice and
instructions for
completing this

8 Substitute payments in lieu of
dividends or interest

9 Payer made direct sales of $5,000 or more of consumer

products to a buyer (recipient) for resale

form, see
Instructions for

pli | Form 1099 Series,

Account number (optional)

1098, 5498, and
1096.

Form 1099-MISC

Department of the Treasury - Internal Revenue Service


Instructions for Recipient

Amounts shown on this return are required to be reported to you and to
the Internal Revenue Service. They may or may not be taxable to you. If
you are an individual, report them on your tax return as explained below.
(Other taxpayers, such as fiduciaries, report the amounts on
corresponding lines of your tax return.)

Boxes 1 and 2.—On Schedule E (Form 1040); or Schedule C if you
provide services that are primarily for your customer's convenience, such
as regular cleaning, changing linen, or maid service.

Box 3.—On the line for “Other income” on Form 1040. If it is trade or
business income, report this amount on Schedule C or F (Form 1040).
Box 4.—Any amount listed in this box represents backup withholding. For
example, persons not furnishing their taxpayer identification number to
the payer become subject to backup withholding at a 20% rate on certain
payments. See Form W-9, Payer’s Request for Taxpayer Identification
Number and Certification, for information on backup withholding. Include
this on your income tax return as tax withheld.

Box 5.—An amount in this box means the fishing boat operator considers
you self-employed. Report this amount on your Schedule C (Form 1040).
See Publication 595, Tax Guide for Commercial Fishermen.

Box 6.—On Schedule C (Form 1040).

Box 7.—Generally, these amounts are considered income from self-
employinent. Report them as part of your trade or business income on

Instructions for Recipient

Amounts shown on this return are required to be reported to you and to
the Internal Revenue Service. They may or may not be taxable to you. If
you are an individual, report them on your tax return as explained below.
(Other taxpayers, such as iduciaries. report the amounts on
corresponding lines of your tax return.)

Boxes 1 and 2.—On Schedule E ‘Form 1646); or Schedule C if you
provide services that are parily for your customer « convenience, such
as regular cleaning, changing ine. or maid service.

Box 3.—On the tine for ‘Other income" on Form 1040. If it is trade or
business income, report this amount on Schedule C a: F (Form 1040).
Box 4.—Any amount listed in this hox represents backup withholding. For
example, persons not furnishing their taxpayer identitication number to
the payer become subject to backup withholding at z 20% rate on certain
payments. See Form W-9, Payer's Request for Taxpaver !dentification
Number and Certification, for information on backup withholding. Include
this on your income tax return as tax withheld.

Box 5.—An amount in this box means the fishing boat cperator considers
you self-employed. Report this amaunt on your Schedule C (Form 1040)
See Publication 595, Tax Guide for Commercial Fishermen.

Box 6.—On Schedule C (Form 1040).

Box 7.—Generally, these amounts are considered income from self-
employment. Report them as part of your trade or business income on

Instructions for Recipient

Amounts shown on this return are required to be reported to you and to

‘the Internal Revenue Service. They may or may not be taxable to you. If

you are an individual, report them on your tax return as explained below.

(Other taxpayers, such as fiduciaries, report the amounts on

corresponding lines of your tax return.)

Boxes 1 and 2.—On Schedule E (Form 1040); or Schedule C if you

provide services that are primarily for your customer's convenience, such

as regular cleaning, changing linen, or maid service.

Box 3.—On the line for ‘Other income" on Form 1040. If it s trade or

business income, report this amount on Schedule C or F (Form 1040).

Box 4.—Any amount listed in this box represents backup withholding. For

‘example, persons not furnishing their taxpayer identification number to

the payer become subject to backup withholding at a 20% rate on certain

payments. See Form W-9, Payer's Request for Taxpayer Identification

Number and Certification, for information on backup withholding. Include

this on your income tax return as tax withheld.

Box 5.—An amount in this box means the fishing boat operator considers
ou self-employed. Report ‘this amount on your Schedule C (Form 1040) .
jee Publication 595, Tax Guide for Commercial Fishermen.

Box 6.—On Schedule C (Form 1040).

Box 7.—Generally, these amounts are considered income from self-

‘employment. Report them as part of your trade or business income on

©U.S. GOVERNMENT PRINTING OFFICE:

+ GOVERNMENT PRINTING OFFICE:

@ PRINTING OFFICE:

Schedule C or F (Form 1040). If you are not self-employed, amounts paid
to you for services rendered are generally reported on Form 1040 on the
line for "Wages, salaries, tips, etc.”

If there are two amounts shown in this box, one may be labeled “EPP.”
This represents excess golden parachute payments. You must pay a 20%
excise tax on this amount. See your Form 1040 instructions under ‘Other
Taxes." The unlabeled amount is your total compensation.

Box 8.—As “Other income” on your tax return. The amount shown 1s
substitute dividends or tax-exempt interest payments received by your
broker on your behalf after transfer of your securities for use in a short sale.

Box 9.—An entry in the checkbox means sales to you of consumer
products on a buy-sell, deposit-commission, or any other basis for resale,
have amounted to $5.000 or more. The person filing this return does not
have to show a dollar amount in this box. The income should generally be
reported on Schedule C (Form 1040).

The amounts shown on this form (except Boxes 4 and 8) may be subject to
self-employment (social sectrity) tax computed on Schedule SE (Form
1040). See Publication 533, Self-Employment Tax, for more information
‘on amounts considered self-employment income. Since no income or social
security taxes will be withheld by the payer, you may be required to make
estimated tax payments. See Form 1 Estimated Tax for Individuals.

1986-493-360 E.1. NO, 43-14-2710

Schedule C or F (Form 1041. If you are not self-employed, amounts paid
to you for services rendered are generally reported on Form 1040 on the
line for "Wages, salaries, tips, etc.”

If there are twe amounts shewn in this box. one may be labeled “EPP ”
This represents excess gold1 parachute payments, You must pay a 20%
excise tax on th's amount. See your Form 1040 instructions under “Other
Taxes.”’ The un-abeled amo:int 1s your total compensation

Box 8.—As “Other income ‘ on your tax return. The amount shown is
substitute dividends or tax-eyempt interest payments received by your
broker on your behalf after ‘ransfer of your securities tor use in a short sale.

Box 9,—An entry in the cher kbox means sales to vou of consumer
products on a buy-sell. depcsit-commission, or any other basis for resale.
have amounted to $5.000 cr more. The person filing this return aces not
have to show a dollar amount in this box. The income should generally be
reported on Schedule C (Form 1040).

The amounts shown on this form (except Boxes 4 and 8) may be subject to
self-employment (social security) tax computed on Schedule SE (Form
1040). See Publication 533, Self-Employment Tax, for more information
on amounts considered self-employment income. Since no income or social
security taxes will be withheld by the payer, you may be required to make
estimated tax payments. See Form 1040-ES, Estimated Tax for Individuals.

1986-493-3m FZ. NO. 4a-40e720

Schedule C or F (Form 1040). If you are not self-employed, amounts paid
to you for services rendered are generally reported on Form 1040 on the
line for "Wages, salaries. tips, etc.”

If there are two amounts shown in this box, one may be labeled “EPP."”
This represents excess golden parachute payments. You must pay a 20%
excise tax on this amount. See your Form 1040 instructions under “Other
Taxes."" The unlabeled amount is your total compensation.

Box 8.—As ‘‘Other income” on your tax return. The amount shown is
substitute dividends or tax-exempt interest payments received by your
broker on your behaif after transfer of your securities for use in a short sale.

Box 9.—An entry in the checkbox means sales to you of consumer
products on a buy-sell. deposit-commission, or any other basis for resale,
have amounted to $5,000 or more. The person filing this return does not
have to show a dollar amount in this box. The income should generally be
reported on Schedule C (Form 1040).

The amounts shown on this form (except Boxes 4 and 8) may be subject to
self-employment (social security) tax computed on Schedule SE (Form
1040). See Publication 533, Self-Employment Tax. for more information
‘on amounts considered self-employment income. Since no income or social
security taxes will be withheld by the payer, you may be required to make
estimated tax payments. See Form 1040-ES, Estimated Tax for individuals.

1986-493-360 E.T. NO. 43-1400716


[Fiype or machine print PAVER'S name, street address, city, state, and ZIP code

For Official Use Only

OMB No.1545-0115

1985

Statement for
Recipients of

Miscellaneous
Income

Copy A

For Internal
Revenue
Service Center
For Paperwork
Reduction Act
Notice and
instructions for
completing this.
form, see
Instructions for
Form 1099 Series,
1098, 5498, and
1096.

ubstitute payments in lieu of
dividends or interest

Do NOT Cut or Separate Forms on This Page

CORRECTED

ZT

Department of the Treasury - Internal Revenue Service

For Official Use Only
re fe]

sees eeetece|

OMB No.1545-0115

1985

Statement for
Recipients of

Miscellaneous
Income

For Internal
Revenue
Service Center
For Paperwork
Reduction Act
Notice and
instructions for
completing this
form, see
Instructions for
Form 1099 Series,
1098, 5498, and
1096.

Substitute payments in lieu of
dividends or interest

Form 1099-MISC

Do NOT Cut or Separate Forms on This Page

9595 E]voiD [x] CORRECTED

- Tp err —
[Type or machine print PAYER’S name, street address, city, state, and ZIP code »

——___—
3 Prizes and awards

Department of the Treasury - Internal Revenue Seryice

(OMB No.1545-0115,

1985

Statement for
Recipients of

Miscellaneous
Income

(2 Royalties |

“(4 Federal income tax withheld Copy A

For Internal
Revenue
Service Center
For Paperwork
Reduction Act
Notice and
instructions for
completing this
form, see
Instructions for
Form 1099 Series,
1098, 5498, and
1096.

—

F'5 Fishing boat proceeds

‘Substitute payments in lieu of
dividends or interest

‘9 Payer made direct
products to a buyer (recipient) for resale

Form 1099-MISC

Department of the Treasury - Internal Revenue Service




[J CORRECTED

PAYER'S name, street address, city, state, and ZIP code 1 Rents OMB No. 1545-0115.
1985 Miscellaneous
2 Royalties Income
Statement for
Recipients of
PAYER'S Federal identification number | RECIPIENT'S identification number 3 Prizes and awards 4 Federal income tax withheld
Copy B

RECIPIENT'S name (first, middle, last)

Street address

City, state, and ZIP code

5 Fishing boat proceeds

6 Medical and health cave payments For Recipient

7 Nonemployee compensation

8 Substitute payments in lieu of

dividends or interest This information
is being furnished

to the Internal

9 Payer made direct sales of $5,000 or more of consumer
products to a buyer (recipient) for resale >L]

Revenue Service.

Account number (optional)

Form 1099-MISC

{] CORRECTED

Department of the Treasury - Internal Revenue Service

PAYER’S name, street address, city, state, and ZIP code 1 Rents OMB No.1545-0115
1985 Miscellaneous
2 Royalties Income
Statement for
Recipients of
PAYER'S Federal identification number | RECIPIENT'S identification number 3 Prizes and awards 4 Federal income tax withheld
Copy B

RECIPIENT'S name (first, middle, last)

Street address

City, state, and ZIP code

5 Fishing boat proceeds

6 Medical and health care payments For Recipient

7 Nonemployee compensation

8 Substitute payments in lieu of

dividends or interest This information
is being furnished

to the Internal

9 Payer made direct sales of $5,000 or more of consumer
products to a buyer (recipient) for resale

Revenue Service.

Sm

Account number (optional)

Form 1099-MISC

Department of the Treasury - Internal Revenue Service

(CORRECTED
PAYER'S name, street address, city, state, and ZIP code 1 Rents. OMB No.1545-0115
1985 Miscellaneous
2 Royalties Income
Statement for
Recipients of
PAYER'S Federal identification number | RECIPIENT'S identification number 3 Prizes and awards 4 Federal income tax withheld
Copy B

RECIPIENT'S name (first, middle, last)

Street address

City, state, and ZIP code

5 Fishing boat proceeds

6 Medical and health care payments For Recipient

7 Nonemployee compensation

8 Substitute payments in lieu of

dividends or interest This information
is being furnished

to the Internal

9 Payer made direct sales of $5,000 or more of consumer
products to a buyer (recipient) for resale

Revenue Service.

»L]

Account number (optional)

Form 1099-MISC

Department of the Treasury - Internal Revenue Service