9292 VOID CORRECTED

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

Inter

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 (see instructions) 2nd TIN not.

$

Form 1099-INT Cat. No. 14410K Department of the Treasury - In

Form 1099-INT

5 Investment expenses

$

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

F

2005
CORRECTED (if checked)

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

Inter

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 (see instructions)

$

Form 1099-INT Department of the Treasury - In

t

(keep for your records)

Form 1099-INT

2005

5 Investment expenses

$
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 

tax as a deduction or a credit on your Form 

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 amount to

figure your adjusted gross income on your income tax return.

See the instructions for Form 1040 to see where to take the

deduction.

Nominees. If this form includes amounts be

another person(s), you are considered a nom

Complete a Form 1099-INT for each of the 

showing the income allocable to each. File 

form with the IRS. Furnish Copy B to each 

yourself as the “payer” and the other owner

“recipient.” File Form(s) 1099-INT with Form 

Summary and Transmittal of U.S. Informatio

the Internal Revenue Service Center for you

1096 list yourself as the “filer.” A husband o

required to file a nominee return to show am

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. Generally, a payer must

backup withhold at a 28% rate if you did not furnish your

taxpayer identification number (TIN) or you did not furnish the

correct TIN to the payer. See Form W-9, Request for Taxpayer Identification Number and Certification, for information

Box 5. Any amount shown is your share of 

penses of a single-class REMIC. If you file F

may deduct these expenses on the “Other e

Schedule A (Form 1040) subject to the 2% 

is included in box 1.

Account number. May show an account or other unique

number the payer assigned to distinguish your account.

on backup withholding. Include this amoun

tax return as tax withheld.
VOID CORRECTED

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

Inter

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 (see instructions) 2nd TIN not.

$

Form 1099-INT Department of the Treasury - In

Form 1099-INT

5 Investment expenses

$

2005
Instructions for Payers

General and specific form instructions are provided as

separate products. The products you should use to complete

Form 1099-INT are the 2005 General Instructions for Forms

1099, 1098, 5498, and W-2G and the 2005 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. To order these instructions

and additional forms call 1-800-TAX-FORM

(1-800-829-3676).

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

January 31, 2006.

File Copy A of this form with the IRS by February 28, 2006.

If you file electronically, the due date is March 31, 2006.

Forms 1099-INT and 1098. If you received 

in the course of your trade or business, you 

report it to the payer of such mortgage inte

IRS on Form 1098, Mortgage Interest State

report mortgage interest to the payer on Fo

purpose of Form 1098 is to report a mortga

deduction. The purpose of Form 1099-INT i

interest income. See the Instructions for Fo

1099-OID, and the Instructions for Form 10

Foreign recipient. If the recipient is a nonre

may have to withhold federal income tax an

1042-S, Foreign Person’s U.S. Source Incom

Withholding. See the Instructions for Form 1

515, Withholding of Tax on Nonresident Alie

Entities.

Caution: Because paper forms are scanned during

processing, you cannot file with the IRS Forms 1096, 1098,

1099, or 5498 that you download and print from the IRS

website.