Form 1099-INT

2012

Cat. No. 14410K

Interest Income

Copy A

For Internal Revenue 

Service Center

Department of the Treasury - Internal Revenue Service

File with Form 1096.

OMB No. 1545-0112

For Privacy Act and 

Paperwork Reduction 

Act Notice, see the 

2012 General

Instructions for

Certain Information

Returns.

9292 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.

Payer's RTN (optional)

1 Interest income

$

2 Early withdrawal penalty

$

3 Interest on U.S. Savings Bonds and Treas. obligations

$

4 Federal income tax withheld

$

5 Investment expenses

$

6 Foreign tax paid

$

7 Foreign country or U.S. possession

8 Tax-exempt interest

$

9 Specified private activity bond interest

$

10 Tax-exempt bond CUSIP no. 11 State 12 State identification no. 13 State tax withheld

$

Form 1099-INT

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

2012 Interest Income

Copy B

For Recipient

Department of the Treasury - Internal Revenue Service

OMB No. 1545-0112

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.

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)

Payer's RTN (optional)

1 Interest income

$

2 Early withdrawal penalty

$

3 Interest on U.S. Savings Bonds and Treas. obligations

$

4 Federal income tax withheld

$

5 Investment expenses

$

6 Foreign tax paid

$

7 Foreign country or U.S. possession

8 Tax-exempt interest

$

9 Specified private activity bond interest

$

10 Tax-exempt bond CUSIP no. 11 State 12 State identification no. 13 State tax withheld

$

Form 1099-INT (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.

Box 1. Shows taxable interest paid to you during the calendar year by the payer. 

This does not include interest shown in box 3. May also show the total amount 

of the credits from clean renewable energy bonds, Gulf tax credit bonds, 

qualified forestry conservation bonds, new clean renewable energy bonds, 

qualified energy conservation bonds, qualified zone academy bonds,

Midwestern tax credit bonds, qualified school construction bonds, and build

America bonds that must be included in your interest income. These amounts

were treated as paid to you during 2012 on the credit allowance dates (March

15, June 15, September 15, and December 15). For more information, see Form 

8912, Credit to Holders of Tax Credit Bonds.

Box 2. Shows interest or principal forfeited because of early withdrawal of time

savings. You may deduct this amount to figure your adjusted gross income on

your income tax return. See the instructions for Form 1040 to see where to take 

the deduction.

Box 3. Shows interest on U.S. Savings Bonds, Treasury bills, Treasury bonds,

and Treasury notes. This may or may not all be taxable. See Pub. 550. This

interest is exempt from state and local income taxes. This interest is not 

included in box 1.

Box 4. Shows backup withholding. Generally, a payer must backup withhold if

you did not furnish your taxpayer identification number (TIN) or you did not

furnish the correct TIN to the payer. See Form W-9. Include this amount on your 

income tax return as tax withheld.

Box 5. Any amount shown is your share of investment expenses of a singleclass REMIC. If you file Form 1040, you may deduct these expenses on the

“Other expenses” line of Schedule A (Form 1040) subject to the 2% limit. This

amount is included in box 1.

Box 6. Shows foreign tax paid. You may be able to claim this tax as a deduction 

or a credit on your Form 1040. See your Form 1040 instructions.

Box 8. Shows tax-exempt interest paid to you during the calendar year by the 

payer. Report this amount on line 8b of Form 1040 or Form 1040A. This amount 

may be subject to backup withholding. See box 4.

Box 9. Shows tax-exempt interest subject to the alternative minimum tax. This

amount is included in box 8. See the Instructions for Form 6251.

Box 10. Shows CUSIP number(s) for tax-exempt bond(s) on which tax-exempt

interest was paid to you during the calendar year and reported in box 8. If blank, 

no CUSIP number was issued for the bond(s).

Boxes 11-13. State tax withheld reporting boxes.

Nominees. If this form includes amounts belonging to another person(s), you

are considered a nominee recipient. Complete a Form 1099-INT for each of the 

other owners showing the income allocable to each. File Copy A of the form with 

the IRS. Furnish Copy B to each owner. List yourself as the “payer” and the 

other owner(s) as the “recipient.” File Form(s) 1099-INT with Form 1096 with the 

Internal Revenue Service Center for your area. On Form 1096 list yourself as the 

“filer.” A husband or wife is not required to file a nominee return to show 

amounts owned by the other.
Form 1099-INT

2012 Interest Income

Copy C

For Payer

Department of the Treasury - Internal Revenue Service

OMB No. 1545-0112

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.

Payer's RTN (optional)

1 Interest income

$

2 Early withdrawal penalty

$

3 Interest on U.S. Savings Bonds and Treas. obligations

$

4 Federal income tax withheld

$

5 Investment expenses

$

6 Foreign tax paid

$

7 Foreign country or U.S. possession

8 Tax-exempt interest

$

9 Specified private activity bond interest

$

10 Tax-exempt bond CUSIP no. 11 State 12 State identification no. 13 State tax withheld

$

Form 1099-INT
Instructions for Payer

General and specific form instructions are provided as 

separate products. The products you should use to complete 

Form 1099-INT are the 2012 General Instructions for Certain 

Information Returns and the 2012 Instructions for Forms 1099-

INT and 1099-OID. 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.

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.

Forms 1099-INT and 1098. If you received mortgage interest

in the course of your trade or business, you may have to

report it to the payer of such mortgage interest and to the IRS 

on Form 1098, Mortgage Interest Statement. Do not report 

mortgage interest to the payer on Form 1099-INT. See the 

instructions for Form 1098 for information on reporting

mortgage interest.

Foreign recipient. If the recipient is a nonresident alien, you

may have to withhold federal income tax and file Form 1042-

S, Foreign Person’s U.S. Source Income Subject to

Withholding. See the Instructions for Form 1042-S and Pub.

515, Withholding of Tax on Nonresident Aliens and Foreign

Entities.

Need help? If you have questions about reporting on Form

1099-INT, 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.