PAYER’S name, street address, city, state, ZIP code, and telephone no. Date of sale or exchange 1a OMB No. 1545-0715 Proceeds From

Broker and

Barter Exchange

1b CUSIP no. Transactions

2 Stocks, bonds, etc. Reported

to IRS

Gross proceeds

$ Gross proceeds less commissions and option premiums

PAYER’S federal identification number RECIPIENT’S identification number 3 Bartering 4 Federal income tax withheld

$ $

RECIPIENT’S name No. of shares exchanged 5

Street address (including apt. no.) Description 7

City, state, and ZIP code

Account number (see instructions) 2nd TIN not.

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



Cat. No. 14411V

7979 VOID CORRECTED

Form 1099-B

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

Copy A

For

Internal Revenue

Service Center

File with Form 1096.

For Privacy Act

and Paperwork

Reduction Act

Notice, see the

2009 General

Instructions for

Forms 1099, 1098,

3921, 3922, 5498,

and W-2G.

8

$

Profit or (loss) realized in

2009

9 Unrealized profit or (loss) on

open contracts—12/31/2008

10 Unrealized profit or (loss) on

open contracts–12/31/2009

11 Aggregate profit or (loss)

$

$ $

Classes of stock

exchanged

6

CORPORATION’S name

12 Check the box if recipient cannot take a loss on their tax

return based on the amount in box 2

2009
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.

PAYER’S name, street address, city, state, ZIP code, and telephone no. Date of sale or exchange 1a OMB No. 1545-0715 Proceeds From

Broker and

Barter Exchange

1b CUSIP no. Transactions

2 Stocks, bonds, etc. Reported

to IRS

Gross proceeds

$ Gross proceeds less commissions and option premiums

PAYER’S federal identification number RECIPIENT’S identification number 3 Bartering 4 Federal income tax withheld

$ $

RECIPIENT’S name No. of shares exchanged 5

Street address (including apt. no.) Description 7

City, state, and ZIP code

Account number (see instructions)

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



(keep for your records)

CORRECTED (if checked)

Form 1099-B

8

$

Profit or (loss) realized in

2009

9 Unrealized profit or (loss) on

open contracts—12/31/2008

10 Unrealized profit or (loss) on

open contracts–12/31/2009

11 Aggregate profit or (loss)

$

$ $

Classes of stock

exchanged

6

CORPORATION’S name

12 If the box is checked, the recipient cannot take a loss on

their tax return based on the amount in box 2

2009
Instructions for Recipient

Brokers and barter exchanges must report proceeds from

transactions to you and the IRS on Form 1099-B. Reporting is also

required when your broker knows or has reason to know that a

corporation in which you own stock has had a change in control or a

substantial change in capital structure. You may be required to

recognize gain from the receipt of cash, stock, or other property that

was exchanged for the corporation’s stock. If your broker reported

this type of transaction to you, the corporation is identified in the

box below your name and address on Form 1099-B.

Box 7. Shows a brief description of the item or service for which the

proceeds or bartering income is being reported. For regulated

futures contracts and forward contracts, “RFC” or other appropriate

description may be shown.

Box 1a. Shows the trade date of the transaction. For aggregate

reporting, no entry will be present.

Box 1b. For broker transactions, may show the CUSIP (Committee

on Uniform Security Identification Procedures) number of the item

reported.

Box 8. Shows the profit or (loss) realized on regulated futures or

foreign currency contracts closed during 2009.

Box 2. Shows the aggregate proceeds from transactions involving

stocks, bonds, other debt obligations, commodities, or forward

contracts. May show the proceeds from the disposition of your

interest(s) in a widely held fixed investment trust. Losses on forward

contracts and changes in control or substantial change in capital

structure are shown in parentheses. This box does not include

proceeds from regulated futures contracts. The broker must indicate

whether gross proceeds or gross proceeds less commissions and

option premiums were reported to the IRS. Report this amount on

Schedule D (Form 1040), Capital Gains and Losses. However, if box

12 is checked, you cannot take a loss on your tax return based on

gross proceeds from an acquisition of control or substantial change

in capital structure reported in box 2. Do not report this loss on

Schedule D (Form 1040). The broker should advise you of any losses

on a separate statement.

Box 9. Shows any year-end adjustment to the profit or (loss) shown

in box 8 due to open contracts on December 31, 2008.

Box 10. Shows the unrealized profit or (loss) on open contracts held

in your account on December 31, 2009. These are considered sold

as of that date. This will become an adjustment reported in box 9 in

2010.

Box 3. Shows the cash you received, the fair market value of any

property or services you received, and/or the fair market value of any

trade credits or scrip credited to your account by a barter exchange.

See Pub. 525, Taxable and Nontaxable Income, for information on

how to report this income.

Box 11. Boxes 8, 9, and 10 are all used to figure the aggregate

profit or (loss) on regulated futures or foreign currency contracts for

the year. Include this amount on your 2009 Form 6781.

Box 4. Shows backup withholding. Generally, a payer must backup

withhold at a 28% 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 amount on your income tax return

as tax withheld.

Regulated Futures Contracts:

Box 5. Shows the number of shares of the corporation’s stock that

you held which were exchanged in the change in control or

substantial change in capital structure.

Box 6. Shows the class or classes of the corporation’s stock that

were exchanged in the change in control or substantial change in

capital structure.

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

payer assigned to distinguish your account.
Copy C

For Payer

For Privacy Act

and Paperwork

Reduction Act

Notice, see the

2009 General

Instructions for

Forms 1099,

1098, 3921, 3922,

5498, and W-2G.

PAYER’S name, street address, city, state, ZIP code, and telephone no. Date of sale or exchange 1a OMB No. 1545-0715 Proceeds From

Broker and

Barter Exchange

1b CUSIP no. Transactions

2 Stocks, bonds, etc. Reported

to IRS

Gross proceeds

$ Gross proceeds less commissions and option premiums

PAYER’S federal identification number RECIPIENT’S identification number 3 Bartering 4 Federal income tax withheld

$ $

RECIPIENT’S name No. of shares exchanged 5

Street address (including apt. no.) Description 7

City, state, and ZIP code

2nd TIN not.

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



Form 1099-B

8

$

Profit or (loss) realized in

2009

9 Unrealized profit or (loss) on

open contracts—12/31/2008

10 Unrealized profit or (loss) on

open contracts–12/31/2009

11 Aggregate profit or (loss)

$

$ $

Classes of stock

exchanged

6

CORPORATION’S name

12 Check the box if recipient cannot take a loss on their tax

return based on the amount in box 2

Account number (see instructions)

VOID CORRECTED

2009
Instructions for Payers

General and specific form instructions are provided as

separate products. The products you should use for

2009 are the General Instructions for Forms 1099,

1098, 3921, 3922, 5498, and W-2G and the 2009

Instructions for Form 1099-B. 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, visit the IRS website

at www.irs.gov or call 1-800-TAX-FORM

(1-800-829-3676).

Due dates. Furnish Copy B of this form to the

recipient by February 16, 2010.

software that generates a file according to the

specifications in Pub. 1220, Specifications for Filing

Forms 1098, 1099, 3921, 3922, 5498, and W-2G

Electronically. IRS does not provide a fill-in form

option.

Caution: Because paper forms are scanned during

processing, you cannot file with the IRS Forms 1096,

1098, 1099, 3921, 3922, or 5498 that you print from

the IRS website.

Foreign recipient. If the recipient of the proceeds is a

nonresident alien, you may have to withhold federal

income tax and file Form 1042-S, Foreign Person’s

U.S. Source Income Subject to Withholding. See the

Instructions for Form 1042-S and Pub. 515,

Withholding of Tax on Nonresident Aliens and Foreign

Entities.

Need help? If you have questions about reporting on

Form 1099-B, call the information reporting customer

service site toll free at 1-866-455-7438 or

304-263-8700 (not toll free). For TTY/TDD equipment,

call 304-267-3367 (not toll free). File Copy A of this form with the IRS by 

March 1, 2010. If you file electronically, the due date is

March 31, 2010. To file electronically, you must have