Form 1099-MISC

2012

Cat. No. 14425J

Miscellaneous 

Income

Copy A

For 

Internal Revenue 

Service Center

Department of the Treasury - Internal Revenue Service

File with Form 1096.

OMB No. 1545-0115

For Privacy Act 

and Paperwork 

Reduction Act 

Notice, see the 

2012 General

Instructions for

Certain

Information

Returns.

9595 VOID CORRECTED

PAYER’S name, street address, city, state, ZIP code, and telephone no.

PAYER’S federal identification 

number

RECIPIENT’S identification 

number

RECIPIENT’S name

Street address (including apt. no.)

City, state, and ZIP code

Account number (see instructions) 2nd TIN not.

1 Rents

$

2 Royalties

$

3 Other income

$

4 Federal income tax withheld

$

5 Fishing boat proceeds

$

6 Medical and health care payments

$

7 Nonemployee compensation

$

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 a

10 Crop insurance proceeds

$

11 12

13 Excess golden parachute 

payments

$

14 Gross proceeds paid to an 

attorney

$

15a Section 409A deferrals

$

15b Section 409A income

$

16 State tax withheld

$

$

17 State/Payer’s state no. 18 State income

$

$

Form 1099-MISC

Do Not Cut or Separate Forms on This Page — Do Not Cut or Separate Forms on This Page
Form 1099-MISC

2012 Miscellaneous 

Income

Copy 1

For State Tax 

Department

Department of the Treasury - Internal Revenue Service

OMB No. 1545-0115

VOID CORRECTED

PAYER’S name, street address, city, state, ZIP code, and telephone no.

PAYER’S federal identification 

number

RECIPIENT’S identification 

number

RECIPIENT’S name

Street address (including apt. no.)

City, state, and ZIP code

Account number (see instructions)

1 Rents

$

2 Royalties

$

3 Other income

$

4 Federal income tax withheld

$

5 Fishing boat proceeds

$

6 Medical and health care payments

$

7 Nonemployee compensation

$

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 a

10 Crop insurance proceeds

$

11 12

13 Excess golden parachute 

payments

$

14 Gross proceeds paid to an 

attorney

$

15a Section 409A deferrals

$

15b Section 409A income

$

16 State tax withheld

$

$

17 State/Payer’s state no. 18 State income

$

$

Form 1099-MISC
Form 1099-MISC

2012 Miscellaneous 

Income

Copy B

For Recipient

Department of the Treasury - Internal Revenue Service

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 

this income is 

taxable and the IRS 

determines that it 

has not been 

reported.

OMB No. 1545-0115

CORRECTED (if checked)

PAYER’S name, street address, city, state, ZIP code, and telephone no.

PAYER’S federal identification 

number

RECIPIENT’S identification 

number

RECIPIENT’S name

Street address (including apt. no.)

City, state, and ZIP code

Account number (see instructions)

1 Rents

$

2 Royalties

$

3 Other income

$

4 Federal income tax withheld

$

5 Fishing boat proceeds

$

6 Medical and health care payments

$

7 Nonemployee compensation

$

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 a

10 Crop insurance proceeds

$

11 12

13 Excess golden parachute 

payments

$

14 Gross proceeds paid to an 

attorney

$

15a Section 409A deferrals

$

15b Section 409A income

$

16 State tax withheld

$

$

17 State/Payer’s state no. 18 State income

$

$

Form 1099-MISC (keep for your records)
Instructions for Recipient

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.

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

assigned to distinguish your account.

Amounts shown may be subject to self-employment (SE) tax. If your net

income from self-employment is $400 or more, you must file a return and

compute your SE tax on Schedule SE (Form 1040). See Pub. 334 for more

information. If no income or social security and Medicare taxes were withheld

and you are still receiving these payments, see Form 1040-ES (or 

Form 1040-ES(NR)). Individuals must report these amounts as explained in the 

box 7 instructions on this page. Corporations, fiduciaries, or partnerships must 

report the amounts on the proper line of their tax returns.

Form 1099-MISC incorrect? If this form is incorrect or has been issued in error, 

contact the payer. If you cannot get this form corrected, attach an explanation 

to your tax return and report your income correctly.

Box 1. Report rents from real estate on Schedule E (Form 1040). However, 

report rents on Schedule C (Form 1040) if you provided significant services to 

the tenant, sold real estate as a business, or rented personal property as a 

business. 

Box 2. Report royalties from oil, gas, or mineral properties, copyrights, and 

patents on Schedule E (Form 1040). However, report payments for a working 

interest as explained in the box 7 instructions. For royalties on timber, coal, and 

iron ore, see Pub. 544.

Box 3. Generally, report this amount on the “Other income” line of Form 1040 

(or Form 1040NR) and identify the payment. The amount shown may be 

payments received as the beneficiary of a deceased employee, prizes, awards, 

taxable damages, Indian gaming profits, or other taxable income. See Pub. 525. 

If it is trade or business income, report this amount on Schedule C or F (Form 

1040).

Box 4. Shows backup withholding or withholding on Indian gaming profits.

Generally, a payer must backup withhold if you did not furnish your taxpayer

identification number. See Form W-9 and Pub. 505 for more information. Report 

this amount 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 Schedule C (Form 1040). See Pub. 334.

Box 6. For individuals, report on Schedule C (Form 1040).

Box 7. Shows nonemployee compensation. If you are in the trade or business of 

catching fish, box 7 may show cash you received for the sale of fish. If the

amount in this box is SE income, report it on Schedule C or F (Form 1040), and 

complete Schedule SE (Form 1040). You received this form instead of Form W-2 

because the payer did not consider you an employee and did not withhold 

income tax or social security and Medicare tax. If you believe you are an 

employee and cannot get the payer to correct this form, report the amount from 

box 7 on Form 1040, line 7 (or Form 1040NR, line 8). You must also complete 

Form 8919 and attach it to your return. If you are not an employee but the 

amount in this box is not SE income (for example, it is income from a sporadic 

activity or a hobby), report it on Form 1040, line 21 (or Form 1040NR, line 21).

Box 8. Shows substitute payments in lieu of dividends or tax-exempt interest

received by your broker on your behalf as a result of a loan of your securities.

Report on the “Other income” line of Form 1040 (or Form 1040NR).

Box 9. If checked, $5,000 or more of sales of consumer products was paid to

you on a buy-sell, deposit-commission, or other basis. A dollar amount does not 

have to be shown. Generally, report any income from your sale of these

products on Schedule C (Form 1040).

Box 10. Report this amount on Schedule F (Form 1040).

Box 13. Shows your total compensation of excess golden parachute payments

subject to a 20% excise tax. See the Form 1040 (or Form 1040NR) instructions 

for where to report.

Box 14. Shows gross proceeds paid to an attorney in connection with legal

services. Report only the taxable part as income on your return.

Box 15a. May show current year deferrals as a nonemployee under a

nonqualified deferred compensation (NQDC) plan that is subject to the

requirements of section 409A, plus any earnings on current and prior year

deferrals.

Box 15b. Shows income as a nonemployee under an NQDC plan that does not 

meet the requirements of section 409A. This amount is also included in box 7 as 

nonemployee compensation. Any amount included in box 15a that is currently 

taxable is also included in this box. This income is also subject to a substantial 

additional tax to be reported on Form 1040 (or Form 1040NR). See “Total Tax” 

in the Form 1040 (or Form 1040NR) instructions.

Boxes 16–18. Shows state or local income tax withheld from the payments.
Form 1099-MISC

2012 Miscellaneous 

Income

Copy 2

To be filed 

with 

recipient's 

state income 

tax return, 

when 

required.

Department of the Treasury - Internal Revenue Service

OMB No. 1545-0115

CORRECTED (if checked)

PAYER’S name, street address, city, state, ZIP code, and telephone no.

PAYER’S federal identification 

number

RECIPIENT’S identification 

number

RECIPIENT’S name

Street address (including apt. no.)

City, state, and ZIP code

Account number (see instructions)

1 Rents

$

2 Royalties

$

3 Other income

$

4 Federal income tax withheld

$

5 Fishing boat proceeds

$

6 Medical and health care payments

$

7 Nonemployee compensation

$

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 a

10 Crop insurance proceeds

$

11 12

13 Excess golden parachute 

payments

$

14 Gross proceeds paid to an 

attorney

$

15a Section 409A deferrals

$

15b Section 409A income

$

16 State tax withheld

$

$

17 State/Payer’s state no. 18 State income

$

$

Form 1099-MISC
Form 1099-MISC

2012 Miscellaneous 

Income

Copy C

For Payer

Department of the Treasury - Internal Revenue Service

OMB No. 1545-0115

For Privacy Act 

and Paperwork 

Reduction Act 

Notice, see the 

2012 General

Instructions for

Certain

Information

Returns.

VOID CORRECTED

PAYER’S name, street address, city, state, ZIP code, and telephone no.

PAYER’S federal identification 

number

RECIPIENT’S identification 

number

RECIPIENT’S name

Street address (including apt. no.)

City, state, and ZIP code

Account number (see instructions) 2nd TIN not.

1 Rents

$

2 Royalties

$

3 Other income

$

4 Federal income tax withheld

$

5 Fishing boat proceeds

$

6 Medical and health care payments

$

7 Nonemployee compensation

$

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 a

10 Crop insurance proceeds

$

11 12

13 Excess golden parachute 

payments

$

14 Gross proceeds paid to an 

attorney

$

15a Section 409A deferrals

$

15b Section 409A income

$

16 State tax withheld

$

$

17 State/Payer’s state no. 18 State income

$

$

Form 1099-MISC
Instructions for Payer

General and specific form instructions are provided 

as separate products. The products you should 

use to complete Form 1099-MISC are the 2012 

General Instructions for Certain Information 

Returns and the 2012 Instructions for Form 

1099-MISC. 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 IRS.gov or 

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

Caution: Because paper forms are scanned during 

processing, you cannot file with the IRS Forms 

1096, 1097, 1098, 1099, 3921, 3922, or 5498 that 

you print from the IRS website.

Due dates. Furnish Copy B of this form to the

recipient by January 31, 2013. The due date is

extended to February 15, 2013, if you are reporting 

payments in boxes 8 or 14.

File Copy A of this form with the IRS by February 

28, 2013. If you file electronically, the due date is 

April 1, 2013. To file electronically, you must have 

software that generates a file according to the 

specifications in Pub. 1220, Specifications for 

Filing Forms 1097, 1098, 1099, 3921, 3922, 5498, 

8935, and W-2G Electronically. IRS does not 

provide a fill-in form option.

Need help? If you have questions about reporting

on Form 1099-MISC, 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 304-579-4827 (not toll free). The

hours of operation are Monday through Friday from 

8:30 a.m. to 4:30 p.m., Eastern time.