Attention!

This form is provided for informational purposes and

should not be reproduced on personal computer

printers by individual taxpayers for filing. The

printed version of this form is a "machine readable"

form. As such, it must be printed using special

paper, special inks, and within precise specifications.

Additional information about the printing of these

specialized tax forms can be found in: Publication

1167, Substitute Printed, Computer-Prepared, and

Computer-Generated Tax Forms and Schedules; and,

Publication 1179, Specifications for Paper Document

Reporting and Paper Substitutes for Forms 1096,

1098, 1099 Series, 5498, and W-2G.

The publications listed above may be obtained by

calling 1-800-TAX-FORM (1-800-829-3676). Be sure

to order using the IRS publication number.
VOID CORRECTED

PAYER’S name, street address, city, state, and ZIP code Original issue discount OMB No. 1545-0117

for 1994

1

Original Issue

Discount 2 Other periodic interest

PAYER’S Federal identification number RECIPIENT’S identification number 3 Early withdrawal penalty 4 Federal income tax withheld

RECIPIENT’S name 5 Description

Street address (including apt. no.)

City, state, and ZIP code

Account number (optional) 2nd TIN Not.

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

$

$

$ $

Copy A

For Paperwork

Reduction Act

Notice and

instructions for

completing this form,

see Instructions for

Forms 1099, 1098,

5498, and W-2G.

File with Form 1096.

Do NOT Cut or Separate Forms on This Page

9696

Cat. No. 14421R

For

Internal Revenue

Service Center
CORRECTED (if checked)

PAYER’S name, street address, city, state, and ZIP code Original issue discount OMB No. 1545-0117

for 1994*

1

Original Issue

Discount 2 Other periodic interest

PAYER’S Federal identification number RECIPIENT’S identification number 3 Early withdrawal penalty 4 Federal income tax withheld

RECIPIENT’S name 5 Description

Street address (including apt. no.)

City, state, and ZIP code

Account number (optional)

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

$

$

$ $

Copy B

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.

(Keep for your records.)

* This may not be the correct figure to report on your

income tax return. See instructions on the back.

For Recipient
Instructions for Recipient

Original issue discount (OID) is the difference between the stated

redemption price at maturity and the issue price of a bond, debenture,

note, or other evidence of indebtedness, or the acquisition price of a

stripped bond or coupon. OID rules also apply to certificates of deposit

(CDs), time deposits, bonus savings plans, and other deposit

arrangements having a term of more than 1 year, provided the payment of

interest is deferred until maturity.

Box 2.—Shows other interest on this obligation for the year, which is an

amount separate from the OID. If you held the obligation the entire year,

report this amount as interest income on your tax return. If you disposed

of the obligation or acquired it from another holder during the year, see

Pub. 550, Investment Income and Expenses, for reporting instructions. If

you are a regular interest holder in a single-class REMIC (as defined in

regulations under section 67(c)), this amount includes your share of the

investment expenses of the REMIC, deductible as a “Miscellaneous

Deduction” on Schedule A (Form 1040) subject to the 2% limit.

OID is taxable as interest over the life of the obligation. If you are the

holder of one of these obligations, you must include a part of the OID in

your gross income each year you hold the obligation.

If, as the record holder, you receive Form 1099-OID showing amounts

belonging to another person, you are considered a nominee recipient.

You must file Form 1099-OID for each of the other owners showing the

amounts allocable to each. Furnish a Form 1099-OID to each owner. File

Form(s) 1099-OID with Form 1096, Annual Summary and Transmittal of

U.S. Information Returns, with the Internal Revenue Service Center for

your area. On each Form 1099-OID, list yourself as the “payer” and the

other owner as the “recipient.” On Form 1096, list yourself as the “filer.”

A husband or wife is not required to file a nominee return to show

amounts owned by the other. If you bought or sold an obligation during

the year and you are not a nominee, you are not required to issue or file

Form 1099-OID showing the OID or stated interest allocable to the

seller/buyer of the obligation.

Box 3.—Shows the interest or principal you forfeited if you withdrew the

money before the maturity date of the obligation, such as from a CD. You

may deduct this on your Federal income tax return only on the specific

line of Form 1040 under “Adjustments to Income.”

Box 4.—Shows backup withholding. For example, persons not furnishing

their taxpayer identification number to the payer become subject to

backup withholding at a 31% rate on certain payments shown on the

form. 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 1.—Shows the OID on the obligation for the part of the year you

owned it. Report the entire amount in box 1 as interest income on your

income tax return. However, if you paid acquisition or bond premium,

Box 5.—Shows the identification number (CUSIP number) or description

of the obligation. The description may include the stock exchange, issuer,

coupon rate, and year of maturity.

or if the obligation is a stripped bond or stripped coupon, you must

compute your proper amount of OID. If you must compute your proper

OID or you bought at market discount, see Pub. 1212, List of Original

Issue Discount Instruments, to figure the correct OID to report on your

tax return.
VOID CORRECTED

PAYER’S name, street address, city, state, and ZIP code Original issue discount OMB No. 1545-0117

for 1994

1

Original Issue

Discount 2 Other periodic interest

PAYER’S Federal identification number RECIPIENT’S identification number 3 Early withdrawal penalty 4 Federal income tax withheld

RECIPIENT’S name 5 Description

Street address (including apt. no.)

City, state, and ZIP code

Account number (optional) 2nd TIN Not.

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

$

$

$ $

Copy C

For Paperwork

Reduction Act

Notice and

instructions for

completing this

form, see

Instructions for

Forms 1099,

1098, 5498,

and W-2G.

For Payer
Payers, Please Note—

Specific information needed to complete this form and other

forms in the 1099 series is given in the Instructions for

Forms 1099, 1098, 5498, and W-2G. A chart in those

instructions gives a quick guide to which form must be filed

to report a particular payment. You can order those

instructions and additional forms by calling 1-800-TAX-FORM

(1-800-829-3676).

Furnish Copy B of this form to the recipient by January 31,

1995.

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

1995.