PAYER’S federal identification number RECIPIENT’S identification number 3 Interest on U.S. Savings Bonds and Treas. obligations

$

RECIPIENT’S name 4 Federal income tax withheld 5 Investment expenses

$ $

Street address (including apt. no.) 6 Foreign tax paid

$

City, state, and ZIP code 8 Tax-exempt interest 9 Specified private activity bond interest

Account number (see instructions) 2nd TIN not.

$

Form 1099-INT Cat. No. 14410K Department of the Treasury - Internal R

Form 1099-INT

7 Foreign country or U.S. possession

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$

10 Tax-exempt bond CUSIP no. (see instructions)

$
PAYER’S federal identification number RECIPIENT’S identification number

RECIPIENT’S name

Street address (including apt. no.)

City, state, and ZIP code

Account number (see instructions)

Form 1099-INT Department of the Treasury - Internal R

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Form 1099-INT

3 Interest on U.S. Savings Bonds and Treas. obligations

$

4 Federal income tax withheld 5 Investment expenses

$ $

6 Foreign tax paid

$

7

$

8 Tax-exempt interest 9 Specified private activity bond interest

$

10 Tax-exempt bond CUSIP no. (see instructions)

$

Foreign country or U.S. possession
Box 1. Shows taxable interest paid to you during the calendar year by the

payer. This does not include interest shown in box 3. May also show the total

amount of the credits from clean renewable energy bonds, Gulf tax credit

bonds, qualified forestry conservation bonds, new clean renewable energy

bonds, qualified energy conservation bonds, qualified zone academy bonds,

Midwestern tax credit bonds, qualified school construction bonds, and build

America bonds that must be included in your interest income. These amounts

were treated as paid to you during 2010 on the credit allowance dates (March

15, June 15, September 15, and December 15). For more information, see

Form 8912, Credit to Holders of Tax Credit Bonds.

Box 6. Shows foreign tax paid. You may be able to claim this ta

tion or a credit on your Form 1040. See your Form 1040 instruc

Box 2. Shows interest or principal forfeited because of early withdrawal of time

savings. You may deduct this amount to figure your adjusted gross income on

your income tax return. See the instructions for Form 1040 to see where to

take the deduction. Nominees. If this form includes amounts belonging to another 

are considered a nominee recipient. Complete a Form 1099-INT 

the other owners showing the income allocable to each. File Co

form with the IRS. Furnish Copy B to each owner. List yourself 

and the other owner(s) as the “recipient.” File Form(s) 1099-INT 

1096 with the Internal Revenue Service Center for your area. O

yourself as the “filer.” A husband or wife is not required to file a 

return to show amounts owned by the other.

Box 3. Shows interest on U.S. Savings Bonds, Treasury bills, Treasury bonds,

and Treasury notes. This may or may not all be taxable. See Pub. 550. This

interest is exempt from state and local income taxes. This interest is not included in box 1.

amount is included in box 1.

Box 8. Shows tax-exempt interest, including exempt-interest di

mutual fund or other regulated investment company, paid to yo

calendar year by the payer. Report this amount on line 8b of Fo

Form 1040A. This amount may be subject to backup withholdin

Box 9. Shows tax-exempt interest subject to the alternative min

amount is included in box 8. See the Instructions for Form 6251

Box 10. Shows CUSIP number(s) for tax-exempt bond(s) on wh

interest was paid to you during the calendar year and reported 

blank, no CUSIP number was issued for the bond(s).
PAYER’S federal identification number RECIPIENT’S identification number

RECIPIENT’S name

City, state, and ZIP code

Account number (see instructions) 2nd TIN not.

Form 1099-INT Department of the Treasury - Internal R

Form 1099-INT

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Street address (including apt. no.)

3 Interest on U.S. Savings Bonds and Treas. obligations

$

4 Federal income tax withheld 5 Investment expenses

$ $

6

$

8 9

7

$

$

Specified private activity bond interest

Foreign country or U.S. possession

10 Tax-exempt bond CUSIP no. (see instructions)

Foreign tax paid

Tax-exempt interest

$
, g, 

1-800-TAX-FORM (1-800-829-3676).

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

January 31, 2011.

File Copy A of this form with the IRS by February 28, 2011.

If you file electronically, the due date is March 31, 2011. To

file electronically, you must have software that generates a

file according to the specifications in Pub. 1220,

Specifications for Filing Forms 1098, 1099, 3921, 3922, 5498,

8935, and W-2G Electronically. IRS does not provide a fill-in

form option.

mortgage interest.

Foreign recipient. If the recipient is a nonresiden

may have to withhold federal income tax and file 

1042-S, Foreign Person’s U.S. Source Income Su

Withholding. See the Instructions for Form 1042-S 

515, Withholding of Tax on Nonresident Aliens an

Entities.

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.

Need help? If you have questions about reporting 

1099-INT, call the information reporting customer 

toll free at 1-866-455-7438 or 304-263-8700 (not 

For TTY/TDD equipment, call 304-579-4827 (not t

The hours of operation are Monday through Frida

8:30 a.m. to 4:30 p.m., Eastern time.