Attention: 

Copy A of this form is provided for informational purposes only. Copy A appears in red, 

similar to the official IRS form. The official printed version of Copy A of this IRS form is 

scannable, but the online version of it, printed from this website, is not. Do not print and file 

copy A downloaded from this website; a penalty may be imposed for filing with the IRS 

information return forms that can’t be scanned. See part O in the current General 

Instructions for Certain Information Returns, available at www.irs.gov/form1099, for more 

information about penalties.

Please note that Copy B and other copies of this form, which appear in black, may be 

downloaded and printed and used to satisfy the requirement to provide the information to 

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See IRS Publications 1141, 1167, and 1179 for more information about printing these tax 

forms.
 

Form 1099-MISC

2021

Cat. No. 14425J

Miscellaneous 

Information

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 

2021 General

Instructions for

Certain

Information

Returns.

9595 VOID CORRECTED

PAYER’S name, street address, city or town, state or province, country, ZIP 

or foreign postal code, and telephone no.

PAYER’S TIN RECIPIENT’S TIN

RECIPIENT’S name

Street address (including apt. no.)

City or town, state or province, country, and ZIP or foreign postal code

Account number (see instructions) FATCA filing 

requirement

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 Payer made direct sales 

totaling $5,000 or more of 

consumer products to 

recipient for resale

8 Substitute payments in lieu of 

dividends or interest

$

9 Crop insurance proceeds

$

10 Gross proceeds paid to an 

attorney

$

11 Fish purchased for resale

$

12 Section 409A deferrals

$

13 Excess golden parachute 

payments

$

14 Nonqualified deferred 

compensation

$

15 State tax withheld

$

$

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

$

$

Form 1099-MISC www.irs.gov/Form1099MISC

Do Not Cut or Separate Forms on This Page — Do Not Cut or Separate Forms on This Page
 

Form 1099-MISC

2021 Miscellaneous 

Information 

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 or town, state or province, country, ZIP 

or foreign postal code, and telephone no.

PAYER’S TIN RECIPIENT’S TIN

RECIPIENT’S name

Street address (including apt. no.)

City or town, state or province, country, and ZIP or foreign postal code

Account number (see instructions) FATCA filing 

requirement

1 Rents

$

2 Royalties

$

3 Other income

$

4 Federal income tax withheld

$

5 Fishing boat proceeds

$

6 Medical and health care payments

$

7 Payer made direct sales 

totaling $5,000 or more of 

consumer products to 

recipient for resale

8 Substitute payments in lieu of 

dividends or interest

$

9 Crop insurance proceeds

$

10 Gross proceeds paid to an 

attorney

$

11 Fish purchased for resale

$

12 Section 409A deferrals

$

13 Excess golden parachute 

payments

$

14 Nonqualified deferred 

compensation

$

15 State tax withheld

$

$

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

$

$

Form 1099-MISC www.irs.gov/Form1099MISC
 

Form 1099-MISC

2021 Miscellaneous 

Information

Copy B

For Recipient

Department of the Treasury - Internal Revenue Service

This is important tax 

information and is 

being furnished to 

the IRS. 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 or town, state or province, country, ZIP 

or foreign postal code, and telephone no.

PAYER’S TIN RECIPIENT’S TIN

RECIPIENT’S name

Street address (including apt. no.)

City or town, state or province, country, and ZIP or foreign postal code

Account number (see instructions) FATCA filing 

requirement

1 Rents

$

2 Royalties

$

3 Other income

$

4 Federal income tax withheld

$

5 Fishing boat proceeds

$

6 Medical and health care payments

$

7 Payer made direct sales 

totaling $5,000 or more of 

consumer products to 

recipient for resale

8 Substitute payments in lieu of 

dividends or interest

$

9 Crop insurance proceeds

$

10 Gross proceeds paid to an 

attorney

$

11 Fish purchased for resale

$

12 Section 409A deferrals

$

13 Excess golden parachute 

payments

$

14 Nonqualified deferred 

compensation

$

15 State tax withheld

$

$

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

$

$

Form 1099-MISC (keep for your records) www.irs.gov/Form1099MISC
Instructions for Recipient

Recipient’s taxpayer identification number (TIN). For your protection, this 

form may show only the last four digits of your social security number (SSN), 

individual taxpayer identification number (ITIN), adoption taxpayer identification 

number (ATIN), or employer identification number (EIN). However, the payer has 

reported your complete TIN to the IRS.

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

assigned to distinguish your account.

FATCA filing requirement. If the FATCA filing requirement box is checked, the 

payer is reporting on this Form 1099 to satisfy its account reporting requirement 

under chapter 4 of the Internal Revenue Code. You may also have a filing 

requirement. See the Instructions for Form 8938.

Amounts shown may be subject to self-employment (SE) tax. Individuals 

should see the Instructions for Schedule SE (Form 1040). Corporations, 

fiduciaries, or partnerships must report the amounts on the appropriate 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 information 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. See Pub. 527.

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 Schedule E (Form 1040) instructions. For royalties on 

timber, coal, and iron ore, see Pub. 544.

Box 3. Generally, report this amount on the “Other income” line of Schedule 1 

(Form 1040) 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 TIN. See 

Form W-9 and Pub. 505 for more information. Report this amount on your 

income tax return as tax withheld.

Box 5. Shows the amount paid to a fishing boat crew member who is 

considered by the operator to be self-employed. Self-employed individuals must 

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

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

Box 7. If checked, consumer products totaling $5,000 or more were sold to you 

for resale, on a buy-sell, a deposit-commission, or other basis. Generally, report 

any income from your sale of these products on Schedule C (Form 1040).

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 Schedule 1 (Form 1040).

Box 9. Report this amount on Schedule F (Form 1040).

Box 10. Shows gross proceeds paid to an attorney in connection with legal 

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

Box 11. Shows the amount paid for the purchase of fish for resale from any 

person engaged in the trade or business of catching fish. See the instructions 

for your tax return for reporting this income.

Box 12. 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 13. Shows your total compensation of excess golden parachute payments

subject to a 20% excise tax. See your tax return instructions for where to report.

Box 14. Shows income as a nonemployee under an NQDC plan that does not meet 

the requirements of section 409A. Any amount included in box 12 that is currently 

taxable is also included in this box. Report this amount as income on your tax 

return. This income is also subject to a substantial additional tax to be reported on 

Form 1040, 1040-SR, or 1040-NR. See the instructions for your tax return.

Boxes 15–17. Show state or local income tax withheld from the payments.

Future developments. For the latest information about developments related to 

Form 1099-MISC and its instructions, such as legislation enacted after they 

were published, go to www.irs.gov/Form1099MISC.

Free File. Go to www.irs.gov/FreeFile to see if you qualify for no-cost online 

federal tax preparation, e-filing, and direct deposit or payment options.
 

Form 1099-MISC

2021 Miscellaneous 

Information

Copy 2

Department of the Treasury - Internal Revenue Service

To be filed with 

recipient’s state 

income tax return, 

when required.

OMB No. 1545-0115

CORRECTED (if checked)

PAYER’S name, street address, city or town, state or province, country, ZIP 

or foreign postal code, and telephone no.

PAYER’S TIN RECIPIENT’S TIN

RECIPIENT’S name

Street address (including apt. no.)

City or town, state or province, country, and ZIP or foreign postal code

Account number (see instructions) FATCA filing 

requirement

1 Rents

$

2 Royalties

$

3 Other income

$

4 Federal income tax withheld

$

5 Fishing boat proceeds

$

6 Medical and health care payments

$

7 Payer made direct sales 

totaling $5,000 or more of 

consumer products to 

recipient for resale

8 Substitute payments in lieu of 

dividends or interest

$

9 Crop insurance proceeds

$

10 Gross proceeds paid to an 

attorney

$

11 Fish purchased for resale

$

12 Section 409A deferrals

$

13 Excess golden parachute 

payments

$

14 Nonqualified deferred 

compensation

$

15 State tax withheld

$

$

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

$

$

Form 1099-MISC www.irs.gov/Form1099MISC
 

Form 1099-MISC

2021 Miscellaneous 

Information

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 

2021 General

Instructions for

Certain

Information

Returns.

VOID CORRECTED

PAYER’S name, street address, city or town, state or province, country, ZIP 

or foreign postal code, and telephone no.

PAYER’S TIN RECIPIENT’S TIN

RECIPIENT’S name

Street address (including apt. no.)

City or town, state or province, country, and ZIP or foreign postal code

Account number (see instructions) FATCA filing 

requirement

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 Payer made direct sales 

totaling $5,000 or more of 

consumer products to 

recipient for resale

8 Substitute payments in lieu of 

dividends or interest

$

9 Crop insurance proceeds

$

10 Gross proceeds paid to an 

attorney

$

11 Fish purchased for resale

$

12 Section 409A deferrals

$

13 Excess golden parachute 

payments

$

14 Nonqualified deferred 

compensation

$

15 State tax withheld

$

$

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

$

$

Form 1099-MISC www.irs.gov/Form1099MISC
Instructions for Payer

To complete Form 1099-MISC, use:

• The 2021 General Instructions for Certain Information 

Returns, and 

• The 2021 Instructions for Forms 1099-MISC and 

1099-NEC.

To complete corrected Forms 1099-MISC, see the 

2021 General Instructions for Certain Information 

Returns.

To order these instructions and additional forms, go 

to www.irs.gov/Form1099MISC.

Caution: Because paper forms are scanned during 

processing, you cannot file Forms 1096, 1097, 1098, 

1099, 3921, or 5498 that you print from the IRS website.

Due dates. Furnish Copy B of this form to the recipient 

by January 31, 2022. The due date is extended to 

February 15, 2022, if you are reporting payments in box 

8 or 10.

File Copy A of this form with the IRS by February 28, 

2022, if you file on paper, or by March 31, 2022, if you 

file electronically. 

To file electronically, you must have software that 

generates a file according to the specifications in Pub. 

1220. The IRS does not provide a fill-in form option for 

Copy A.

Need help? If you have questions about reporting on 

Form 1099-MISC, call the information reporting

customer service site toll free at 866-455-7438 or 

304-263-8700 (not toll free). Persons with a hearing or 

speech disability with access to TTY/TDD equipment 

can call 304-579-4827 (not toll free).