9292 VOID CORRECTED

PAYER’S name, street address, city, state, ZIP code, and telephone no. OMB No. 1545-0112 Payer’s RTN (optional)

Interest Income

PAYER’S Federal identification number RECIPIENT’S identification number 1 Interest income not included in box 3 Copy A

$ For

Internal Revenue

Service Center

Early withdrawal penalty Interest on U.S. Savings

Bonds and Treas. obligations

RECIPIENT’S name 2 3

$ $ File with Form 1096.

For Privacy Act and

Paperwork

Reduction Act

Notice, see the

2000 General

Instructions for

Forms 1099, 1098,

5498, and W-2G.

Street address (including apt. no.) 4 Federal income tax withheld

$

Foreign country or U.S.

possession

City, state, and ZIP code 6 Foreign tax paid 7

Account number (optional) 2nd TIN Not.

$

Form 1099-INT Cat. No. 14410K Department of the Treasury - Internal Revenue Service

Form 1099-INT

5 Investment expenses

$

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

2000

CORRECTED (if checked)

PAYER’S name, street address, city, state, ZIP code, and telephone no. OMB No. 1545-0112 Payer’s RTN (optional)

Interest Income

PAYER’S Federal identification number RECIPIENT’S identification number 1 Interest income not included in box 3

$

Early withdrawal penalty Interest on U.S. Savings

Bonds and Treas. obligations

RECIPIENT’S name 2 3

$ $

Street address (including apt. no.) 4 Federal income tax withheld

$

Foreign country or U.S.

possession

City, state, and ZIP code 6 Foreign tax paid 7

Account number (optional)

$

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

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.

(Keep for your records.)

Form 1099-INT

5 Investment expenses

$

2000
Instructions for Recipient

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

by the payer. This does not include interest shown in box 3.

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.

If you receive a Form 1099-INT for interest paid on a taxexempt obligation, see the instructions for your income tax

return.

Box 2. Shows interest or principal forfeited because of early

withdrawal of time savings. You may deduct this on the

“Penalty on early withdrawal of savings” line of Form 1040.

Nominees. If this form includes amounts belonging to

another person, you are considered a nominee recipient. You

must file Form 1099-INT for each of the other owners

showing the income allocable to each. You must also furnish

a Form 1099-INT to each of the other owners. File Form(s)

1099-INT 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-INT, 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.

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

Treasury bonds, and Treasury notes. This may or may not be

all taxable. See Pub. 550, Investment Income and Expenses.

This interest is exempt from state and local income taxes.

This interest is not included in box 1.

Box 4. Shows backup withholding. For example, persons not

furnishing their taxpayer identification number to the payer

become subject to backup withholding at a 31% rate. See

Form W-9, Request for Taxpayer Identification Number and

Certification, for information on backup withholding. Include

this amount on your income tax return as tax withheld.

Box 5. Any amount shown is your share of investment

expenses of a single-class 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.
VOID CORRECTED

PAYER’S name, street address, city, state, ZIP code, and telephone no. OMB No. 1545-0112 Payer’s RTN (optional)

Interest Income

PAYER’S Federal identification number RECIPIENT’S identification number 1 Interest income not included in box 3 Copy C

$ For Payer

Early withdrawal penalty Interest on U.S. Savings

Bonds and Treas. obligations

RECIPIENT’S name 2 3

$ $

Street address (including apt. no.) 4 Federal income tax withheld

$

Foreign country or U.S.

possession

City, state, and ZIP code 6 Foreign tax paid 7

Account number (optional) 2nd TIN Not.

$

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

Form 1099-INT

For Privacy Act and

Paperwork

Reduction Act

Notice, see the

2000 General

Instructions for

Forms 1099, 1098,

5498, and W-2G.

5 Investment expenses

$

2000
Payers, Please Note—

To help make it easier for you to get only the information you

need to complete the Forms 1099, 1098, 5498, and W-2G

you file, we are now providing general and specific form

instructions as separate products. The new products you

should use for 2000 are the General Instructions for Forms

1099, 1098, 5498, and W-2G, which contains general

information concerning Form 1099-INT and other forms in

the 1099 series, and the separate specific instructions for

each information return you file. Specific information needed

to complete this form is given in the 2000 Instructions for

Forms 1099-INT and 1099-OID. A chart in the general

instructions gives a quick guide to which form must be filed

to report a particular payment. You can order those

instructions and additional forms by calling 1-800-TAX-FORM

(1-800-829-3676). You can also get forms and instructions

from the IRS’s Internet Web Site at www.irs.gov.

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

January 31, 2001.

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

2001. If you file electronically, the due date is April 2, 2001.

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. The

purpose of Form 1098 is to report a mortgage interest

deduction. The purpose of Form 1099-INT is to report

interest income. See the 2000 Instructions for Forms

1099-INT and 1099-OID, and the 2000 Instructions for

Form 1098.

Foreign interest recipient. If the recipient of the interest 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 Corporations.

Caution: Because the IRS processes paper forms by

machine (optical character recognition equipment), you

cannot file with the IRS Forms 1096, 1098, 1099, or 5498

that you print from the IRS’s Internet Web Site.