VOID CORRECTED

PAYER’S name, street address, city, state, and ZIP code Original issue discount OMB No. 1545-0117

for 1992

1

Original Issue

Discount

2 Other periodic interest

PAYER’S Federal identification number RECIPIENT’S identification number 3 Early withdrawal penalty 4 Federal income tax withheld

RECIPIENT’S name 5 Description

Street address (including apt. no.)

City, state, and ZIP code

Account number (optional) 2nd TIN Not.

Form 1099-OID Department of the Treasury - Internal Revenue Service

$

$

$ $

Copy A

For

Internal Revenue

Service Center

For Paperwork

Reduction Act

Notice and

instructions for

completing this

form, see

Instructions for

Forms 1099, 1098,

5498, and W-2G.

File with Form 1096.

Do NOT Cut or Separate Forms on This Page

9 6 9 6

Cat. No. 14421R

PAYER’S name, street address, city, state, and ZIP code Original issue discount OMB No. 1545-0117

for 1992*

1

Original Issue

2 Other periodic interest Discount

PAYER’S Federal identification number RECIPIENT’S identification number 3 Early withdrawal penalty

RECIPIENT’S name 5 Description

Street address (including apt. no.)

City, state, and ZIP code

Account number (optional)

Form 1099-OID Department of the Treasury - Internal Revenue Service

CORRECTED (if checked)

Copy B

For Recipient

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.

* This may not be the correct figure to report on your

income tax return. See instructions on back.

(keep for your records)

4 Federal income tax withheld

$ $

$

$
Instructions for Recipient

Original issue discount (OID) is the difference between the stated

redemption price at maturity and the issue price of a bond, debenture,

note, or other evidence of indebtedness, or the acquisition price of a

stripped bond or coupon. OID rules also apply to certificates of deposit,

time deposits, bonus savings plans, and other deposit arrangements

having a term of more than 1 year, provided the payment of interest is

deferred until maturity.

Box 2.—Shows other interest on this obligation for the year, which is an

amount separate from the OID. If you held the obligation the entire year,

report this amount as interest income on your tax return. If you disposed

of the obligation or acquired it from another holder during the year, see

Pub. 550, Investment Income and Expenses, for reporting instructions. If

you are a regular interest holder in a single class REMIC (as defined in

regulations under section 67(c)), this amount includes your share of the

investment expenses of the REMIC, which are deductible as a

“Miscellaneous Deduction” on Schedule A (Form 1040) subject to the

2% limit.

OID is taxable as interest over the life of the obligation. If you are the

holder of one of these obligations, you must include a part of the OID in

your gross income each year you hold the obligation.

If, as the record holder, you receive Form 1099-OID showing amounts

belonging to another person, you are considered a nominee recipient.

You must file Form 1099-OID for each of the other owners showing the

amounts allocable to each. Furnish a Form 1099-OID to each owner. File

Form(s) 1099-OID with Form 1096, Annual Summary and Transmittal of

U. S. Information Returns, with the Internal Revenue Service Center for

your area. On each Form 1099-OID, list yourself as the “payer” and the

other owner as the “recipient.” 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. If you bought or sold an obligation during

the year and you are not a nominee, you are not required to issue or file

Form 1099-OID showing the OID or stated interest allocable to the

seller/buyer of the obligation.

Box 3.—Shows the interest or principal forfeited by you if you withdrew

the money before the maturity date of the obligation, such as from a CD.

You may deduct this on your Federal income tax return only on the

specific line of Form 1040 under “Adjustments to Income.”

Box 4.—Shows 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 shown on the

form. See Form W-9, Request for Taxpayer Identification Number and

Certification, for information on backup withholding. Include this amount

Box 1.—Shows the OID on the obligation for the part of the year you on your income tax return as tax withheld.

owned it. If you bought the obligation at original issuance and you held

the obligation for the entire year or for the part of the year it was

outstanding, report the entire amount in Box 1 as interest income on your

Box 5.—Shows the identification number (CUSIP number) or description

of the obligation. The description may include the stock exchange, issuer,

coupon rate, and year of maturity.

income tax return. However, if you paid acquisition or bond premium or

bought at market discount, or if the obligation is a stripped bond or

stripped coupon, you must compute your proper amount of OID. See

Pub. 1212, List of Original Issue Discount Instruments. Report the correct

OID as interest on your tax return.
VOID CORRECTED

PAYER’S name, street address, city, state, and ZIP code Original issue discount OMB No. 1545-0117

for 1992

1

Original Issue

2 Other periodic interest Discount

PAYER’S Federal identification number RECIPIENT’S identification number 3 Early withdrawal penalty 4 Federal income tax withheld

RECIPIENT’S name 5 Description

Street address (including apt. no.)

City, state, and ZIP code

Account number (optional) 2nd TIN Not.

Form 1099-OID Department of the Treasury - Internal Revenue Service

$

$

$ $

Copy C

For Payer

For Paperwork

Reduction Act

Notice and

instructions for

completing this

form, see

Instructions for

Forms 1099, 1098,

5498, and W-2G.