PAYER’S name, street address, city, state, ZIP code, and telephone no. Date of sale 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 Description 5

Street address (including apt. no.) Post–5/5/2003 profit or

(loss) realized

Profit or (loss) realized 6b

in 2003

6a

City, state, and ZIP code

$ $

Account number (optional) 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

2003 General

Instructions for

Forms 1099, 1098,

5498, and W-2G.

2003

7

$

Unrealized profit or (loss) on

open contracts—12/31/2002

8 Unrealized profit or (loss) on

open contracts—12/31/2003

9a Aggregate profit or (loss) 9b Post–5/5/2003 aggregate

profit or (loss)

$

$ $
Proceeds From

Broker and

Barter Exchange

Transactions

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.

CORRECTED (if checked)

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

1b CUSIP no.

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 5 Description

Street address (including apt. no.) Post–5/5/2003 profit or

(loss) realized

Profit or (loss) realized 6b

in 2003

6a

City, state, and ZIP code

$ $

Account number (optional)

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



(keep for your records)

Form 1099-B

2003

7

$

Unrealized profit or (loss) on

open contracts—12/31/2002

8 Unrealized profit or (loss) on

open contracts—12/31/2003

9a Aggregate profit or (loss) 9b Post–5/5/2003 aggregate

profit or (loss)

$

$ $
Instructions for Recipient

Brokers and barter exchanges must report proceeds from

transactions to you and to the Internal Revenue Service. This form is

used to report these proceeds.

Box 5. 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

Box 1a. Shows the trade date of the transaction. For aggregate description may be shown.

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 6a. Shows the profit or (loss) realized on regulated futures or

foreign currency contracts closed during 2003.

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 the IRS. Report

this amount on Schedule D (Form 1040), Capital Gains and Losses.

Box 7. Shows any year-end adjustment to the profit or (loss) shown

in box 6a due to open contracts on December 31, 2002.

Box 8. Shows the unrealized profit or (loss) on open contracts held

in your account on December 31, 2003. These are considered sold

as of that date. This will become an adjustment reported in box 7 in

2004.

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 9a. Boxes 6a, 7, and 8 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 2003 Form 6781, Part I,

column (b).

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.

Box 6b. Shows the portion of the amount shown in Box 6a closed

after May 5, 2003. Include this amount on your 2003 Form 6781,

Gains and Losses From Section 1256 Contracts and Straddles, Part

I, column (c).

Box 9b. Shows the portion of the amount shown in Box 9a after

May 5, 2003. Include this amount on your 2003 Form 6781, Part I,

column (c).

Regulated Futures Contracts:
Proceeds From

Broker and

Barter Exchange

Transactions

Copy C

For Payer

For Privacy Act

and Paperwork

Reduction Act

Notice, see the

2003 General

Instructions for

Forms 1099,

1098, 5498,

and W-2G.

VOID CORRECTED

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

1b CUSIP no.

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 Description 5

Street address (including apt. no.) Post–5/5/2003 profit or

(loss) realized

Profit or (loss) realized 6b

in 2003

6a

City, state, and ZIP code

$ $

Account number (optional)

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



Form 1099-B

2003

7

$

Unrealized profit or (loss) on

open contracts—12/31/2002

8 Unrealized profit or (loss) on

open contracts—12/31/2003

9a Aggregate profit or (loss) 9b Post–5/5/2003 aggregate

profit or (loss)

$

$

2nd TIN not.

$
Instructions for Payers

General and specific form instructions are provided as

separate products. The products you should use for 2003 are

the General Instructions for Forms 1099, 1098, 5498, and

W-2G and the separate specific instructions for each

information return you file. Specific information needed to

complete this form is given in the 2003 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,

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

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

February 2, 2004.

File Copy A of this form with the IRS by March 1, 2004. If

you file electronically, the due date is March 31, 2004.

Caution: Because the IRS processes paper forms by

machine (optical character recognition equipment), you

cannot file with the IRS Forms 1096, 1098, 1099, or 5498

that you print from the IRS website.