9595 VOID CORRECTED

PAYER’S name, street address, city, state, ZIP code, and telephone no. Rents 1

$

2 Royalties

$

3 Other income

$

PAYER’S Federal identification number RECIPIENT’S identification number Fishing boat proceeds 4 Federal income tax withheld 5

$ $

RECIPIENT’S name 6 Medical and health care payments 7 Nonemployee compensation

$ $

Payer made direct sales of

$5,000 or more of consumer

products to a buyer

(recipient) for resale 

Substitute payments in lieu of 9

dividends or interest

8

Street address (including apt. no.)

$

City, state, and ZIP code 10 Crop insurance proceeds 11 State income tax withheld

$ $

Account number (optional) 2nd TIN Not. 12 State/Payer’s state number

Form 1099-MISC Cat. No. 14425J Department of the Treasury - Internal Revenue Service

Copy A

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.

For

Internal Revenue

Service Center

OMB No. 1545-0115

Form 1099-MISC

13

$

Miscellaneous

Income

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

2000

VOID CORRECTED

PAYER’S name, street address, city, state, ZIP code, and telephone no. Rents 1

$

Miscellaneous

Income

2 Royalties

$

3

$

PAYER’S Federal identification number RECIPIENT’S identification number Fishing boat proceeds 4 Federal income tax withheld 5

$ $

RECIPIENT’S name 6 Medical and health care payments 7 Nonemployee compensation

$ $

Payer made direct sales of

$5,000 or more of consumer

products to a buyer

(recipient) for resale 

Substitute payments in lieu of 9

dividends or interest

8

Street address (including apt. no.)

$

City, state, and ZIP code 10 Crop insurance proceeds 11 State income tax withheld

$ $

Account number (optional) 12 State/Payer’s state number

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

Copy 1

For State Tax

Department

Other income

OMB No. 1545-0115

Form 1099-MISC

13

$

2000

CORRECTED (if checked)

PAYER’S name, street address, city, state, ZIP code, and telephone no. Rents 1

$

Miscellaneous

Income

2 Royalties

$

3

$

PAYER’S Federal identification number RECIPIENT’S identification number Fishing boat proceeds 4 Federal income tax withheld 5

$ $

RECIPIENT’S name 6 Medical and health care payments 7 Nonemployee compensation

$ $

Payer made direct sales of

$5,000 or more of consumer

products to a buyer

(recipient) for resale 

Substitute payments in lieu of 9

dividends or interest

8

Street address (including apt. no.)

$

City, state, and ZIP code 10 Crop insurance proceeds 11 State income tax withheld

$ $

Account number (optional) 12 State/Payer’s state number

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

Copy B

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.)

For Recipient

Other income

OMB No. 1545-0115

Form 1099-MISC

13

$

2000
If you are an individual, report the taxable amounts shown on this form on

Form 1040, as explained below. (Others, such as corporations, fiduciaries, or

partnerships, report the amounts on the proper line of your tax return.)

Box 13. “A” or “EPP” may be shown to identify the income you received:

Boxes 1 and 2. Report rents from real estate on Schedule E (Form 1040). If

you provided significant services to the tenant, sold real estate as a business,

or rented personal property as a business, report on Schedule C or C-EZ

(Form 1040). For royalties on timber, coal, and iron ore, see Pub. 544, Sales

and Other Dispositions of Assets.

Box 8. Shows substitute payments in lieu of dividends or tax-exempt interest

received by your broker on your behalf after transfer of your securities for use

in a short sale. Report on the “Other income” line of Form 1040.

Box 3. Generally, report on the “Other income” line of Form 1040 and identify

the payment. If it is trade or business income, report this amount on Schedule

C, C-EZ, or F (Form 1040). The amount shown may be payments you received

as the beneficiary of a deceased employee, prizes, awards, taxable damages,

Indian gaming profits, or other taxable income.

Box 9. If marked, 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. Generally, report any income from your sale of these products on

Schedule C or C-EZ (Form 1040).

Box 4. Shows backup withholding or withholding on Indian gaming profits.

Generally, a payer must backup withhold at a 31% rate if you did not furnish

your taxpayer identification number to the payer. 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 10. Report on the “Crop insurance proceeds. . .” line on Schedule F

(Form 1040).

Amounts shown on this form may be subject to self-employment tax. If

your net income from self-employment is $400 or more, you must file a return

and compute your self-employment tax on Schedule SE (Form 1040). See

Pub. 533, Self-Employment Tax, for information on self-employment income. If

no income or social security and Medicare taxes were 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.

Box 5. An amount in this box means the fishing boat operator considers you

self-employed. Report this amount on Schedule C or C-EZ (Form 1040). See

Pub. 595, Tax Highlights for Commercial Fishermen.

Box 6. Report on Schedule C or C-EZ (Form 1040).

Box 7. Generally shows nonemployee compensation. If you are in the trade or

business of catching fish, box 7 may show cash you received for the sale of

fish. Generally, payments reported in this box are income from

self-employment. Since you received this form, rather than Form W-2, the

payer may have considered you self-employed and did not withhold social

security or Medicare taxes. Report self-employment income on Schedule C,

C-EZ, or F (Form 1040), and compute the self-employment tax on Schedule

SE (Form 1040). However, if you are not self-employed, report this amount on

the “Wages, salaries, tips, etc.” line of Form 1040. Call the IRS for information

about how to report any social security and Medicare taxes.

A—Gross proceeds paid to an attorney in connection with legal services.

Report only the taxable part as income on your return.

EPP—Excess golden parachute payments subject to a 20% excise tax. See

your Form 1040 instructions for the “Total Tax” line. The amount in box 7 is

your total compensation.

Other information may be provided to you in box 13 without “A” or “EPP.”
CORRECTED (if checked)

PAYER’S name, street address, city, state, ZIP code, and telephone no. Rents 1

$

Miscellaneous

Income

2 Royalties

$

3

$

PAYER’S Federal identification number RECIPIENT’S identification number Fishing boat proceeds 4 Federal income tax withheld 5

$ $

RECIPIENT’S name 6 Medical and health care payments 7 Nonemployee compensation

$ $

Payer made direct sales of

$5,000 or more of consumer

products to a buyer

(recipient) for resale 

Substitute payments in lieu of 9

dividends or interest

8

Street address (including apt. no.)

$

City, state, and ZIP code 10 Crop insurance proceeds 11 State income tax withheld

$ $

Account number (optional) 12 State/Payer’s state number

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

Copy 2

To be filed

with

recipient’s

state income

tax return,

when

required.

Other income

OMB No. 1545-0115

Form 1099-MISC

13

$

2000

VOID CORRECTED

PAYER’S name, street address, city, state, ZIP code, and telephone no. Rents 1

$

Miscellaneous

Income

2 Royalties

$

3

$

PAYER’S Federal identification number RECIPIENT’S identification number Fishing boat proceeds 4 Federal income tax withheld 5

$ $

RECIPIENT’S name 6 Medical and health care payments 7 Nonemployee compensation

$ $

Payer made direct sales of

$5,000 or more of consumer

products to a buyer

(recipient) for resale 

Substitute payments in lieu of 9

dividends or interest

8

Street address (including apt. no.)

$

City, state, and ZIP code 10 Crop insurance proceeds 11 State income tax withheld

$ $

Account number (optional) 2nd TIN Not. 12 State/Payer’s state number

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

Copy C

For Payer

Other income

OMB No. 1545-0115

Form 1099-MISC

13

$

2000

For Privacy Act

and Paperwork

Reduction Act

Notice, see the

2000 General

Instructions for

Forms 1099, 1098,

5498, and W-2G.
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-MISC 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 Form 1099-MISC. 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

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.

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.

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.