Nonemployee compensation

VOID CORRECTED

PAYER’S name, street address, city, state, ZIP code, and telephone no. 1 Rents OMB No. 1545-0115

$

2 Royalties

$

3 Other income Federal income tax withheld

RECIPIENT’S identification

number

PAYER’S Federal identification

number

5 Fishing boat proceeds 6 Medical and health care payments

$ $

RECIPIENT’S name Substitute payments in lieu of

dividends or interest

7 8

$ $

Street address (including apt. no.) 9 10 Crop insurance proceeds

City, state, and ZIP code

Gross proceeds paid to

an attorney

Excess golden parachute 14

payments

Account number (see instructions) 13

$

16 State tax withheld 17 State/Payer’s state no.

$

18 State income

$

$

$ $

4

$ $

Payer made direct sales of

$5,000 or more of consumer

products to a buyer

(recipient) for resale 

Form 1099-MISC

Miscellaneous

Income

$

9595

2nd TIN not.

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

Cat. No. 14425J

Copy A

File with Form 1096.

For Privacy Act

and Paperwork

Reduction Act

Notice, see the

2005 General

Instructions for

Forms 1099,

1098, 5498,

and W-2G.

For

Internal Revenue

Service Center

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

11 12

2005

15a Section 409A deferrals 15b Section 409A income

$ $
11 12

Nonemployee compensation

VOID CORRECTED

PAYER’S name, street address, city, state, ZIP code, and telephone no. 1 Rents OMB No. 1545-0115

$

2 Royalties

$

3 Other income Federal income tax withheld

RECIPIENT’S identification

number

PAYER’S Federal identification

number

5 Fishing boat proceeds 6 Medical and health care payments

$ $

RECIPIENT’S name Substitute payments in lieu of

dividends or interest

7 8

$ $

Street address (including apt. no.) 9 10 Crop insurance proceeds

City, state, and ZIP code

Gross proceeds paid to

an attorney

Excess golden parachute 14

payments

Account number (see instructions) 13

$

16 State tax withheld 17 State/Payer’s state no.

$

Department of the Treasury - Internal Revenue Service

18 State income

$

$

$ $

4

$ $

Payer made direct sales of

$5,000 or more of consumer

products to a buyer

(recipient) for resale 

Form 1099-MISC

Form 1099-MISC

Miscellaneous

Income

Copy 1

For State Tax

Department

$

2005

15a Section 409A deferrals 15b Section 409A income

$ $
11 12

(keep for your records)

Nonemployee compensation

CORRECTED (if checked)

PAYER’S name, street address, city, state, ZIP code, and telephone no. 1 Rents OMB No. 1545-0115

$

2 Royalties

$

3 Other income

RECIPIENT’S identification

number

PAYER’S Federal identification

number

5 Fishing boat proceeds 6 Medical and health care payments

$ $

RECIPIENT’S name Substitute payments in lieu of

dividends or interest

7 8

$ $

Street address (including apt. no.) 9 10 Crop insurance proceeds

City, state, and ZIP code

Gross proceeds paid to

an attorney

Excess golden parachute 14

payments

Account number (see instructions) 13

$

16 State tax withheld 17 State/Payer’s state no.

$

Department of the Treasury - Internal Revenue Service

18 State income

$

$

$ $

4

$ $

Payer made direct sales of

$5,000 or more of consumer

products to a buyer

(recipient) for resale 

Form 1099-MISC

Form 1099-MISC

Miscellaneous

Income

$

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.

Federal income tax withheld

2005

15a Section 409A deferrals 15b Section 409A income

$ $
Box 15a. Shows current year deferrals as a nonemployee under a

section 409A nonqualified deferred compensation (NQDC) plan. Any

earnings on current and prior year deferrals must also be reported.

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 as a result of a loan

of your securities. Report on the “Other income” line of Form 1040.

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

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, Taxable and Nontaxable Income. If it

is trade or business income, report this amount on Schedule C,

C-EZ, or F (Form 1040).

Box 9. If checked, $5,000 or more of sales of consumer products was

paid to you on a buy-sell, deposit-commission, or other basis. A dollar

amount does not have to be shown. 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 28% rate if you

did not furnish your taxpayer identification number. See Form W-9,

Request for Taxpayer Identification Number and Certification, for

more information. Report this amount on your income tax return as

tax withheld.

Box 10. Report this amount on line 8 of Schedule F (Form 1040).

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

payer assigned to distinguish your account.

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. 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. If payments in this box are SE income, report this

amount on Schedule C, C-EZ, or F (Form 1040), and complete

Schedule SE (Form 1040). You received this form instead of Form

W-2 because the payer did not consider you an employee and did

not withhold income tax or social security and Medicare taxes.

Contact the payer if you believe this form is incorrect or has been

issued in error. If you believe you are an employee, report this

amount on line 7 of Form 1040 and call the IRS for information on

how to report any social security and Medicare taxes.

Box 13. Shows your total compensation of excess golden parachute

payments subject to a 20% excise tax. See the Form 1040

instructions for where to report.

Box 14. Shows gross proceeds paid to an attorney in connection with

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

Instructions to Recipients

Box 15b. Shows income as a nonemployee under a NQDC plan that

does not meet the requirements of section 409A. This amount is also

included in box 7 as nonemployee compensation. Any amount

included in box 15a that is currently taxable is also included in this

box. This income is also subject to a substantial additional tax to be

reported on Form 1040. See “Total Tax” in the Form 1040

instructions.

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

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

a return and compute your SE tax on Schedule SE (Form 1040). See

Pub. 533, Self-Employment Tax, for more information. If no income

or social security and Medicare taxes were withheld and you are still

receiving these payments, see Form 1040-ES, Estimated Tax for

Individuals. Individuals must report as explained below.

Corporations, fiduciaries, or partnerships report the amounts on the

proper line of your tax return.

Boxes 16–18. Shows state or local income tax withheld from the

payments.
11 12

Nonemployee compensation

CORRECTED (if checked)

PAYER’S name, street address, city, state, ZIP code, and telephone no. 1 Rents OMB No. 1545-0115

$

2 Royalties

$

3 Other income Federal income tax withheld

RECIPIENT’S identification

number

PAYER’S Federal identification

number

5 Fishing boat proceeds 6 Medical and health care payments

$ $

RECIPIENT’S name Substitute payments in lieu of

dividends or interest

7 8

$ $

Street address (including apt. no.) 9 10 Crop insurance proceeds

City, state, and ZIP code

Gross proceeds paid to

an attorney

Excess golden parachute 14

payments

Account number (see instructions) 13

$

16 State tax withheld 17 State/Payer’s state no.

$

Department of the Treasury - Internal Revenue Service

18 State income

$

$

$ $

4

$ $

Payer made direct sales of

$5,000 or more of consumer

products to a buyer

(recipient) for resale 

Form 1099-MISC

Form 1099-MISC

Miscellaneous

Income

Copy 2

To be filed

with

recipient’s

state income

tax return,

when

required.

$

2005

15a Section 409A deferrals 15b Section 409A income

$ $
11 12

Nonemployee compensation

VOID CORRECTED

PAYER’S name, street address, city, state, ZIP code, and telephone no. 1 Rents OMB No. 1545-0115

$

2 Royalties

$

3 Other income Federal income tax withheld

RECIPIENT’S identification

number

PAYER’S Federal identification

number

5 Fishing boat proceeds 6 Medical and health care payments

$ $

RECIPIENT’S name Substitute payments in lieu of

dividends or interest

7 8

$ $

Street address (including apt. no.) 9 10 Crop insurance proceeds

City, state, and ZIP code

Gross proceeds paid to

an attorney

Excess golden parachute 14

payments

Account number (see instructions) 13

$

16 State tax withheld 17 State/Payer’s state no.

$

Department of the Treasury - Internal Revenue Service

18 State income

$

$

$ $

4

$ $

Payer made direct sales of

$5,000 or more of consumer

products to a buyer

(recipient) for resale 

Form 1099-MISC

Form 1099-MISC

Miscellaneous

Income

Copy C

For Payer

2nd TIN not.

$

For Privacy Act

and Paperwork

Reduction Act

Notice, see the

2005 General

Instructions for

Forms 1099,

1098, 5498,

and W-2G.

2005

15a Section 409A deferrals 15b Section 409A income

$ $
Instructions for Payers

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.

Caution: Because paper forms are

scanned during processing, you cannot

file with the IRS Forms 1096, 1098,

1099, or 5498 that you print from the

IRS website.

General and specific form instructions

are provided as separate products. The

products you should use to complete

Form 1099-MISC are the 2005 General

Instructions for Forms 1099, 1098,

5498, and W-2G and the 2005

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. To

order these instructions and additional

forms, call 1-800-TAX-FORM

(1-800-829-3676).