(LJ CORRECTED (if checked)

PAYER’S name, street address, city, state, and ZIP code 1 Rents ‘OMB No. 1545-0115
$ .
2 Rojas 1990 Miscellaneous
$ Income
3 Prizes, awards, etc. Statement for
$ Recipients of
PAYER'S Federal identification number | RECIPIENT'S identification number | 4 Federal income tax withheld | 5 Fisning boat proceeds Copy B
$ $ For Recipient
RECIPIENT'S name 6 Medical and health care payments | 7 Nonemployee compensation This 1s important tax
$ $ intormation and is
being furnished to the

Street address

City, state, and ZIP code

'8 Substitute payments in lieu of
dividends or interest

9 Payer made direct sales of
$5,000 or more of consumer
products toa buyer

internal Revenue
Service. If you are
tequired to file a
return, a negligence
penalty or other

$ (reciptent) for resale [_]
10 Crop insurance proceeds 11 State income tax withheld
$ $

sanction may be
imposed on you if this
income is taxable and

Account number (optional)

2 State/Payer's state number

tne IRS determines
that it has not been
reported.

Form 1099-MISC

Department of the Treasury

LJ CORRECTED (if checked)

+ Internal Revenue Service

Street address

City, state, and ZIP code

PAYER'S name, street address, city, state, and ZIP code 1 Rents OMB No. 1545-0115
$ 1
2 Royalties 1990 Miscellaneous
Income
3 Prizes, awards, etc. Statement for
$ Recipients of
PAYER’S Federal identification number | RECIPIENT'S identification number 4 Federal income tax withheld | 5 Fishing boat proceeds Copy B
$ $ For Recipient
RECIPIENT'S name 6 Medical and health care payments | 7 Nonemployee compensation This 1s important tax
$ $ information and is
being furnished to the

‘8 Substitute payments in lieu of
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9 Payer made direct sales of
$5,000 or more of consumer
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internal Revenue
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required to file a
return, a negligence
penalty or other

$ (recipient) for resale >
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$ $

sanction may be
imposed on you if this
income is taxable and

‘Account number (optional)

2 State/Payer's state number

tie IRS determines
that it has not been
reported.

Form 1099-MISC

Department of the Treasury

(CORRECTED (if checked)

+ Internal Revenue Service

Street address

City, state, and ZIP code

PAYER'S name, street address, city, state, and ZIP code 1 Rents ‘OMB No. 1545.0115
$ |
ah 4990 Miscellaneous
joyalties
$ Income
3 Prizes, awards, etc. Statement for
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$ $ For Recipient
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$ $_ information and 1s,
being furnished to the

8 Substitute payments in lieu of
dividends or interest

‘9 Payer made direct sales of
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internal Revenue
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return, a negligence

l10 Crop insurance proceeds

$

[11 State income tax withheld

$

penalty or other

sanction may be
imposed on you if this
income is taxable and

Account number (optional)

[12 State/Payer’s state number

tne IRS determines
that it has not been
reported.

Form 1099-MISC

Department of the Treasury

+ Internal Revenue Service






Instructions for Recipient

If you are an individual, report the taxable amounts shown on this form on
your tax return, as expiained below. (Other taxpayers, such as fiduciaries
or partnerships, report the amounts on the corresponding lines of your tax
return.)

Boxes 1 and 2.—Report on Scheaule E (Form 1040); or Schedule C
(Form 1040) if you provided services that were primarily for your
customer's convenience, such as regular cleaning, changing linen, or maid
service.

Box 3.—Report on the line for ‘‘Other income" on Form 1040 and
identify the payment. If it is trade or business income, report this amount
‘on Schedule C or F (Form 1040).

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. See Form W-9,
Request for Taxpayer Identification Number and Certification, for
information on backup withholding. Include this 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
Publication 595, Tax Guide for Commercial Fishermen

Box 6.—Report on Schedule C (Form 1040).

Box 7 —Generaliy, this amount 's considered income from self-
employment. Report it as part of your trade or business income on
Schedule C or F (Form 1040). If you are not self-employed, amounts paid

Instructions for Recipient

If you are an individual, report the taxable amounts shown on this form on
your tax return, as explained below. (Other taxpayers, such as fiduciaries
or partnerships, report the amounts on the corresponding lines of your tax
return.)

Boxes 1 and 2.—Report on Schedule E (Form 1040); or Schedule C
(Form 1040) if you provided services that were primarily for your
customer's convenience, such as regular cleaning, changing linen, or maid
service.

Box 3.—Report on the line for ‘‘Other income” on Form 1040 and
identify the payment. If it 1s trade or business income, report this amount.
on Schedule C or F (Form 1040).

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. See Form W-9,
Request for Taxpayer Identification Number and Certification, for
information on backup withholding. Include this 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
Publication 595, Tax Guide for Commercial Fishermen.

Box 6.—Report on Schedule C (Form 1040).

Box 7 —Generally, this amount ts considered income from self:
employment. Report it as part of your trade or business income on
Schedule C or F (Form 1040). If you are not self-employed, amounts paid

Instructions for Recipient

if you are an individual, report the taxable amounts shown on this form on
your tax return, as explained below. (Other taxpayers, such as fiduciaries
or partnerships, report the amounts on the corresponding lines of your tax
return.)

Boxes 1 and 2.—Report on Schedule E (Form 1040); or Schedule C
(Form 1040) if you provided services that were primarily for your
Customer's convenience, such as regular cleaning, changing linen, or maid
service.

Box 3.—Report on the line for ‘Other income" on Form 1040 and
identify the payment. If it is trade or business income, report this amount
‘on Schedule C or F (Form 1040).

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. See Form W-9,
Request for Taxpayer Identification Number and Certification, for
information on backup withholding. Include thts 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
Publication 595, Tax Guide for Commerciai Fishermen

Box 6.—Report on Schedule C (Form 1040).

Box 7 —Generally, this amount !s considered income from self:
employment. Report it as part of your trade or business income on
Sehedite © ar F (Farm 1040) If vou are not self-emoloved. amounts paid

to you for services rendered are generally reported on Form 1040 on the
line for “Wages, salaries, tips, etc.’

if there are two amounts shown in this box. one may be labeled "EPP."
This represents excess golden parachute payments. You must pay a 20%
excise tax on this amount. See your Form 1040 instructions under “Other
Taxes.” The unlabeled amount ts your total compensation.

Box 8.—Report as ‘Other income" on your tax return, The amount shown
1s substitute payments in lieu of dividends or tax-exempt interest received
by your broker on your behalf after transfer of your securities for use ina
short sale.

Box 9.—An entry in the checkbox means sales to you of consumer
products on a buy-sell, deposit-commission, or any other basis for resale
have amounted to $5,000 or more. The person filing this return does not
have to show a dollar amount in this box. Any income from your sale of
these products should generally be reported on Schedule C (Form 1040).

Box 10.—Report on the line for “Crop insurance proceeds” on Schedule F
(Form 1040).

Certain amounts shown on this form may be subject to self-employment
(ocial security) tax computed on Schedule SE (Form 1040). See
Publication 533, Self-Employment Tax, for more information on amounts
considered self-employment income. Since no income or social security
taxes are withheld by the payer, you may have to make estimated tax
payments if you are still receiving these payments. See Form 1040-ES,
Estimated Tax for Individuals

to you for services rendered are generally reported on Form 1040 on the
line for "Wages, salaries, tips, etc.”

If there are two amounts shown in this box, one may be labeled “EPP "
This represents excess golden parachute payments. You must pay a 20%
excise tax on this amount. See your Form 1040 instructions under “Other
Taxes.” The unlabeled amount is your total compensation.

Box 8.—Report as ‘Other income” on your tax return. The amount shown
1s Substitute payments in lieu of dividends or tax-exempt interest received
by your broker on your behalf after transfer of your securities for use ina
short sale

Box 9.—An entry in the checkbox means sales to you of consumer
products on a buy-sell, deposit-commission, or any other basis for resale
have amounted to $5,000 or more. The person filing this return does not
have to show a dollar amount in this box. Any income from your sale of
these products should generally be reported on Schedule C (Form 1040).

Box 10.—Report on the line for “Crop insurance proceeds” on Schedule F
(Form 1040).

Certain amounts shown on this form may be subject to self-employment
(Social security) tax computed on Schedule SE (Form 1040). See
Publication 533, Self-Employment Tax, for more information on amounts
considered self-employment income. Since no income or social security
taxes are withheld by the payer, you may have to make estimated tax
payments if you are still receiving these payments. See Form 1040-ES,
Estimated Tax for Individuals.

to you for services rendered are generally reported on Form 1040 on the
line for “Wages, salaries, tips, etc.””

If there are two amounts shown in this box, one may be labeled “EPP.”
This represents excess golden parachute payments. You must pay a 20%
excise tax on this amount. See your Form 1040 instructions under “Other
Taxes." The unlabeled amount 1s your total compensation.

Box 8.—Report as “‘Other income"” on your tax return, The amount shown
is substitute payments in lieu of dividends or tax-exempt interest received
by your broker on your behalf after transfer of your securities for use ina
short sale.

Box 9.—An entry in the checkbox means sales to you of consumer
products on a buy-sell, deposit-commission, or any other basis for resale
have amounted to $5,000 or more. The person filing this return does not
have to show a dollar amount in this box. Any income from your sale of
these products should generally be reported on Schedule C (Form 1040).

Box 10.—Report on the line for “Crop insurance proceeds" on Schedule F
(Form 1040)

Certain amounts shown on this form may be subject to self-employment
(Social security) tax computed on Schedule SE (Form 1040). See
Publication 533, Self-Employment Tax, for more information on amounts
considered self-employment income. Since no income or social security
taxes are withheld by the payer, you may have to make estimated tax
payments if you are still receiving these payments. See Form 1040-ES,
Estimated Tax for Individuals.


C1 voip

(J CORRECTED

PAYER'S name, street address, city, state, and ZIP code 1 Rents OMB No. 1545-0115
$
2 Royals 7990 Miscellaneous
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‘3 Prizes, awards, etc. Statement for
$ Recipients of
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1098, 5498, and

Form 1099-MISC

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(J CORRECTED

Department of the Treasury - Internal Revenue Service

PAYER’S name, street address, city, state, and ZIP code 1 Rents OMB No. 1545-0115.
$ Miscellaneous
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Form 1099-MISC

Department of the Treasury - Internal Revenue Service

Street address

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$ +
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2 Royalties 1990 Miscellaneous
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Do NOT Cut or Separate Forms on This Page

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9595 Clvoi [[] CORRECTED
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+ Internal Revenue Service

Form 1099-MISC

Department of the Treasury

Do NOT Cut or Separate Forms on This Page
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(J CORRECTED (if checked)

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Form 1099-MISC

Department of the Treasury

(FJ CORRECTED (if checked)

+ Internal Revenue Service

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$ .
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Department of the Treasury - Internal Revenue Service

(CORRECTED (if checked)

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Form 1099-MISC

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Department of the Treasury

+ Internal Revenue Service