Clvoio

(_] CORRECTED

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

OMB No.1545-0112

1986

Statement for
Recipients of

Interest Income

PAYER’S Federal identification number

RECIPIENT'S identification number

T Earnings from savings and loan associations, credit unions, bank

deposits, bearer certificates of

deposit, etc.

Copy C
For Payer

RECIPIENT'S name (first, middle, last)

Street address

City, state, and ZIP code

2 Amount of forfeiture

3 U.S. Savings Bonds, etc.

For Paperwork
Reduction Act
Notice and

4 Federal income tax withheld

‘Account number (optional)

5 Foreign tax paid (if eligible for
foreign tax credit)

possession

6 Foreign country or U.S.

instructions for,
completing this
form, see
Instructions for
Forms 1099,
1098, 5498,
1096, and W-2G.

o

sc U.S. GOVERNMENT PRINTING OFFICE: 1985-463-163

Cvoip

(I CorRRECTED

Department of the Treasury - Internal Revenue Service

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

OMB No.1545-0112

1986

Statement for
Recipients of

Interest Income

PAYER'S Federal identification number

RECIPIENT'S identification number

T Earnings from savings and loan associations, credit unions, bank]

deposits, bearer certificates of

deposit, etc.

Copy C
For Payer

RECIPIENT'S name (first, middle, last)

Street address

City, state, and ZIP code

2 Amount of forfeiture

3 U.S. Savings Bonds, ete

For Paperwork
Reduction Act
Notice and

4 Federal income tax withheld

‘Account number (optional)

5 Foreign tax paid if eligible for
foreign tax credit)

possession

Oo

6 Foreign country or U.S.

instructions for.
completing this
form, see
Instructions for
Forms 1099,
1098, 5498,
1096, and W-2G.

vr U.S. GOVERNMENT PRINTING OFFICE: 1985-463-163

(voip

(_] CORRECTED

Department of the Treasury - Internal Revenue Service

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

OMB No.1545-0112

1986

Statement for
Recipients of

Interest Income

PAYER'S Federal identification number

RECIPIENT'S identification number

1 Earnings from savings and loan associations, credit unions, bank’

deposits, bearer certificates of

deposit, etc.

Copy C
For Payer

RECIPIENT'S name (first, middle, last)

Street address

City, state, and ZIP code

2 Amount of forfeiture

3 USS. Savings Bonds, etc.

For Paperwork
Reduction Act
Notice and

‘4 Federal income tax withheld

‘Account number (optional)

5 Foreign tax paid (if eligible for
foreign tax credit)

possession

6 Foreign country or U.S.

instructions for,
completing this
form, see
Instructions for
Forms 1099,
1098, 5498,
1096, and W-2G.

ve U.S. GOVERNMENT PRINTING OFFICE: 1985-463-163

Department of the Treasury - Internal Revenue Service


Instructions for Recipient

Box 1.— interest paid to you during the calendar year by
the payer, except interest included in Box 3.

If you receive a Form 1099-INT for interest paid on a tax-
exempt obligation, please see the instructions for your
1986 income tax return.

Box 2.— Interest or principal forfeited because of early
withdrawal of time savings. You may deduct this on your
Federal income tax return, Form 1040, even if you do not
itemize your deductions.

Box 3.—Interest on U.S. Savings Bonds, Treasury bills,
Treasury bonds, and Treasury notes. This may or may not
be all taxable. See Publication 550, Investment Income
and Expenses. This interest is exempt from state or local
income taxes.

Box 4.—Backup withholding. For example, persons not
furnishing their taxpayer identification number to the payer

Instructions for Recipient

Box 1.—Interest paid to you during the calendar year by
the payer, except interest included in Box 3.

If you receive a Form 1099-INT for interest paid on a tax-
exempt obligation, please see the instructions for your
1986 income tax return.

Box 2.— interest or principal forfeited because of early
withdrawal of time savings. You may deduct this on your
Federal income tax return, Form 1040, even if you do not
itemize your deductions.

Box 3.—Interest on U.S. Savings Bonds, Treasury bills,
Treasury bonds, and Treasury notes. This may or may not
be all taxable. See Publication 550, Investment Income
and Expenses. This interest is exempt from state or local
income taxes.

Box 4.—Backup withholding. For example, persons not
furnishing their taxpayer identification number to the payer

Instructions for Recipient

Box 1.—Interest paid to you during the calendar year by
the payer, except interest included in Box 3.

If you receive a Form 1099-INT for interest paid on a tax-
exempt obligation, please see the instructions for your
1986 income tax return

Box 2.—Interest or principal forfeited because of early
withdrawal of time savings. You may deduct this on your
Federal income tax return, Form 1040, even if you do not
itemize your deductions.

Box 3.—Interest on U.S. Savings Bonds, Treasury bills,
Treasury bonds, and Treasury notes. This may or may not
be all taxable. See Publication 550, Investment Income
and Expenses. This interest is exempt from state or local
income taxes.

Box 4.—Backup withholding. For example, persons not
furnishing their taxpayer identification number to the payer

become subject to backup withholding at a 20% rate. See
Form W-9, Payer’s Request for Taxpayer Identification
Number and Certification, for information on backup
withholding. Include this amount on your income tax
return as tax withheld.

If your Federal identification number is shown on this
form, and two or more recipients are shown or the form
includes amounts belonging to another person, you are
considered a nominee recipient. You must file Form
1099-INT for each of the other owners showing the
income allocable to each. File Form(s) 1099-INT with
Form 1096, Annual Summary and Transmittal of U.S.
Information Returns, at the Internal Revenue Service
Center for your area. On Forms 1099-INT and 1096, you
should be listed as the “payer.” On Form 1099-INT, the
other owner(s) should be listed as the “recipient.” A
husband or wife is not required to file a nominee return to
show payments for the other.

become subject to backup withholding at a 20% rate. See
Form W-9, Payer's Request for Taxpayer Identification
Number and Certification, for information on backup
withholding. Include this amount on your income tax
return as tax withheld.

If your Federal identification number is shown on this
form, and two or more recipients are shown or the form
includes amounts belonging to another person, you are
considered a nominee recipient. You must file Form
1099-INT for each of the other owners showing the
income allocable to each. File Form(s) 1099-INT with
Form 1096, Annual Summary and Transmittal of U.S.
Information Returns, at the Internal Revenue Service
Center for your area. On Forms 1099-INT and 1096, you
should be listed as the “payer.” On Form 1099-INT, the
other owner(s) should be listed as the “recipient.” A
husband or wife is not required to file a nominee return to
show payments for the other.

become subject to backup withholding at a 20% rate. See
Form W-9, Payer's Request for Taxpayer Identification
Number and Certification, for information on backup
withholding. Include this amount on your income tax
return as tax withheld.

'f your Federal identification number is shown on this
form, and two or more recipients are shown or the form
includes amounts belonging to another person, you are
considered a nominee recipient. You must file Form
1099-INT for each of the other owners showing the
income allocable to each. File Form(s) 1099-INT with
Form 1096, Annual Summary and Transmittal of U.S.
Information Returns, at the Internal Revenue Service
Center for your area. On Forms 1099-INT and 1096, you
should be listed as the “payer.” On Form 1099-INT, the
other owner(s) should be listed as the “recipient.” A
husband or wife is not required to file a nominee return to
show payments for the other.


OID = [R]CORRECTED _For Official Use Only

| Type or machine print PAYER'S name, street address, city, state, and ZIP code

1986 Interest Income

Statement for
Recipients of

* Gepost, bearer cerfcate of Gepost eta eM Copy A
For Internal
Revenue"
Service Center
For Paperwork
Reduction Act
Notice and
instructions for
completing this
form, see
Instructions for
Forms 1099,
1098, 5498,
eee . . 2 tf 1096, and W-2G:
Form 1099-INT Do NOT Cut or Separate Forms on This Page _€?2"tment of the Treasury - Internal Revenue Service
9292 [4 voip CORRECTED _ For Official Use Only
‘name, street address, city, state, and ZIP code ‘OMB No.1545-0112

1 986 Interest Income

Statement for

Recipients of

T Earnings from savings and loan associations, credit unions, bank| Copy A
deposits, bearer certificates of deposit, etc. For Internal

Revenue

Service Center

> —_ — . _ 7 For Paperwork
i Reduction Act
Notice and

instructions for

completing this

form, see

Instructions for

Forms 1099,

1098, 5498,

1096, and W-2G.

Form 1099-INT Do NOT Cut or Separate Forms on This Page _DePattment ofthe Treasury - Internal Revenue Service

9252 [voip = RJCORRECTED _For Official Use Only
i "| OMB No.1545-0112

1986

Statement for
Recipients of

Interest Income

24 1 Earnings from savings and loan associations, credit unions, bank Copy A
4 deposits, bearer certificates of deposit, etc. For Internal
——e- = Revenue

U.S. Savings Bonds, etc. Service Center

Reduction Act

Notice and

instructions for

completing this

form, see

), 4 . Instructions for

= . _— Se Forms 1099,

scount number (optional) Eo pe tench s 1098, 5498,
1096, and W-2G.

>| 2 sess < sos For Paperwork

Form 1099-INT Do NOT Cut or Separate Forms on This Page _eP2"tment of the Treasury - Internal Revenue Service




(1) CORRECTED

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

OMB No. 1545-0112

1986

Statement for
Recipients of

Interest Income

PAYER’S Federal identification number | RECIPIENT'S identification number

1 Earnings from savings and loan associations, credit unions, bank

deposits, bearer certificates of

Copy B
For Recipient
This is important tax

deposit, etc

RECIPIENT'S name (first, middle, last)

Street address

City, state, and ZIP code

2 Amount of forfeiture

3 US. Savings Bonds, etc. information and is
being furnished to
the Internal Revenue

Service. If you are

4 Federal income tax withheld

required to file a

y ]/ return, a negligence

Y penalty or other

‘Account number (optional)

5 Foreign tax pad (if eligible for
foreign tax credit)

sanction will be
imposed on you if this
income is taxable and
the IRS determines
that it has not been
reported.

6 Foreign country or U.S.
possession

Form 1099-INT

(-] CORRECTED

Department of the Treasury - Internal Revenue Service

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

(OMB No. 1545-0112

1986

Statement for
Recipients of

Interest Income

PAYER’S Federal identification number | RECIPIENT'S identification number

1 Earnings from savings and loan associations, credit unions, bank

deposits, bearer certificates of

Copy B
For Recipient
This is important tax

deposit, etc.

RECIPIENT'S name (first, middle, last)

Street address

City, state, and ZIP code

2 Amount of forfeiture

3 US. Savings Bonds, etc information and is
being furnished to
the Internal Revenue

Service. If you are

4 Federal income tax withheld

y required to file a
Y return, a negligence
Y penalty or other

‘Account number (optional)

5 Foreign tax paid (if eligible for
foreign tax credit)

sanction will be
imposed on you if this
income is taxable and
the IRS determines
that it has not been

6 Foreign country or U.S.
possession

reported.

Form 1099-INT

(FJ CORRECTED

Department of the Treasury - Internal Revenue Service

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

OMB No. 1545-0112

1986

Statement for
Recipients of

Interest Income

PAYER’S Federal identification number | RECIPIENT'S identification number

1 Earnings from savings and loan associations, credit unions, bank

deposits, bearer certificates of

Copy B
For Recipient
This is important tax

deposit, etc:

RECIPIENT'S name (first, middle, last)

Street address

City, state, and ZIP code

2 Amount of forfeiture

3 USS. Savings Bonds, etc. information and is
being furnished to
the Internal Revenue

Service. If you are

4 Federal income tax withheld

required to file a
return, a negligence
penalty or other

8

‘Account number (optional)

5 Foreign tax paid (if eligible for
foreign tax credit)

sanction will be
imposed on you if this
income is taxable and
the IRS determines
that it has not been
reported

6 Foreign country or U.S.
possession

Form 1099-INT

Department of the Treasury - Internal Revenue Service