Clvoiw

(CORRECTED

PAYER’S name, street address, city, state, and ZIP code

la Date of sale

1b CUSIP No

2. Stocks, bonds, etc.

(OMB No, 1545-0715 Proceeds From
Broker and
1991 Barter Exchange
Transactions

Reported } H Gross proceeds
tolRS Gross proceeds less commissions and option premiums

PAYER’S Federal identification number | RECIPIENT'S identification number | 3. Bartering 4 Federal income tax withheld
Copy C
RECIPIENT'S name 5 Description For Payer
For Paperwork
Reduction Act
Regulated Futures Contracts Notice and
Street address (including apt. no.) 6 Profit or (loss) realized in| 7 Unrealized profit or (loss) on instructions for
1991 open contracts—12/31/90 completing this
Ss form,
City, state, and ZIP code $ $ Instructions for
Unrealized profit or (loss) on | 9 Aggregate profit or (loss) Forms 1099,
. open contracts— 12/31/91 1098, 5498
‘Account number (optional) 2nd TIN Not. q ,
and W-2G.
$ $
Form 1099-B Department of the Treasury - Internal Revenue Service
{voi =] CORRECTED

PAYER’S name, street address, city, state, and ZIP code la Date of sale ‘OMB No, 1545-0715 Proceeds From
Broker and
ib CUSIP No. 1991 Barter Exchange
Transactions
2 Stocks, bonds, etc. Reported } H Gross proceeds

$ toIRS Gross proceeds less commissions and option premiums

PAYER'S Federal identification number | RECIPIENT'S identification number | 3 Bartering 4 Federal income tax withheld
Copy C
RECIPIENT'S name 3 Description For Payer
For Paperwork
Regulated Futures Contracts Reduction jet
Street address (including apt. no.) 6 Profit or (loss) realizedin | 7 Unrealized profit or (loss) on instructions for
1991 open contacts—12/31/90 | Completing this
form, see
City, state, and ZIP code $ $ Instructions for
Unrealized profit or (loss) on | 9 Aggregate profit or (loss) Forms 1099,
open contracts—12/31/91 1098, 5498
‘Account number (optional) 2nd TIN Not. A "
$ $ and W-2G.
Form 1099-B Department of the Treasury - Internal Revenue Service

(voip =] CORRECTED .

PAYER’S name, street address, city, state, and ZIP code 1a Date of sale ‘OMB No. 1545-0715 Proceeds From
Broker and
1b CUSIP No. 1991 Barter Exchange
Transactions
2 Stocks, bonds, ete. Reported | H Gross proceads
toiRs Gross proceeds less commissions and option premiums
PAYER’S Federal identification number] RECIPIENT'S identification number | 3. Bartenng 4 Federal mcome tax withheld
$ Copy C
RECIPIENT'S name 5 Description For Payer
For Paperwork
Regulated Futures Contracts Reduction Act
Street address (including apt. no.) 6 Profit or (loss) realized in| 7 Unrealized profit or (loss) on instructions for
1991 ‘open contracts—12/31/90 completing this
City, state, and ZIP code $ $ In etre Sor
& Unrealized profit or (loss) on | 9 Aggregate profit or (loss) Forms 1099,
itr —12/31/91 "
‘Account number (optional) Bad TINNat | CPENCONHACES—12/31/8. 1098, 5498,
$ $ and W-2G.

Form 1099-B

Department of the Treasury - Internal Revenue Service


Instructions for Recipient

Brokers and barter exchanges must report proceeds from transactions to
the Internal Revenue Service. This form is used to report these proceeds.
You must report amounts from your Forms 1099-B in the applicable parts
of Schedule D (Form 1040) or Form 6781.

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 2.—Shows the proceeds from transactions involving stocks, bonds,
other debt obligations, commodities, or forward contracts. Losses on
forward contracts 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 IRS.

Box 3.—Shows the fair market value of any trade credits or scrip credited to
your account for exchanges of property or services as well as cash received.
See the instructions for your tax return on how to report this amount.

Box 4.—Shows backup withholding. For example, persons not furnishing
their taxpayer identification number to the payer become subject to backup

Brokers and barter exchanges must report proceeds from transactions to
the Internal Revenue Service. This form is used to report these proceeds.
You must report amounts from your Forms 1099-B in the applicable parts
of Schedule D (Form 1040) or Form 6781.

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 2.—Shows the proceeds from transactions involving stocks, bonds,
other debt obligations, commodities, or forward contracts. Losses on
forward contracts 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 IRS.

Box 3.—Shows the fair market value of any trade credits or scrip credited to
your account for exchanges of property or services as well as cash received.
See the instructions for your tax return on how to report this amount.

Box 4.—Shows backup withholding. For example, persons not furnishing
their taxpayer identification number to the payer become subject to backup

Instructions for Recipient

Brokers and barter exchanges must report proceeds from transactions to
the Internal Revenue Service. This form is used to report these proceeds.
You must report amounts from your Forms 1099-B in the applicable parts
of Schedule D (Form 1040) or Form 6781.

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 2.—Shows the proceeds from transactions involving stocks, bonds,
other debt obligations, commodities, or forward contracts. Losses on
forward contracts are shown in parentheses. This box does not include
proceeds from regulated futures contracts. The broker must indicate
whether gross proceeds or grass proceeds less commissions and option
premiums were reported to IRS.

Box 3.—Shows the fair market value of any trade credits or scrip credited to
your account for exchanges of property or services as well as cash received.
See the instructions for your tax return on how to report this amount.

Box 4.—Shows backup withholding. For example, persons not furnishing
their taxpayer identification number to the payer become subject to backup

withholding at a 20% rate on certain payments. 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.

Box 5.—Shows a brief description of the item or service for which the
proceeds are being reported. For regulated futures contracts and forward
contracts, “RFC” or other appropriate description, and any amount
subject to backup withholding, may be shown.

Box 6.—Shows the profit or (loss) realized on regulated futures or foreign
currency contracts closed during 1991.

Box 7.—Shows any year-end adjustment to.the pit or (loss) shown in
Box 6 due to open contracts on December 31, 1990.

Box 8.—Shows the unrealized profit or (loss) on open contracts held in
your account on December 31, 1991. These are considered sold as of that
date. This will become an adjustment reported in Box 7 in 1992.

Box 9.—Boxes 6, 7, and 8 are used to figure the aggregate profit or (loss)
on regulated futures or foreign currency contracts for the year. Include
this figure on your 1991 Form 6781, Gains and Losses From Section
1256 Contracts and Straddles.

withholding at a 20% rate on certain payments. 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.

Box 5.—Shows a brief description of the item or service for which the
proceeds are being reported. For regulated futures contracts and forward
contracts, “RFC” or other appropriate description, and any amount
subject to backup withholding, may be shown.

Box 6.—Showws the profit or (loss) realized on regulated futures or foreign
currency contracts closed during 1991.

Box 7.—Shows any year-end adjustment to the profit or (loss) shown in
Box 6 due to open contracts on December 31, 1990.

Box 8.—Shows the unrealized profit or (loss) on open contracts held in
your account on December 31, 1991. These are considered sold as of that
date. This will become an adjustment reported in Box 7 in 1992.

Box 9.—Boxes 6, 7, and 8 are used to figure the aggregate profit or (loss)
on regulated futures or foreign currency contracts for the year. Include
this figure on your 1991 Form 6781, Gains and Losses From Section
1256 Contracts and Straddles.

withholding at a 20% rate on certain payments. 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.

Box 5.—Shows a brief description of the item or service for which the
proceeds are being reported. For regulated futures contracts and forward
contracts, “RFC” or other appropriate description, and any amount
subject to backup withholding, may be shown.

Box 6.—Shows the profit or (loss) realized on regulated futures or foreign
currency contracts closed during 1991.

Box 7.—Shows any year-end adjustment to the pratt or (loss) shown in
Box 6 due to open contracts on December 31, 1990.

Box 8.—Shows the unrealized profit or (loss) on open contracts held in
your account on December 31, 1991. These are considered sold as of that
date. This will become an adjustment reported in Box 7 in 1992.

Box 9.—Boxes 6, 7, and 8 are used to figure the aggregate profit or (loss)
on regulated futures or foreign currency contracts for the year. Include
this figure on your 1991 Form 6781, Gains and Losses From Section
1256 Contracts and Straddles.


79749 Civoip — (-] CORRECTED

Type or machine print PAYER’S name, street address, city, state, and ZIP code | 1a Dateofsale(MMDDYY) | OMB No. 1545-0715 Proceeds From
Broker and
1b CUSIP No. 1991 Barter Exchange
Transactions

2 Stocks, bonds, etc. Reported } H Gross proceeds
$ tolRs Gross proceds less commissions and option premiums
PAYER'S Federal identification number _ | RECIPIENT'S identification number | 3 Bartering 4 Federal income tax withheld Copy A
$ For Internal
Revenue Service
Type or machine print RECIPIENT'S name 5. Description Center

File with Form 1096.

Regulated Futures Contracts

For Paperwork

Street address (including apt. no )

City, state, and ZIP code

6 Profit or (loss) realized in
1991

Reduction Act
Notice and
instructions for
completing this

7 Unrealized profit or (loss) on
‘open contracts— 12/31/90

Account number (optional)

2nd TIN Not.

$ $ form, see
8 Unrealized profit or (loss) on | 9 Aggregate profit or (loss) Instructions for
‘open contracts—12/31/91 Forms 1099,
1098, 5498,

$ $ and W-2G.

Form 1099-B

Department of the Treasury - Internal Revenue Service

Do NOT Cut or Separate Forms on This Page

79749 Civoip = [_] CORRECTED

“Type or machine print PAYER’S name, street address, city, state, and ZIP code | 1a Dateofsale(MMDDYY) | OMB No. 1545-0715 Proceeds From
Broker and
1b CUSIP No. 1991 Barter Exchange
Transactions

2 Stocks, bonds, ete. Reported | H Gross proceeds
$ toIRS Gross proceeds less commissions and option premiums
PAYERS Federal identification number | RECIPIENT'S identification number | 3 Bartering 4 Federal income tax withheld Copy A
$ $ For Internal
Revenue Service
Type or machine print RECIPIENT'S name 5 Description Center

File with Form 1096.

Regulated Futures Contracts

For Paperwork

Street address (including apt. no.)

City, state, and ZIP code

6 Profit or (loss) realized in
1991

$

Reduction Act
Notice and
instructions for
completing this
form, see

7 Unrealized profit or (loss) on
open contracts—12/31/90

$

‘Account number (optional)

2nd TIN Not.

‘8 Unrealized profit or (loss) on
‘open contracts— 12/31/91

$

Instructions for
Forms 1099,
1098, 5498,

and W-2G.

9 Aggregate profit or (loss)

$

Form 1099-B

Do NOT Cut or Separate Forms on This Page

Department of the Treasury - Internal Revenue Service

79749 [Clvoip [_] CORRECTED

Type or machine print PAYER’S name, street address, city, state, and ZIP code] 1a Dateofsale(MMDDYY) | OMB No. 1545-0715 Proceeds From
Broker and
1b CUSIP No. 1991 Barter Exchange
Transactions

2 Stocks, bonds, ete, Reported | H Gross proceeds
to IRS Gross proceeds less commissions and option premiums
PAYER’S Federal identification number | RECIPIENT'S identification number | 3. Bartening 4 Federal income tax withheld Copy A
$ For Internal
Revenue Service
Type or machine print RECIPIENT'S name 5 Description Center
File with Form 1096.
Regulated Futures Contracts For Paperwork
Street address (including apt. no.) 6 Profitor (loss) realized in | 7 Unrealized profit or (loss) on Reduction Act
1991 open contracts—12/31/90 Notice and
instructions for
i completing this
City, state, and ZIP code $ $ forny see
Unrealized profit or (loss) on | 9 Aggregate profit or (loss) Instructions for
open contracts—12/31/91 Forms 1099,
‘Account number (optional) 2nd TIN Not. toe 5498"
$ $ and W-2G.

Form 1099-B

Department of the Treasury - Internal Revenue Servic:




[LJ CORRECTED (if checked)

Street address (including apt. no.)

City, state, and ZIP code

Regulated Futi

ures Contracts

6 Profit or (loss) realized in
1991

$

7 Unrealized profit or (loss) on
‘open contracts—12/31/90

$

‘8 Unrealized profit or (loss) on
open contracts—12/31/91

9 Aggregate profit or (loss)

PAYER’S name, street address, city, state, and ZIP code Ja Date of sale ‘OMB No, 1545-0715 Proceeds From
Broker and
1b CUSIP No. 1991 Barter Exchange
Transactions
2 Stocks, bonds, ete. Reported | H Gross proceeds
$ to IRS Gross proceeds less commissions and option premiums
PAYER'S Federal identification number | RECIPIENT'S identification number | 3 Bartering 4 Federal income tax withheld Copy B
$ For Recipient
This is important tax
RECIPIENT'S name 5 Description information and is

being furnished to the
Internal Revenue
Service. If you are
required to file a
return, a neglience
penalty or other
sanction may be
imposed on you if this
income is taxable and
the IRS determines

Form 1099-B

(C1 CORRECTED (if checked)

‘Account number (optional) that thas not born
$ $ reported.
Department of the Treasury - Internal Revenue Service

Street address (including apt. no.)

City, state, and ZIP code

Regulated Futures Contracts

6 Profit or (loss) realized in
1991

$

7 Unrealized profit or (loss) on
open contracts—12/31/90

$

Account number (optional)

® Unrealized profit or (loss) on
open contracts—12/31/91

$

9 Aggregate profit or (loss)

$

PAYER’S name, street address, city, state, and ZIP code la Date of sale OMB No. 1545-0715 Proceeds From
Broker and
1b CUSIP No. 199 1 Barter Exchange
Transactions
2 Stocks, bonds, etc. Revortd | H Gross proceeds
tors} Gross proceeds less commissions and option premiums
PAYER'S Federal identification number RECIPIENT'S identification number | 3 Bartering 4 Federal income tax withheld! Copy B
$ For Recipient
This is important tax
RECIPIENT'S name 5 Description information and is

being furnished to the
Internal Revenue
Service. If you are
required to file a
return, a neglience
penalty or other
sanction may be
imposed on you if this
income is taxable and
the IRS determines
that it has not been
reported.

Form 1099-B

Department of the Treasury - I

(J CORRECTED (if checked)

PAYER’S name, street address, city, state, and ZIP code

la Dateof sale

‘OMB No. 1545-0715,

1b CUSIP No.

1991

Internal Revenue Service

Proceeds From
Broker and

Barter Exchange

Transactions

missions and option premiums

Street address (including apt. no.)

City, state, and ZIP code

2 Stocks, bonds, ete. Reported | H ‘Gross proceeds
to1RS_! |} Gross proceeds less com
PAYER'S Federal identification number | RECIPIENT'S identification number | 3 Bartering ‘4 Federal income tax withheld
$ $
RECIPIENT'S name 5 Description

Regulated Futures Contracts

6 Profit or (loss) realized in
1991

$

7 Unrealized profit or (loss) on
‘open contracts—12/31/90

$

8 Unrealized profit or (loss) on

‘Account number (optional)

open contracts—12/31/91

$

"9 Aggregate profit or (03s)

$

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 neglience
penalty or other
sanction may be
imposed on you if this
income is taxable and
the IRS determines
that it has not been
reported.

Form 1099-B

Department of the Treasury - I

Internal Revenue Service