VOID CORRECTED

CREDITOR’S name, street address, city, state, and ZIP code OMB No. 1545-1424

Cancellation

of Debt

CREDITOR’S federal identification number DEBTOR’S identification number 1 Date canceled 2 Amount of debt canceled

$

3 Interest if included in box 2

5

DEBTOR’S name

Street address (including apt. no.) Debt description

City, state, and ZIP code

Account number (see instructions)

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

8585

Cat. No. 26280W

6

$

4

Form 1099-C

Check for bankruptcy 7 Fair market value of property

$

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

2006 General

Instructions for

Forms 1099, 1098,

5498, and W-2G.

2006
CORRECTED (if checked)

CREDITOR’S name, street address, city, state, and ZIP code OMB No. 1545-1424

Cancellation

of Debt

CREDITOR’S federal identification number DEBTOR’S identification number 1 Date canceled 2 Amount of debt canceled

$

3 Interest if included in box 2

5

DEBTOR’S name

Street address (including apt. no.) Debt description

City, state, and ZIP code

Account number (see instructions)

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

Copy B

For Debtor

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

taxable income results

from this transaction

and the IRS determines

that it has not been

reported.

(keep for your records)

4

$

Form 1099-C

6 7 Bankruptcy (if checked) Fair market value of property

$

2006
Instructions for Debtor

If a federal government agency, certain agencies connected with the

Federal government, financial institution, credit union, or an organization

having a significant trade or business of lending money (such as a finance or

credit card company) cancels or forgives a debt you owe of $600 or more, this

form must be provided to you. Generally, if you are an individual, you must

include all canceled amounts, even if less than $600, on the “Other income”

line of Form 1040. If you are a corporation, partnership, or other entity, report

the canceled debt on your tax return. See the instructions for your tax return.

However, some canceled debts are not includible, or fully includible, in your

income, such as certain student loans (see Pub. 525), certain debts reduced

by the seller after purchase (see Pub. 334), qualified farm debt (see Pub. 225),

qualified real property business debt (see Pub. 334), or debts canceled in

bankruptcy (see Pub. 908). Do not report a canceled debt as income if you did

not deduct it but would have been able to do so on your tax return if you had

paid it. Also, do not include canceled debts in your income to the extent you

were insolvent. If you exclude a canceled debt from your income because it

was canceled in a bankruptcy case or during insolvency, or because the debt

is qualified farm debt or qualified real property business debt, or debt

canceled due to Hurricane Katrina, file Form 982, Reduction of Tax Attributes

Due to Discharge of Indebtedness (and Section 1082 Basis Adjustment).

Box 1. Shows the date the debt was canceled.

Box 2. Shows the amount of debt canceled.

Box 6. If the box is marked, the creditor has indicated the debt was canceled

in a bankruptcy proceeding.

Box 5. Shows a description of the debt. If box 7 is completed, box 5 shows a

description of the property.

Box 3. Shows interest if included in the canceled debt in box 2. See Pub. 525,

Taxable and Nontaxable Income, to see if you must include the interest in

gross income.

Box 7. If, in the same calendar year, a foreclosure or abandonment of property

occurred in connection with the cancellation of the debt, the fair market value

(FMV) of the property will be shown, or you will receive a separate Form

1099-A, Acquisition or Abandonment of Secured Property. Generally, the gross

foreclosure bid price is considered to be the FMV. For an abandonment or

voluntary conveyance in lieu of foreclosure, the FMV is generally the appraised

value of the property. You may have income or loss because of the acquisition

or abandonment. See Pub. 544, Sales and Other Dispositions of Assets, for

information about foreclosures and abandonments.

Account number. May show an account or other unique number the creditor

assigned to distinguish your account.

Note. You may not have to include in income a canceled debt (for example,

cancellation of a mortgage) if you are an individual whose principal residence

was in the Hurricane Katrina disaster area on August 25, 2005. This relief

applies to discharges made on or after August 25, 2005, and before January 1,

2007. For more details, see Pub. 4492, Tax Information Related to Hurricanes

Katrina, Rita, and Wilma, and the instructions below for canceled debt not

included in income.
VOID CORRECTED

CREDITOR’S name, street address, city, state, and ZIP code OMB No. 1545-1424

Cancellation

of Debt

CREDITOR’S federal identification number DEBTOR’S identification number 1 Date canceled 2 Amount of debt canceled

$

3 Interest if included in box 2

5

DEBTOR’S name

Street address (including apt. no.) Debt description

City, state, and ZIP code

Account number (see instructions)

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

$

4

Form 1099-C

6 7 Check for bankruptcy Fair market value of property

$

For Creditor

For Privacy Act

and Paperwork

Reduction Act

Notice, see the

2006 General

Instructions for

Forms 1099,

1098, 5498,

and W-2G.

Copy C

2006
Instructions for Creditors

General and specific form instructions are provided as

separate products. The products you should use to complete

Form 1099-C are the 2006 General Instructions for Forms

1099, 1098, 5498, and W-2G, and the 2006 Instructions for

Forms 1099-A and 1099-C. 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 debtor by

January 31, 2007.

File Copy A of this form with the IRS by February 28, 2007.

If you file electronically, the due date is April 2, 2007. To file

electronically, you must have software that generates a file

according to the specifications in Pub. 1220, Specifications

for Filing Forms 1098, 1099, 5498, and W-2G Electronically

or Magnetically. IRS does not provide a fill-in form option.

Caution: Because paper forms are scanned during

processing, you cannot file Forms 1096, 1098, 1099, or 5498

that you download and print from the IRS website.