Attention: 

Copy A of this form is provided for informational purposes only. Copy A appears in red, 

similar to the official IRS form. The official printed version of Copy A of this IRS form is 

scannable, but the online version of it, printed from this website, is not. Do not print and file 

copy A downloaded from this website; a penalty may be imposed for filing with the IRS 

information return forms that can’t be scanned. See part O in the current General 

Instructions for Certain Information Returns, available at www.irs.gov/form1099, for more 

information about penalties.

Please note that Copy B and other copies of this form, which appear in black, may be 

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Information returns may also be filed electronically using the IRS Filing Information Returns 

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forms.
 

Form 1099-C

2021

Cat. No. 26280W

Cancellation 

of Debt

Copy A

For 

Internal Revenue 

Service Center

Department of the Treasury - Internal Revenue Service

File with Form 1096. 

OMB No. 1545-1424

For Privacy Act and 

Paperwork Reduction 

Act Notice, see the 

2021 General 

Instructions for 

Certain Information 

Returns.

8585 VOID CORRECTED

CREDITOR'S name, street address, city or town, state or province, country, 

ZIP or foreign postal code, and telephone no.

CREDITOR'S TIN DEBTOR'S TIN

DEBTOR'S name

Street address (including apt. no.)

City or town, state or province, country, and ZIP or foreign postal code

Account number (see instructions)

1 Date of identifiable event

2 Amount of debt discharged

$

3 Interest, if included in box 2

$

4 Debt description

5 Check here if the debtor was personally liable for 

repayment of the debt . . . . . . . . ▶

6 Identifiable event code 7 Fair market value of property

$

Form 1099-C www.irs.gov/Form1099C

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

Form 1099-C

2021 Cancellation 

of Debt

Copy B

For Debtor

Department of the Treasury - Internal Revenue Service

This is important tax 

information and is being 

furnished to the IRS. If 

you are required to file a 

return, a negligence 

penalty or other 

sanction may be 

imposed on you if 

taxable income results 

from this transaction 

and the IRS determines 

that it has not been 

reported.

OMB No. 1545-1424

CORRECTED (if checked)

CREDITOR'S name, street address, city or town, state or province, country, 

ZIP or foreign postal code, and telephone no.

CREDITOR'S TIN DEBTOR'S TIN

DEBTOR'S name

Street address (including apt. no.)

City or town, state or province, country, and ZIP or foreign postal code

Account number (see instructions)

1 Date of identifiable event

2 Amount of debt discharged

$

3 Interest, if included in box 2

$

4 Debt description

5 If checked, the debtor was personally liable for 

repayment of the debt . . . . . . . . ▶

6 Identifiable event code 7 Fair market value of property

$

Form 1099-C (keep for your records) www.irs.gov/Form1099C
Instructions for Debtor

You received this form because a federal government agency or an applicable 

financial entity (a creditor) has discharged (canceled or forgiven) a debt you 

owed, or because an identifiable event has occurred that either is or is deemed 

to be a discharge of a debt of $600 or more. If a creditor has discharged a debt 

you owed, you are required to include the discharged amount in your income, 

even if it is less than $600, on the “Other income” line of your Form 1040 or 

1040-SR. However, you may not have to include all of the canceled debt in your 

income. There are exceptions and exclusions, such as bankruptcy and 

insolvency. See Pub. 4681, available at IRS.gov, for more details. If an 

identifiable event has occurred but the debt has not actually been discharged, 

then include any discharged debt in your income in the year that it is actually 

discharged, unless an exception or exclusion applies to you in that year. 

Debtor's taxpayer identification number (TIN). For your protection, this form 

may show only the last four digits of your TIN (social security number (SSN), 

individual taxpayer identification number (ITIN), adoption taxpayer identification 

number (ATIN), or employer identification number (EIN)). However, the creditor 

has reported your complete TIN to the IRS.

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

assigned to distinguish your account. 

Box 1. Shows the date the earliest identifiable event occurred or, at the 

creditor's discretion, the date of an actual discharge that occurred before an 

identifiable event. See the code in box 6. 

Box 2. Shows the amount of debt either actually or deemed discharged. Note: If 

you don't agree with the amount, contact your creditor. 

Box 3. Shows interest if included in the debt reported in box 2. See Pub. 4681 

to see if you must include the interest in gross income.

Box 4. Shows a description of the debt. If box 7 is completed, box 4 also shows 

a description of the property. 

Box 5. Shows whether you were personally liable for repayment of the debt 

when the debt was created or, if modified, at the time of the last modification. 

See Pub. 4681 for reporting instructions. 

Box 6. Shows the reason your creditor has filed this form. The codes in this box 

are described in more detail in Pub. 4681. A—Bankruptcy; B—Other judicial 

debt relief; C—Statute of limitations or expiration of deficiency period; D—

Foreclosure election; E—Debt relief from probate or similar proceeding; F—By 

agreement; G—Decision or policy to discontinue collection; or H—Other actual 

discharge before identifiable event. 

Box 7. If, in the same calendar year, a foreclosure or abandonment of property 

occurred in connection with the cancellation of the debt, the fair market value 

(FMV) of the property will be shown, or you will receive a separate Form 1099-A. 

Generally, the gross foreclosure bid price is considered to be the FMV. For an 

abandonment or voluntary conveyance in lieu of foreclosure, the FMV is 

generally the appraised value of the property. You may have income or loss 

because of the acquisition or abandonment. See Pub. 4681 for information 

about foreclosures and abandonments. If the property was your main home, see 

Pub. 523 to figure any taxable gain or ordinary income.

Future developments. For the latest information about developments related to 

Form 1099-C and its instructions, such as legislation enacted after they were 

published, go to www.irs.gov/Form1099C.

FreeFile. Go to www.IRS.gov/FreeFile to see if you qualify for no-cost online 

federal tax preparation, e-filing, and direct deposit or payment options.
 

Form 1099-C

2021 Cancellation 

of Debt

Copy C

For Creditor

Department of the Treasury - Internal Revenue Service

OMB No. 1545-1424

For Privacy Act 

and Paperwork 

Reduction Act 

Notice, see the 

2021 General 

Instructions for 

Certain Information 

Returns.

VOID CORRECTED

CREDITOR'S name, street address, city or town, state or province, country, 

ZIP or foreign postal code, and telephone no.

CREDITOR'S TIN DEBTOR'S TIN

DEBTOR'S name

Street address (including apt. no.)

City or town, state or province, country, and ZIP or foreign postal code

Account number (see instructions)

1 Date of identifiable event

2 Amount of debt discharged

$

3 Interest, if included in box 2

$

4 Debt description

5 Check here if the debtor was personally liable for 

repayment of the debt . . . . . . . . ▶

6 Identifiable event code 7 Fair market value of property

$

Form 1099-C www.irs.gov/Form1099C
Instructions for Creditor

To complete Form 1099-C, use:

• The 2021 General Instructions for Certain Information 

Returns, and

• The 2021 Instructions for Forms 1099-A and 1099-C.

To order these instructions and additional forms, go 

to www.irs.gov/Form1099C.

Caution: Because paper forms are scanned during 

processing, you cannot file Forms 1096, 1097, 1098, 

1099, 3921, or 5498 that you print from the IRS website.

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

January 31, 2022.

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

2022. If you file electronically, the due date is March 31, 

2022. To file electronically, you must have software that 

generates a file according to the specifications in Pub. 

1220. The IRS does not provide a fill-in form option for 

Copy A.

Need help? If you have questions about reporting on 

Form 1099-C, call the information reporting customer 

service site toll free at 866-455-7438 or 304-263-8700 

(not toll free). Persons with a hearing or speech 

disability with access to TTY/TDD equipment can call 

304-579-4827 (not toll free).