2016 / 2017 w2, 1099, payroll and aca 1095 catalog

Real Business Solutions

Your reliable source for Payroll Software, W2/1099

Software and tax forms

www.PayrollMate.com • 1-800-507-1992

®

2016 - 2017

1095 Mate

1094-C / 1095-C Printing

and E-�ling SoftwarePayroll Mate

Best Value inPayroll Software

Wide Range of TaxForms and Envelopes

Including W2s and 1099s

W2 Mate

W2 and 1099 Printing

and E-�ling Software

Big Selectionof Computer

Checks and Envelopes

Payroll Mate Receives 4.5 Stars out of 5 by the CPA Practice Advisor Magazine

4.5

We are pleased to o�er youour products catalog:Payroll Mate software allows usersto prepare payroll, pay employees,calculate payroll taxes, print payrollchecks generate payroll reports,export payroll data to ERP / accounting software and processpayroll forms.

You will also �nd W2 MateSoftware for preparing,printing and E-�ling: W2,1099-MISC, 1099-INT, 1099-DIV, 1099-K, 1099-R,1099-S, 1098-T, 1098, 1099-A,1099-B, 1099-C, 1099-OIDand 1099-PATR forms.

You can also rely on1095 Mateto meet your A�ordable CareAct reporting requirements.

To compliment our softwareyou will also �nd a widerange of checks, tax formsand compatible envelopes,all guaranteed to be 100%compliant with governmentregulations.

Please don’t hesitate to call ifyou have a question or needinformation about a productor tax form.

W2/1099 Software......................................................1Payroll Software...........................................................2Payroll Mate Compatible Checks...........................3W-2/1099 Kits...............................................................4W-2 Forms......................................................................51099-MISC Forms........................................................61099-INT/1099-DIV/1099-R Forms........................71099-S/1098-T/1098 Forms.....................................81099-A/1099-B/1099-C Forms................................91099-OID/1099-PATR/ 1099-K.............................. 10W-2 Envelopes and Perforated Paper................ 111099 Envelopes and Perforated Paper.............. 12W-2/1099 Sets............................................................ 13

Tax FormsA complete line of W-2 and 1099 tax forms areavailable. If you are ready to place your order or you can’t �nd what you are looking for,please do not hesitate to call our sales teamat: 800-507-1992.

Real Business Solutions - PO Box 1010 - Orland Park, IL 60462Website: www.W2Mate.com

To place your order call 800-507-1992

Place your order online at:

www.W2Mate.com

www.W2Mate.com • 1-800-507-1992 1

W2 Mate Features

W3, W2 Copy A, W2 Copy B, W2 Copy C, W2 Copy D, W2 Copy State 1 and Copy State 2

IMPORTS DATA FROM QUICKBOOKS, PEACHTREE, DACEASY,M.S. DYNAMICS, AND CSV

This option allows users to import W2 and 1099 data from QuickBooks, Microsoft Dynamics GP, DacEasy, andCSV / Excel format. Import 1099 data from Peachtree. Import W2 data from electronic filing format (EFW2 format) andimport 1099 data from 1099 electronic filing format (IRS publication 1220 format).

REQUIRESOPTION #1

This option allows you to create SSA and IRS E-File submissions for W-2 and 1099 forms supported by W2 Mate.**

REQUIRESOPTION #2

*SSA requires that forms submitted to SSA in black and white must be printed from a laser printer (non-reflective ink).**You must have an IRS Transmitter Control Code (TCC) in order to send your 1099 to the IRS electronically. The SSA requires all transmitters to register for W2 reporting.***Utility requires W2 Mate software and W2 Mate Option #6 for the same tax year.

PRINTS ON THE FOLLOWING OFFICIAL IRS LASER FORMS:

Automatically calculates totals for W3 and 1096. Exports W2 and 1099 forms to Excel. Password protection and Data validation.Generates Mailing Labels. Backup and Restore Capability. Data Rollover from year to year.

This feature allows you to create employee copies of W2 form and recipient copies of 1099 form in PDF format (with password protection for security purposes). The resulting PDF file(s) can then be sent to employees/recipients instead of paper copies.

REQUIRESOPTION #3

REQUIRESOPTION #4

REQUIRESOPTION #5

1096, 1099-MISC Copy A, 1099-MISC Copy B, 1099-MISC Copy C, 1099-MISC Copy State 1 and1099-MISC Copy State 2

PRINTS THE FOLLOWING FORMS ON BLANK PAPER WITH BLACK INK:

W2 Copy B, W2 Copy C, W2 Copy D, W2 Copy State 1 and W2 Copy State 2

1099-MISC Copy B, 1099-MISC Copy C, 1099-MISC Copy State 1 and 1099-MISC Copy State 2

PRINTS SSA APPROVED FORMS ON BLANK PAPER WITH BLACK INK:

This option adds the ability to W2 Mate to print government-approved substitutes for forms W2 Copy A and W3 on plain white paper using a laser printer.*

NETWORK SUPPORT

With this option you can share the data managed by W2 Mate between more than one machine on your network.

ELECTRONIC FILING**

1099 (INT, DIV, K, R, S, A, B , C, PATR, OID), 1098 and 1098-T

GENERATES PASSWORD-PROTECTED W2 AND 1099-MISC FORMS IN PDF FORMAT

This option prints on blank paper 1099-INT,1099-DIV,1099-S,1098-T,1098,1099-A ,1099-B,1099-C,1099-PATR,1099-OIDcopies (B and C) and1099-R Copies (B, C and D). It also prints on official IRS laser forms 1099-INT,1099-DIV,1099-S,1098-T,1098,1099-A ,1099-B,1099-C,1099-PATR,1099-OID, 1099-R and 1099-K.

REQUIRESOPTION #6

W2 Mate generates forms for one tax year only. Other years would require a purchase of W2 Mate for that specific year.

1099 Emailer is bulk email sending utility that allows users to automatically batch e-mail to recipient's emails W2,1099, and 1098 forms in PDF format instead of mailing out hard copy forms ***

AUTOMATICALLY BATCH EMAIL PDF 1099S / W2S REQUIRES1099 EMAILER

1

Our W2 Forms and 1099 FormsPrinting/E-filing software is veryeasy, powerful and yet veryaffordable. W2 Mate fits theneeds of most users regardlessof their W2 and 1099 Formspreparation needs.

So if you are a small businesspreparing W2 Forms for youremployees in house, you are amid-size business preparing1099 Forms for your contractors,or printing W2 Forms from yourlegacy accounting software, orif you are an accountantpreparing W2/1099 forms andtransmittals for your clientsthen W2 Mate is definitely for you.

The Ultimate W2 & 1099 Forms Printing and E-Filing Software

Your reliable source for Payroll Software, W2/1099 Software and tax forms.22

Finally a payroll program that is easy, powerful and most importantly affordable. Payroll Mate is a complete software for payroll, that fits the needs of most users regardless of their payroll needs.

So if you are an accountant preparing payroll for your clients, you are a small business doing your payroll in house, or you are payroll services provider, Payroll Mate will do the job for you.

Payroll Mate greatly reduces the time to prepare payroll, create forms and print checks: Payroll Mate automatically calculates net pay, federal withholding tax, Social Security tax, Medicare, state and local payroll taxes.

Payroll Mate also supports different types of payroll pay periods, prints checks, prepares payrol1 forms 941, 943, 944, 940, W2 and W3. Payroll Mate also supports user-defined Income, Tax, and Deduction categories making it very flexible and powerful.

**Please check online to see if your state is supported.

Vendor Center REQUIRES OPTION #6

Payroll Mate Features

Prints on preprinted red scannable W2 Copy A and W3 forms

Supports customizable income, tax and deductions categories

Supports income per mile and per piece

Supports fringe benefi ts Generates comprehensive reports including payroll journal, tax liability and deposit requirement

Prints forms 940, 941, 943, 944, W2 Copy B, W2 Copy C, W2 Copy D, W2 Copy State 1 and W2 Copy State 2 on blank paper

Exports Payroll reports to Excel, CSV and PDF

Automatically calculates federal and state tax withholding

Prints on Laser and Inkjet checks

Free updates during the tax year

One step backup and restore

Number of companies supported

Number of employees per company

Prints SSA approved W2 Copy A and W3 forms on blank paper REQUIRES OPTION #1

Generates Direct Deposit File REQUIRES OPTION #2

Ability to support up to 100 Companies and 1000 Employees per company

Ability to print MICR checks on blank check stock

Support for State Payroll Tax reporting**

Login password

REQUIRES OPTION #3

REQUIRES OPTION #4

REQUIRES OPTION #5

Exports payroll check data into formats importable by QuickBooks, Quicken and other small business accounting software solutions.

Export Payroll Data to Peachtree (Sage50)

Import Employee list from CSV and Peachtree (Sage50)

Payroll Mate Networking NETWORK OPTION

10

75

www.PayrollMate.com 1-800-507-1992 33

We offer Payroll Mate compatible checks and envelopes at very low

prices

Save addressing time with dual window envelopes!Use this double window envelope for convenience when mailing checks. Guaranteed to work with Payroll Mate Laser or Ink Jet Payroll Checks.

For check orders, send us a sample voided check. We will print the account number as shown on the sample voided check. Please indicate any changes on the face of the voided check. Fax this order form along with the voided check to 708-590-0910. Once we have received your order, you will receive an e-mail requesting to approve a proof of the check. If you have any questions, please contact our support team at 708-479-8731.

Double-Window Compatible

Check Envelope#CK2UPENVRB

Payroll Mate Blank Check Stock

We also offer blank check

stock

22222 Voida Employee’s social security number For O�cial Use Only �

OMB No. 1545-0008

b Employer identi�cation number (EIN)

c Employer’s name, address, and ZIP code

d Control number

e Employee’s �rst name and initial Last name Su�.

f Employee’s address and ZIP code

1 Wages, tips, other compensation 2 Federal income tax withheld

3 Social security wages 4 Social security tax withheld

5 Medicare wages and tips 6 Medicare tax withheld

7 Social security tips 8 Allocated tips

9 10 Dependent care bene�ts

11 Nonquali�ed plans 12a See instructions for box 12Co d e

12bCo d e

12cCo d e

12dCo d e

13 Statutory employee

Retirement plan

Third-party sick pay

14 Other

15 State Employer’s state ID number 16 State wages, tips, etc. 17 State income tax 18 Local wages, tips, etc. 19 Local income tax 20 Locality name

Form W-2 Wage and Tax Statement

Copy A For Social Security Administration — Send this entire page with Form W-3 to the Social Security Administration; photocopies are not acceptable.

Department of the Treasury—Internal Revenue Service For Privacy Act and Paperwork Reduction Act Notice, see the separate instructions.

Cat. No. 10134D

Do Not Cut, Fold, or Staple Forms on This Page


OMB No. 1545-0008



d Control number









12bCo d e

12cCo d e

12dCo d e


Retirement plan


14 Other





Cat. No. 10134D


Form 1099-MISC

Cat. No. 14425J

Miscellaneous Income

Copy AFor

Internal Revenue Service Center

Department of the Treasury - Internal Revenue Service

File with Form 1096.

OMB No. 1545-0115

For Privacy Act and Paperwork

Reduction Act Notice, see the

2015 General Instructions for

Certain Information

Returns.

9595 VOID CORRECTEDPAYER’S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.

PAYER’S federal identi�cation number RECIPIENT’S identi�cation number

RECIPIENT’S name

Street address (including apt. no.)

City or town, state or province, country, and ZIP or foreign postal code

Account number (see instructions) FATCA �ling requirement

2nd TIN not.

1 Rents

$2 Royalties

$3 Other income

$4 Federal income tax withheld

$5 Fishing boat proceeds

$

6 Medical and health care payments

$7 Nonemployee compensation

$

8 Substitute payments in lieu of dividends or interest

$9 Payer made direct sales of

$5,000 or more of consumer products to a buyer (recipient) for resale �

10 Crop insurance proceeds

$11 12

13 Excess golden parachute payments

$

14 Gross proceeds paid to an attorney

$15a Section 409A deferrals

$

15b Section 409A income

$

16 State tax withheld

$$

17 State/Payer’s state no. 18 State income

$$

Form 1099-MISC www.irs.gov/form1099misc

Do Not C ut or S e pa ra t e F orms on T his P a ge — Do Not C ut or S e pa ra t e F orms on T his P a ge

Form 1099-MISC

Cat. No. 14425J


Copy AFor




OMB No. 1545-0115




Certain Information

Returns.



RECIPIENT’S name




2nd TIN not.

1 Rents

$2 Royalties

$3 Other income



$



$





$11 12


$



$


$


$$


$$




All you need to file your W2 and 1099 Forms!

W2 KitIncludes: • 30 W-2 Copy A Laser or Ink Jet Forms • 5 W-3 Summary Forms • W2 Mate software

W2 Mate will print Copies B, C, D, State 1 and State 2 on blank paper with black ink.

1099 KitIncludes • 30 1099-Misc Copy A Laser or Ink Jet Forms • 5 1096 Summary Forms • W2 Mate software

W2 Mate will print Copies B, C, State 1 and State 2 on blank paper with black ink.

1099 Kit#1099KIT08

Kits

1099 Kit#1099KIT08

Do Not Staple

Form 1096Department of the Treasury Internal Revenue Service

Annual Summary and Transmittal of U.S. Information Returns

OMB No. 1545-0108

FILER'S name

Street address (including room or suite number)


Name of person to contact Telephone number

Email address Fax number

For O�cial Use Only

1 Employer identi�cation number 2 Social security number 3 Total number of forms 4 Federal income tax withheld

$

5 Total amount reported with this Form 1096

$6 Enter an “X” in only one box below to indicate the type of form being �led.

W-2G 32

1097-BTC 50

1098 81

1098-C 78

1098-E 84

1098-Q 74

1098-T 83

1099-A 80

1099-B 79

1099-C 85

1099-CAP 73

1099-DIV 91

1099-G 86

1099-INT 92

1099-K 10

1099-LTC 93

1099-MISC 95

1099-OID 96

1099-PATR 97

1099-Q 31

1099-R 98

1099-S 75

1099-SA 94

3921 25

3922 26

5498 28

5498-ESA 72

5498-SA 27

7 If this is your �nal return , enter an “X” here . . . . . �

Return this entire page to the Internal Revenue Service. Photocopies are not acceptable.

Under penalties of perjury, I declare that I have examined this return and accompanying documents, and, to the best of my knowledge and belief, they are true, correct, and complete.

Signature � Title � Date �

InstructionsFuture developments. For the latest information about developments related to Form 1096, such as legislation enacted after it was published, go to www.irs.gov/form1096.Reminder. The only acceptable method of �ling information returns with Internal Revenue Service/Information Returns Branch is electronically through the FIRE system. See Pub. 1220, Speci�cations for Electronic Filing of Forms 1097, 1098, 1099, 3921, 3922, 5498, and W-2G.Purpose of form. Use this form to transmit paper Forms 1097, 1098, 1099, 3921, 3922, 5498, and W-2G to the Internal Revenue Service. Do not use Form 1096 to transmit electronically. For electronic submissions, see Pub. 1220.Caution. If you are required to �le 250 or more information returns of any one type, you must �le electronically. If you are required to �le electronically but fail to do so, and you do not have an approved waiver, you may be subject to a penalty. For more information, see part F in the 2015 General Instructions for Certain Information Returns.Who must �le. The name, address, and TIN of the �ler on this form must be the same as those you enter in the upper left area of Forms 1097, 1098, 1099, 3921, 3922, 5498, or W-2G. A �ler is any person or entity who �les any of the forms shown in line 6 above.

Enter the �ler’s name, address (including room, suite, or other unit number), and TIN in the spaces provided on the form.

When to �le. File Form 1096 as follows.• With Forms 1097, 1098, 1099, 3921, 3922, or W-2G, file by February 29, 2016.• With Forms 5498, file by May 31, 2016.

Where To FileSend all information returns �led on paper with Form 1096 to the following.

If your principal business, o�ce or agency, or legal residence in

the case of an individual, is located in

Use the following three-line address

� �

Alabama, Arizona, Arkansas, Connecticut, Delaware, Florida, Georgia, Kentucky, Louisiana, Maine, Massachusetts, Mississippi, New Hampshire, New Jersey, New Mexico, New York, North Carolina, Ohio, Pennsylvania, Rhode Island, Texas, Vermont, Virginia, West Virginia

Department of the Treasury Internal Revenue Service Center

Austin, TX 73301

For more information and the Privacy Act and Paperwork Reduction Act Notice, see the 2015 General Instructions for Certain Information Returns.

Cat. No. 14400O Form 1096 (2015)

DO NOT STAPLE

33333a Control number For O�cial Use Only �

OMB No. 1545-0008

b Kind of Payer (Check one)

941 Military 943 944

CT-1Hshld. emp.

Medicare govt. emp.

Kind of Employer (Check one)

None apply 501c non-govt.

State/local non-501c State/local 501c Federal govt.


(Check if

applicable)

c Total number of Forms W-2 d Establishment number

e Employer identi�cation number (EIN)

f Employer’s name

g Employer’s address and ZIP code

h Other EIN used this year






11 Nonquali�ed plans 12a Deferred compensation

12b13 For third-party sick pay use only

14 Income tax withheld by payer of third-party sick pay15 State Employer’s state ID number

16 State wages, tips, etc. 17 State income tax 18 Local wages, tips, etc. 19 Local income tax

Employer's contact person Employer's telephone number For O�cial Use Only

Employer's fax number Employer's email address

Under penalties of perjury, I declare that I have examined this return and accompanying documents and, to the best of my knowledge and belief, they are true, correct, and complete.


Form W-3 Transmittal of Wage and Tax Statements Department of the Treasury Internal Revenue Service

Send this entire page with the entire Copy A page of Form(s) W-2 to the Social Security Administration (SSA). Photocopies are not acceptable. Do not send Form W-3 if you �led electronically with the SSA. Do not send any payment (cash, checks, money orders, etc.) with Forms W-2 and W-3.

ReminderSeparate instructions. See the 2016 General Instructions for Forms W-2 and W-3 for information on completing this form. Do not �le Form W-3 for Form(s) W-2 that were submitted electronically to the SSA.

Purpose of FormA Form W-3 Transmittal is completed only when paper Copy A of Form(s) W-2, Wage and Tax Statement, is being �led. Do not �le Form W-3 alone. All paper forms must comply with IRS standards and be machine readable. Photocopies are not acceptable. Use a Form W-3 even if only one paper Form W-2 is being �led. Make sure both the Form W-3 and Form(s) W-2 show the correct tax year and Employer Identi�cation Number (EIN). Make a copy of this form and keep it with Copy D (For Employer) of Form(s) W-2 for your records. The IRS recommends retaining copies of these forms for four years.

E-FilingThe SSA strongly suggests employers report Form W-3 and Forms W-2 Copy A electronically instead of on paper. The SSA provides two free e-�ling options on its Business Services Online (BSO) website:• W-2 Online. Use �ll-in forms to create, save, print, and submit up to 50 Forms W-2 at a time to the SSA.• File Upload. Upload wage �les to the SSA you have created using payroll or tax software that formats the �les according to the SSA’s Speci�cations for Filing Forms W-2 Electronically (EFW2).

W-2 Online �ll-in forms or �le uploads will be on time if submitted by March 31, 2017. For more information, go to www.socialsecurity.gov/employer . First time �lers, select “ Go to Register ”; returning �lers select “Go To Log In .”

When To FileMail Form W-3 with Copy A of Form(s) W-2 by February 28, 2017.

Where To File Paper FormsSend this entire page with the entire Copy A page of Form(s) W-2 to:

Social Security Administration Data Operations Center Wilkes-Barre, PA 18769-0001

Note: If you use “Certi�ed Mail” to �le, change the ZIP code to “18769-0002.” If you use an IRS-approved private delivery service, add “ATTN: W-2 Process, 1150 E. Mountain Dr.” to the address and change the ZIP code to “18702-7997.” See Publication 15 (Circular E), Employer’s Tax Guide, for a list of IRS-approved private delivery services.

For Privacy Act and Paperwork Reduction Act Notice, see the separate instructions.

800-507-1992

www.W2Mate.com

XP, Vista, 7, 8,10

RFor Windows

R

R

800-507-1992

www.W2Mate.com

XP, Vista, 7, 8,10

RFor Windows

R

R

W2 Kit#W2KIT08

www.PayrollMate.com • 1-800-507-1992 55

W-2 Forms

• SSA - compliant forms guaranteed compatible with W2 Mate, Payroll Mate or your W2 Filing Software

• Each 8½” x 11” sheet is developed in compliance with IRS regulations

• Order the quantity equal to the number of employees for which you file

W-2 Forms

Item Number Description Envelope

Traditional Forms

W3FED08RB W-3 Transmittal Form –W2FED08RB W-2 Employer Federal Copy A –W2B08RB W-2 Employee Federal Copy B W2UPENVRB

W2C08RB W-2 Employee File Copy C W2UPENVRBW2D08RB W-2 Employer File Copy D –W2S108RB W-2 Employer State/City Copy 1 –W2S208RB W-2 Employee State/City Copy 2 W2UPENVRB

EMPLOYER’S COPY

Copy A: For Social Security AdministrationCopy 1: For State, City or Local Tax Department Copy D: For Employer’s Records

EMPLOYEE’S COPY Copy B: Filed with Employee’s federal Tax Return Copy C: For Employee’s RecordsCopy 2: Filed with Employee’s State, City or Local Income Tax Return

W-2 Employer Federal Copy A#W2FED08RB

W-2 Employee File Copy C#W2C08RB

W-2 Employee Federal Copy B#W2B08RB

W-2 Employee State/City Copy 2#W2S208RB

W-2 Employer State/City Copy 1#W2S108RB

W-2 Employer File Copy D#W2D08RB

W-3 Transmittal Form

Great for Small Business!


OMB No. 1545-0008



d Control number









12bCo d e

12cCo d e

12dCo d e


Retirement plan


14 Other





Cat. No. 10134D



OMB No. 1545-0008



d Control number









12bCo d e

12cCo d e

12dCo d e


Retirement plan


14 Other





Cat. No. 10134D


DO NOT STAPLE


OMB No. 1545-0008



CT-1Hshld. emp.

Medicare govt. emp.





(Check if

applicable)



f Employer’s name





















W-2 Online �ll-in forms or �le uploads will be on time if submitted by www.socialsecurity.gov/

employer . First time �lers, select “ Go to Register ”; returning �lers select “Go To Log In .”






22222a Employee’s social security number

OMB No. 1545-0008



d Control number








11 Nonquali�ed plans 12a Co d e

12bCo d e

12cCo d e

12dCo d e


Retirement plan


14 Other



Department of the Treasury—Internal Revenue Service


OMB No. 1545-0008



d Control number









12bCo d e

12cCo d e

12dCo d e


Retirement plan


14 Other





OMB No. 1545-0008



d Control number









12bCo d e

12cCo d e

12dCo d e


Retirement plan


14 Other





OMB No. 1545-0008



d Control number









12bCo d e

12cCo d e

12dCo d e


Retirement plan


14 Other





OMB No. 1545-0008



d Control number









12bCo d e

12cCo d e

12dCo d e


Retirement plan


14 Other





OMB No. 1545-0008



d Control number









12bCo d e

12cCo d e

12dCo d e


Retirement plan


14 Other





OMB No. 1545-0008



d Control number









12bCo d e

12cCo d e

12dCo d e


Retirement plan


14 Other





OMB No. 1545-0008



d Control number









12bCo d e

12cCo d e

12dCo d e


Retirement plan


14 Other





OMB No. 1545-0008



d Control number









12bCo d e

12cCo d e

12dCo d e


Retirement plan


14 Other





OMB No. 1545-0008



d Control number









12bCo d e

12cCo d e

12dCo d e


Retirement plan


14 Other




#W3FED08RB

W-2 Form Parts Description


1099-MISC Forms

• IRS - compliant forms guaranteed compatible with W2 Mate or your 1099 printing software


• Order the quantity equal to the number of recipients for which you file

1099-MISC Federal Copy A#MISFED08RB

1099-MISC Forms


1096FED08RB 1096 Transmittal Form –MISFED08RB 1099-MISC Federal Copy A –MISREC08RB 1099-MISC Recipient Copy B 10992UPENV08RB

MISPAY08RB 1099-MISC Payer Copy C –MIS108RB 1099-MISC Payer State Copy 1 –MIS208RB 1099-MISC Recipient State Copy 2 10992UPENV08RB

1099-MISC Payer Copy C#MISPAY08RB

1099-MISC Recipient Copy B

1099-MISC Recipient State Copy 2#MIS208RB

1099-MISC Payer State Copy 1#MIS108RB

1096 Transmittal Form#1096FED08RB

PAYER’S COPY

Copy A: For Internal Revenue ServiceCopy C: For Payer’s record State 1: For State, City, or Local Tax Department

RECIPIENT’S COPY

Copy B: To be filed with Recipient’sTax ReturnState 2: To be filed with Recipient’s State, City, or Local Income Tax Return

Form 1099-MISC

Cat. No. 14425J


Copy AFor




OMB No. 1545-0115



Instructions for

Certain Information

Returns.



RECIPIENT’S name




2nd TIN not.

1 Rents

$2 Royalties

$3 Other income



$



$





$11 12


$



$


$


$$


$$



Form 1099-MISC

Cat. No. 14425J


Copy AFor




OMB No. 1545-0115



Instructions for

Certain Information

Returns.



RECIPIENT’S name




2nd TIN not.

1 Rents

$2 Royalties

$3 Other income



$



$





$11 12


$



$


$


$$


$$



Form 1099-MISC


Copy 1For State Tax

Department


OMB No. 1545-0115VOID CORRECTED

PAYER’S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.


RECIPIENT’S name




1 Rents

$2 Royalties

$3 Other income



$



$





$11 12


$



$


$


$$


$$


Form 1099-MISC


Copy 1For State Tax

Department





RECIPIENT’S name




1 Rents

$2 Royalties

$3 Other income



$



$





$11 12


$



$


$


$$


$$


Form 1099-MISC


Copy BFor Recipient


This is important tax information and is being furnished to

the Internal Revenue Service. If you are

required to �le 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.

OMB No. 1545-0115CORRECTED (if checked)



RECIPIENT’S name




1 Rents

$2 Royalties

$3 Other income



$



$





$11 12


$



$


$


$$


$$

Form 1099-MISC (keep for your records) www.irs.gov/form1099misc

Form 1099-MISC


Copy BFor Recipient












RECIPIENT’S name




1 Rents

$2 Royalties

$3 Other income



$



$





$11 12


$



$


$


$$


$$


#MISREC08RB

Form 1099-MISC


Copy 2





RECIPIENT’S name




1 Rents

$2 Royalties

$3 Other income



$



$





$11 12


$



$


$


$$


$$


To be �led with recipient's state

income tax return, when required.

Form 1099-MISC


Copy 2





RECIPIENT’S name




1 Rents

$2 Royalties

$3 Other income



$



$





$11 12


$



$


$


$$


$$




Form 1099-MISC


Copy CFor Payer


OMB No. 1545-0115




Certain Information

Returns.

VOID CORRECTEDPAYER’S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.


RECIPIENT’S name




2nd TIN not.

1 Rents

$2 Royalties

$3 Other income



$



$





$11 12


$



$


$


$$


$$


Form 1099-MISC


Copy CFor Payer


OMB No. 1545-0115




Certain Information

Returns.



RECIPIENT’S name




2nd TIN not.

1 Rents

$2 Royalties

$3 Other income



$



$





$11 12


$



$


$


$$


$$


Do Not Staple 6969



OMB No. 1545-0108

FILER'S name







$



W-2G 32

1097-BTC 50

1098 81

1098-C 78

1098-E 84

1098-Q 74

1098-T 83

1099-A 80

1099-B 79

1099-C 85

1099-CAP 73

1099-DIV 91

1099-G 86

1099-INT 92

1099-K 10

1099-LTC 93

1099-MISC 95

1099-OID 96

1099-PATR 97

1099-Q 31

1099-R 98

1099-S 75

1099-SA 94

3921 25

3922 26

5498 28

5498-ESA 72

5498-SA 27












� �



Austin, TX 73301

Cat. No. 14400O Form 1096

1099-MISC Form Parts Description

www.W2Mate.com • 1-800-507-1992 77

Most Popular Preprinted 1099 Forms• IRS - compliant forms guaranteed compatible with

W2 Mate or your 1099 filing Software



• Payments of Dividends and Capital Gains


DIVFED08RB 1099-DIV Federal Copy A –DIVREC08RB 1099-DIV Recipient Copy B 10992UPENVRB

DIVPAY08RB 1099-DIV Payer Copy C –

• Distributions from Pensions, Annuities, etc.


RFED08RB 1099-R Federal Copy A –RREC08RB 1099-R Recipient Copy B 10992UPENVRB

RPAY08RB 1099-R Recipient File Copy C –R1D08RB 1099-R State Copy 1/Payer Copy D –R208RB 1099-R Recipient State Copy 2 10992UPENVRB

1099-DIV Forms

1099-R Forms

1099-INT Forms• Payments of Interest Income


INTFED08RB 1099-INT Federal Copy A –INTREC08RB 1099-INT Recipient Copy B

INTPAY08RB 1099-INT Payer Copy C –

1099-INT Federal Copy A

#INTFED08RB

1099-DIV Federal Copy A

#DIVFED08RB

1099-R Federal Copy A

#RFED08RB1099-R Recipient Copy B#RREC08RB

1099-R Recipient File Copy C

#RPAY08RB

1099-DIV Recipient Copy B

#DIVREC08RB

1099-INT Recipient Copy B

#INTREC08RB

1099-DIV Payer Copy C

#DIVPAY08RB

1099-INT Payer Copy C

#INTPAY08RB

1099-INT / 1099-DIV / 1099-R Forms

Form 1099-INT

Cat. No. 14410K

Interest Income

Copy A

For Internal Revenue

Service Center



OMB No. 1545-0112




Certain Information

Returns.



RECIPIENT’S name



FATCA �ling requirement

Account number (see instructions) 2nd TIN not.

Payer's RTN (optional)

1 Interest income

$2 Early withdrawal penalty

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


$5 Investment expenses

$6 Foreign tax paid

$7 Foreign country or U.S. possession

8 Tax-exempt interest

$

9 Speci�ed private activity bond interest

$10 Market discount

$

11 Bond premium

$12 Bond premium on Treasury obligations

$13 Bond premium on tax–exempt bond

$14 Tax-exempt and tax credit

bond CUSIP no.15 State 16 State identi�cation no. 17 State tax withheld

$$

Form 1099-INT www.irs.gov/form1099int


Form 1099-INT

Cat. No. 14410K

Interest Income

Copy A


Service Center



OMB No. 1545-0112




Certain Information

Returns.



RECIPIENT’S name






1 Interest income





$6 Foreign tax paid



$


$10 Market discount

$

11 Bond premium


$13 Bond premium on tax–exempt bond



$$



Form 1099-INT

Interest Income

Copy B

For Recipient


This is important tax information and is

being furnished to the Internal Revenue

Service. If you are required to �le 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.

OMB No. 1545-0112

CORRECTED (if checked)PAYER’S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.


RECIPIENT’S name




Account number (see instructions)


1 Interest income





$6 Foreign tax paid



$


$10 Market discount

$

11 Bond premium


$13 Bond premium on tax-exempt bond



$$

Form 1099-INT (keep for your records) www.irs.gov/form1099int

Form 1099-INT

Interest Income

Copy B

For Recipient









OMB No. 1545-0112



RECIPIENT’S name






1 Interest income





$6 Foreign tax paid



$


$10 Market discount

$

11 Bond premium





$$


Form 1099-INT

Interest Income

Copy C

For Payer


OMB No. 1545-0112




Certain Information

Returns.



RECIPIENT’S name






1 Interest income





$6 Foreign tax paid



$


$10 Market discount

$

11 Bond premium





$$


Form 1099-INT

Interest Income

Copy C

For Payer


OMB No. 1545-0112




Certain Information

Returns.



RECIPIENT’S name






1 Interest income





$6 Foreign tax paid



$


$10 Market discount

$

11 Bond premium





$$


Form 1099-DIV

Cat. No. 14415N

Dividends and Distributions

Copy AFor




OMB No. 1545-0110




Certain Information

Returns.



RECIPIENT’S name





1a Total ordinary dividends

$ 1b Quali�ed dividends

$ 2a Total capital gain distr.

$ 2b Unrecap. Sec. 1250 gain

$ 2c Section 1202 gain

$

2d Collectibles (28%) gain

$ 3 Nondividend distributions

$ 4 Federal income tax withheld

$ 5 Investment expenses

$ 6 Foreign tax paid

$

7 Foreign country or U.S. possession

8 Cash liquidation distributions

$ 9 Noncash liquidation distributions

$ 10 Exempt-interest dividends

$

11 Speci�ed private activity bond interest dividends

$ 12 State 13 State identi�cation no. 14 State tax withheld

$ $

Form 1099-DIV www.irs.gov/form1099div

Do Not Cut or Separate Forms on This Page — Do Not Cut or Separate Forms on This Page

Form 1099-DIV

Cat. No. 14415N


Copy AFor




OMB No. 1545-0110




Certain Information

Returns.



RECIPIENT’S name










$






$





$



$ $



Form 1099-INT

Interest Income

Copy B

For Recipient









OMB No. 1545-0112



RECIPIENT’S name






1 Interest income





$6 Foreign tax paid



$


$10 Market discount

$

11 Bond premium





$$


Form 1099-INT

Interest Income

Copy B

For Recipient









OMB No. 1545-0112



RECIPIENT’S name






1 Interest income





$6 Foreign tax paid



$


$10 Market discount

$

11 Bond premium





$$


Form 1099-DIV


Copy C

For Payer


OMB No. 1545-0110




Certain Information

Returns.



RECIPIENT’S name










$






$





$



$ $


Form 1099-DIV


Copy C

For Payer


OMB No. 1545-0110




Certain Information

Returns.



RECIPIENT’S name










$






$





$



$ $


Form 1099-R

Cat. No. 14436Q

Distributions From Pensions, Annuities,

Retirement or Pro�t-Sharing

Plans, IRAs, Insurance

Contracts, etc.

Copy A For




OMB No. 1545-0119


Reduction Act Notice, see the 2015 General

Instructions for Certain

Information Returns.

9898 VOID CORRECTEDPAYER’S name, street address, city or town, state or province, country, and ZIP or foreign postal code

PAYER’S federal identi�cation number

RECIPIENT’S identi�cation number

RECIPIENT’S name



10 Amount allocable to IRR within 5 years

$

11 1st year of desig. Roth contrib.


1 Gross distribution

$2a Taxable amount

$2b Taxable amount

not determinedTotal distribution

3 Capital gain (included in box 2a)

$

4 Federal income tax withheld

$5 Employee contributions

/Designated Roth contributions or insurance premiums

$

6 Net unrealized appreciation in employer’s securities

$7 Distribution code(s)

IRA/ SEP/

SIMPLE

8 Other

$ %9a Your percentage of total

distribution %

9b Total employee contributions

$12 State tax withheld

$$

13 State/Payer’s state no. 14 State distribution

$$

15 Local tax withheld

$$

16 Name of locality 17 Local distribution

$$

Form 1099-R www.irs.gov/form1099r


Form 1099-R

Cat. No. 14436Q




Contracts, etc.

Copy A For




OMB No. 1545-0119


Reduction Act Notice, see the 2015 General



9898 VOID CORRECTEDPAYER’S name, street address, city or town, state or province, country, and ZIP or foreign postal code



RECIPIENT’S name




$




$2a Taxable amount

$2b Taxable amount



$




$



IRA/ SEP/

SIMPLE

8 Other


distribution %



$$


$$


$$


$$



Form 1099-R




Contracts, etc.

Copy B Report this

income on your federal tax

return. If this form shows

federal income tax withheld in

box 4, attach this copy to your return.


This information is being furnished to

the Internal Revenue Service.


PAYER’S name, street address, city or town, state or province, country, and ZIP or foreign postal code



RECIPIENT’S name




$




$2a Taxable amount

$2b Taxable amount



$




$



IRA/ SEP/

SIMPLE

8 Other


distribution %



$$


$$


$$


$$


Form 1099-R




Contracts, etc.

Copy B Report this

income on your federal tax

return. If this form shows

federal income tax withheld in

box 4, attach this copy to your return.








RECIPIENT’S name




$




$2a Taxable amount

$2b Taxable amount



$




$



IRA/ SEP/

SIMPLE

8 Other


distribution %



$$


$$


$$


$$


Form 1099-R




Contracts, etc.

Copy C For Recipient's

Records








RECIPIENT’S name




$




$2a Taxable amount

$2b Taxable amount



$




$



IRA/ SEP/

SIMPLE

8 Other


distribution %



$$


$$


$$


$$

Form 1099-R (keep for your records) www.irs.gov/form1099r

Form 1099-R




Contracts, etc.

Copy C For Recipient's

Records








RECIPIENT’S name




$




$2a Taxable amount

$2b Taxable amount



$




$



IRA/ SEP/

SIMPLE

8 Other


distribution %



$$


$$


$$


$$

Form 1099-R (keep for your records) www.irs.gov/form1099r

10992UPENVRB






• Tuition Statement


1098TFED08RB 1098-T Federal Copy A –1098TREC08RB 1098-T Recipient Copy B 3UPENVRB

1098TPAY08RB 1098-T Payer Copy C –

1098-T Forms

1098 Forms

1099-S Forms• Proceeds from Real Estate Transactions


SFED08RB 1099-S Federal Copy A –SREC08RB 1099-S Recipient Copy B 3UPENVRB

SPAY08RB 1099-S Payer Copy C –

1098-T Federal Copy A

1098 Federal Copy A 1098 Recipient

Copy B#1098REC08RB

1098 Payer Copy C

#1098PAY08RB

Copy B

#1098TREC08RB

1099-S RecipientCopy B

#SREC08RB

1098-T Pay reCopy C

#1098TPAY08RB

1099-S Payer Copy C

#SPAY08RB

1099-S FederalCopy A

#SFED08RB

• Mortgage Interest Statement


1098FED08RB 1098 Federal Copy A –1098REC08RB 1098 Recipient Copy B 10992UPNVRB

1098PAY08RB 1098 Payer Copy C –

1099-S / 1098-T / 1098 Forms

Form 1099-S

Proceeds From Real Estate Transactions

OMB No. 1545-0997

Copy AFor


File with Form 1096. For Privacy Act and Paperwork



Certain Information

Returns.

7575 VOID CORRECTED

Form 1099-S Cat. No. 64292E www.irs.gov/form1099s Department of the Treasury - Internal Revenue Service

FILER'S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone number

TRANSFEROR'S name



Account or escrow number (see instructions)

1 Date of closing

2 Gross proceeds

$3 Address or legal description (including city, state, and ZIP code)

4 Check here if the transferor received or will receive property or services as part of the consideration

5 Buyer's part of real estate tax

$

Do Not C ut or S epa ra t e F orms on T his P a ge — Do Not C ut or S epa ra t e F orms on T his P a ge

Form 1099-S


OMB No. 1545-0997

Copy AFor





Certain Information

Returns.

7575 VOID CORRECTED



TRANSFEROR'S name




1 Date of closing

2 Gross proceeds




$


Form 1099-S


OMB No. 1545-0997

Copy AFor





Certain Information

Returns.

7575 VOID CORRECTED



TRANSFEROR'S name




1 Date of closing

2 Gross proceeds




$


Form 1099-S


OMB No. 1545-0997

Copy BFor Transferor

This is important tax information and is being furnished to the Internal Revenue Service. If you


sanction may be imposed on you if this item is required to be reported and the IRS


CORRECTED (if checked)

Department of the Treasury - Internal Revenue Servicewww.irs.gov/form1099s


TRANSFEROR'S name




1 Date of closing

2 Gross proceeds

$3 Address or legal description

4 Transferor received or will receive property or services as part of the consideration (if checked) . . .


$Form 1099-S (keep for your records)

Form 1099-S


OMB No. 1545-0997









TRANSFEROR'S name




1 Date of closing

2 Gross proceeds





Form 1099-S


OMB No. 1545-0997









TRANSFEROR'S name




1 Date of closing

2 Gross proceeds





Form 1099-S


OMB No. 1545-0997

Copy CFor Filer





VOID CORRECTED



TRANSFEROR'S name




1 Date of closing

2 Gross proceeds




$Form 1099-S

Form 1099-S


OMB No. 1545-0997

Copy CFor Filer





VOID CORRECTED



TRANSFEROR'S name




1 Date of closing

2 Gross proceeds




$Form 1099-S

Form 1099-S


OMB No. 1545-0997

Copy CFor Filer





VOID CORRECTED



TRANSFEROR'S name




1 Date of closing

2 Gross proceeds




$Form 1099-S

1098-T Recipient

#1098TFED08RB

#1098FED08RB

Form 1098-T

Cat. No. 25087J

Tuition Statement

Copy AFor




OMB No. 1545-1574

For Privacy Act and Paperwork Reduction

Act Notice, see the

Instructions for Certain Information

Returns.

8383 VOID CORRECTEDFILER'S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone number

STUDENT'S name



Service Provider/Acct. No. (see instr.)

1 Payments received for

expenses

$2 Amounts billed for

related expenses

$3 Check if you have changed your

reporting method for 2016

4 Adjustments made for a prior year

$

5 Scholarships or grants

$6 Adjustments to

scholarships or grants for a prior year

$

7 Check this box if the amount in box 1 or 2 includes amounts for an academic period beginning January — March 2017

8 Check if at least

half-time student

9 Check if a graduate

student . . . .

10 Ins. contract reimb./refund

$Form 1098-T www.irs.gov/form1098tDo Not C ut or S e pa ra t e F orms on T his P a ge — Do Not C ut or S e pa ra t e F orms on T his P a ge

Form 1098-T

Cat. No. 25087J

Tuition Statement

Copy AFor




OMB No. 1545-1574


Act Notice, see the


Returns.


STUDENT'S name





expenses


related expenses




$


$6 Adjustments to


$


8 Check if at least

half-time student


student . . . .



Form 1098-T

Cat. No. 25087J

Tuition Statement

Copy AFor




OMB No. 1545-1574


Act Notice, see the


Returns.


STUDENT'S name





expenses


related expenses




$


$6 Adjustments to


$


8 Check if at least

half-time student


student . . . .



Form 1098-T

Tuition Statement

Copy BFor Student


This is important tax information

and is being furnished to the

Internal Revenue Service. This form

must be used to complete Form 8863

to claim education credits. Give it to the

tax preparer or use it to prepare the tax return.

OMB No. 1545-1574CORRECTED


STUDENT'S name





expenses


related expenses

$3 If this box is checked, your educational institution

has changed its reporting method for 2016


$


$6 Adjustments to


$

7 Checked if the amount in box 1 or 2 includes

amounts for an academic period beginning January — March 2017

8 Check if at least

half-time student

9 Checked if a graduate

student . . . .


$Form 1098-T (keep for your records) www.irs.gov/form1098t

Form 1098-T

Tuition Statement

Copy BFor Student










STUDENT'S name





expenses


related expenses




$


$6 Adjustments to


$



8 Check if at least

half-time student


student . . . .



Form 1098-T

Tuition Statement

Copy BFor Student










STUDENT'S name





expenses


related expenses




$


$6 Adjustments to


$



8 Check if at least

half-time student


student . . . .



Form 1098-T

Tuition Statement

Copy CFor Filer


OMB No. 1545-1574


Reduction Act Notice, see

the Instructions for

Certain Information Returns.

VOID CORRECTEDFILER'S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone number

STUDENT'S name





expenses


related expenses




$


$6 Adjustments to


$


8 Check if at least

half-time student


student . . . .


$Form 1098-T www.irs.gov/form1098t

Form 1098-T

Tuition Statement

Copy CFor Filer


OMB No. 1545-1574






STUDENT'S name





expenses


related expenses




$


$6 Adjustments to


$


8 Check if at least

half-time student


student . . . .



Form 1098-T

Tuition Statement

Copy CFor Filer


OMB No. 1545-1574






STUDENT'S name





expenses


related expenses




$


$6 Adjustments to


$


8 Check if at least

half-time student


student . . . .



Form 1098

(Rev. July 2016)

Cat. No. 14402K

Mortgage Interest

Statement

Copy A For




OMB No. 1545-0901




Certain Information

Returns.

8181 VOID CORRECTED RECIPIENT'S/LENDER'S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.

RECIPIENT'S/LENDER'S federal identi�cation number

PAYER'S/BORROWER'S taxpayer identi�cation no.

PAYER'S/BORROWER'S name



10 Other


1 Mortgage interest received from payer(s)/borrower(s)

$ 2 Outstanding mortgage principal as of 1/1/2016

$

3 Mortgage origination date

4 Refund of overpaid interest

$

5 Mortgage insurance premiums

$6 Points paid on purchase of principal residence

$7 Is address of property securing mortgage same as PAYER'S/BORROWER'S address? If Yes, check box . . . . . . . . . . If No, enter address of property securing mortgage below

8 Address of property securing mortgage (see instructions)

9 If property securing mortgage has no address, provide description of the property (see instructions)

Form 1098 www.irs.gov/form1098

Do Not Cut or S eparate Forms on This Page — Do Not Cut or S eparate Forms on This Page

Form 1098

(Rev. July 2016)

Cat. No. 14402K

Mortgage Interest

Statement

Copy A For




OMB No. 1545-0901




Certain Information

Returns.

8181 VOID CORRECTED RECIPIENT'S/LENDER'S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.






10 Other


1 Mortgage interest received from payer(s)/borrower(s)

$ 2 Outstanding mortgage principal as of 1/1/2016

$



$



$7 Is address of property securing mortgage same as PAYER'S/BORROWER'S address? If Yes, check box . . . . . . . . . . If No, enter address of property securing mortgage below

8 Address of property securing mortgage (see instructions)

9 If property securing mortgage has no address, provide description of the property (see instructions)

Form 1098 www.irs.gov/form1098


Form 1098

Mortgage Interest

Statement


The information in boxes 1 through 9 is important tax

information and is being furnished to the Internal

Revenue Service. If you are required to �le a return, a

negligence penalty or other sanction may be imposed

on you if the IRS determines that an underpayment oftax results because youoverstated a deduction

for this mortgage interest or for these points, reported

in boxes 1 and 6; or because you didn't report

the refund of interest (box 4); or because you

claimed a non-deductible item.


RECIPIENT'S/LENDER'S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.






10 Other


*Caution: The amount shown may not be fully deductible by you. Limits based on the loan amount and the cost and value of the secured property may apply. Also, you may only deduct interest to the extent it was incurred by you, actually paid by you, and not reimbursed by another person.

1 Mortgage interest received from payer(s)/borrower(s)*

$ 2 Outstanding mortgage

$



$



$7 Is address of property securing mortgage same as PAYER'S/BORROWER'S address? If Yes, box is checked . . . . . . . . . If No, see box 8 or 9, below

8 Address of property securing mortgage

9 If property securing mortgage has no address, below is the description of the property

Form 1098 (Keep for your records) www.irs.gov/form1098

Form 1098

Mortgage Interest

Statement


















10 Other





$



$







Form 1098

Mortgage Interest

Statement


















10 Other





$



$







Form 1098

Mortgage Interest

Statement


















10 Other





$



$












• Proceeds from Broker and Barter Exchange Transactions


BFED08RB 1099-B Federal Copy A –BREC08RB 1099-B Recipient Copy B 10992UPENVRB

BPAY08RB 1099-B Payer Copy C –

1099-B Forms

1099-C Forms

1099-A Forms• Acquisition or Abandonment of Secured Property


AFED08RB 1099-A Federal Copy A –AREC08RB 1099-A Recipient Copy B 3UPENVRB

APAY08RB 1099-A Payer Copy C –

1099-B FederalCopy A

#BFED08RB1099-B Recipient

Copy B#BREC08RB

1099-A RecipientCopy B

#AREC08RB

1099-B PayerCopy C

#BPAY08RB

1099-A PayerCopy C

#APAY08RB

1099- A Federal

#AFED08RB

• Cancellation of Debt


CFED08RB 1099-C Federal Copy A –CREC08RB 1099-C Recipient Copy B 3UPENVRB

CPAY08RB 1099-C Payer Copy C –

1099-A / 1099-B / 1099-C Forms

1099-C FederalCopy A

#CFED08RB1099-C Recipient

Copy B#CREC08RB

1099-C PayerCopy C

#CPAY08RB

Form 1099-A

Acquisition or Abandonment of

Secured Property

Copy AFor



OMB No. 1545-0877





8080 VOID CORRECTEDLENDER’S name, street address, city or town, state or province, country, ZIP or foreign postal code, a nd telephone no.

LENDER’S federal identi�cation number BORROWER’S identi�cation number

BORROWER’S name




1 Date of lender's acquisition or knowledge of abandonment

2 Balance of principal outstanding

$3 4 Fair market value of property

$5 If checked, the borrower was personally liable for repayment

of the debt . . . . . . . . . . . �

6 Description of property

Form 1099-ADo Not C ut or S epa ra t e F orms on T his P a ge — Do Not C ut or S epa ra t e F orms on T his P a ge

Form 1099-A


Secured Property

Copy AFor



OMB No. 1545-0877







BORROWER’S name








of the debt . . . . . . . . . . . �



Form 1099-A


Secured Property

Copy AFor



OMB No. 1545-0877







BORROWER’S name








of the debt . . . . . . . . . . . �



Form 1099-A


Secured Property

Copy BFor Borrower



are required to �le a return, a negligence


imposed on you if taxable income results

from this transaction and the IRS determines

that it has not been reported.

OMB No. 1545-0877

CORRECTED (if checked)LENDER’S name, street address, city or town, state or province, country, ZIP or foreign postal code, a nd telephone no.


BORROWER’S name








of the debt . . . . . . . . . . . �


Form 1099-A (keep for your records) www.irs.gov/form1099a

Form 1099-A


Secured Property

Copy BFor Borrower








OMB No. 1545-0877



BORROWER’S name








of the debt . . . . . . . . . . . �



Form 1099-A


Secured Property

Copy BFor Borrower








OMB No. 1545-0877



BORROWER’S name








of the debt . . . . . . . . . . . �



Form 1099-A


Secured Property

Copy CFor Lender


OMB No. 1545-0877





VOID CORRECTEDLENDER’S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.


BORROWER’S name








of the debt . . . . . . . . . . . �


Form 1099-A www.irs.gov/form1099a

Form 1099-A


Secured Property

Copy CFor Lender


OMB No. 1545-0877







BORROWER’S name








of the debt . . . . . . . . . . . �



Form 1099-A


Secured Property

Copy CFor Lender


OMB No. 1545-0877







BORROWER’S name








of the debt . . . . . . . . . . . �



7979 VOID CORRECTED

Form 1099-B

Proceeds From Broker and

Barter Exchange Transactions

Copy A


Service Center


OMB No. 1545-0715



Instructions for

Certain Information

Returns.

PAYER'S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.

PAYER'S federal identi�cation number RECIPIENT'S identi�cation number

RECIPIENT'S name




CUSIP number

Applicable check box on Form 8949

1a Description of property (Example 100 sh. XYZ Co.)

1b Date acquired 1c Date sold or disposed

1d Proceeds

$1e Cost or other basis

$1f Code, if any 1g Adjustments

$2 Type of gain or loss:

Short-term

Long-term

3 Check if basis reported to IRS


$5 Check if noncovered

security

6 Reported to IRS:

Gross proceeds

Net proceeds

7 Check if loss is not allowed based on amount in 1d

8 Pro�t or (loss) realized in 2015 on closed contracts

$

9 Unrealized pro�t or (loss) on open contracts—12/31/2014

$10 Unrealized pro�t or (loss) on

open contracts—12/31/2015

$

11 Aggregate pro�t or (loss) on contracts

$12 13 Bartering

$

14 State name 15 State identi�cation no. 16 State tax withheld

$$

Form 1099-BDo Not C ut or S e pa ra t e F orms on T his P a ge — Do Not C ut or S e pa ra t e F orms on T his P a ge

7979 VOID CORRECTED

Form 1099-B



Copy A


Service Center


OMB No. 1545-0715



Instructions for

Certain Information

Returns.



RECIPIENT'S name




CUSIP number




1d Proceeds




Short-term

Long-term




security

6 Reported to IRS:

Gross proceeds

Net proceeds



$




$


$12 13 Bartering

$


$$

Form 1099-BDo Not C ut or S e pa ra t e F orms on T his P a ge — Do Not C ut or S e pa ra t e F orms on T his P a ge


Form 1099-B



Copy BFor Recipient









OMB No. 1545-0715PAYER'S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.


RECIPIENT'S name




CUSIP number




1d Proceeds




Short-term

Long-term

3 If checked, basis reported to IRS


$5 If checked, noncovered

security

6 Reported to IRS:

Gross proceeds

Net proceeds

7 If checked, loss is not allowed based on amount in 1d


$




$


$12 13 Bartering

$


$$

Form 1099-B (Keep for your records) www.irs.gov/form1099b


Form 1099-B



Copy BFor Recipient









OMB No. 1545-0715PAYER'S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.


RECIPIENT'S name




CUSIP number




1d Proceeds




Short-term

Long-term

3 If checked, basis reported to IRS


$5 If checked, noncovered

security

6 Reported to IRS:

Gross proceeds

Net proceeds

7 If checked, loss is not allowed based on amount in 1d


$




$


$12 13 Bartering

$


$$

Form 1099-B (Keep for your records) www.irs.gov/form1099b

VOID CORRECTED

Form 1099-B



Copy CFor Payer

OMB No. 1545-0715



Instructions for

Certain Information

Returns.



RECIPIENT'S name




CUSIP number




1d Proceeds




Short-term

Long-term




security

6 Reported to IRS:

Gross proceeds

Net proceeds



$




$


$12 13 Bartering

$


$$

Form 1099-B

VOID CORRECTED

Form 1099-B



Copy CFor Payer

OMB No. 1545-0715



Instructions for

Certain Information

Returns.



RECIPIENT'S name




CUSIP number




1d Proceeds




Short-term

Long-term




security

6 Reported to IRS:

Gross proceeds

Net proceeds



$




$


$12 13 Bartering

$


$$

Form 1099-B

Form 1099-C

Cat. No. 26280W

Cancellation of Debt

Copy AFor




OMB No. 1545-1424


Act Notice, see the


Returns.

8585 VOID CORRECTEDCREDITOR'S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.

CREDITOR'S federal identi�cation number DEBTOR'S identi�cation number

DEBTOR'S name




1 Date of identi�able event

2 Amount of debt discharged

$3 Interest if included in box 2

$4 Debt description

5 Check here if the debtor was personally liable for repayment of the debt . . . . . . . . �

6 Identi�able event code 7 Fair market value of property

$Form 1099-C www.irs.gov/form1099c


Form 1099-C

Cat. No. 26280W


Copy AFor




OMB No. 1545-1424


Act Notice, see the


Returns.



DEBTOR'S name







$4 Debt description





Form 1099-C

Cat. No. 26280W


Copy AFor




OMB No. 1545-1424


Act Notice, see the


Returns.



DEBTOR'S name







$4 Debt description





Form 1099-C


Copy BFor Debtor








OMB No. 1545-1424

CORRECTED (if checked)CREDITOR'S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.


DEBTOR'S name







$4 Debt description

5 If checked, the debtor was personally liable for repayment of the debt . . . . . . . . �


$Form 1099-C (keep for your records) www.irs.gov/form1099c

Form 1099-C


Copy BFor Debtor








OMB No. 1545-1424



DEBTOR'S name







$4 Debt description




Form 1099-C


Copy BFor Debtor








OMB No. 1545-1424



DEBTOR'S name







$4 Debt description




Form 1099-C


Copy CFor Creditor


OMB No. 1545-1424




Returns.

VOID CORRECTEDCREDITOR'S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.


DEBTOR'S name







$4 Debt description




Form 1099-C


Copy CFor Creditor

OMB No. 1545-1424




Returns.



DEBTOR'S name







$4 Debt description



$Form 1099-C

Form 1099-C


Copy CFor Creditor

OMB No. 1545-1424




Returns.



DEBTOR'S name







$4 Debt description



$Form 1099-C

Copy A






• Taxable Distributions Received from Cooperatives


PATRFED08RB 1099-PATR Federal Copy A –PATRREC08RB 1099-PATR Recipient Copy B 3UPENVRB

PATRPAY08RB 1099-PATR Payer Copy C –

1099-PATR Forms

1099-OID Forms• Original Issue Discount


OIDFED08RB 1099-OID Federal Copy A –OIDREC08RB 1099-OID Recipient Copy B 2UPENVRB

OIDPAY08RB 1099-OID Payer Copy C –

1099-PATR FederalCopy A

#PATRFED08RB1099-PATR Recipient

Copy B#PATRREC08RB

1099-OID RecipientCopy B

#OIDREC08RB

1099-PATR PayerCopy C

#PATRPAY08RB

1099-OID PayerCopy C

#OIDPAY08RB

1099-OID FederalCopy A

#OIDFED08RB

1099-OID / 1099-PATR /1099-K Forms

• Payment Card and Third Party Network Transactions


KFED08RB 1099-K Federal Copy A –KREC08RB 1099-K Recipient Copy B 2UPENVRB

KPAY08RB 1099-K Payer Copy C –

1099-K Forms

1099-K FederalCopy A

#KFED08RB 1099-K RecipientCopy B

#KREC08RB 1099-K PayerCopy C

#KPAY08RB

Form 1099-OID

Cat. No. 14421R

Original Issue Discount


Service Center



OMB No. 1545-0117







RECIPIENT’S name





1 Original issue discount for 2016

$2 Other periodic interest


$


$5 Market discount

$

6 Acquisition premium

$ 7 Description

8 Original issue discount on U.S. Treasury obligations


$

10 Bond premium

$11 State 12 State identi�cation no. 13 State tax withheld

$$

Copy A

Form 1099-OID www.irs.gov/form1099oid


Form 1099-OID

Cat. No. 14421R



Service Center



OMB No. 1545-0117







RECIPIENT’S name








$


$5 Market discount

$


$ 7 Description



$

10 Bond premium


$$

Copy A



Form 1099-OID


Copy B

For Recipient


This is important tax



this income is

determines that it has not been

OMB No. 1545-0117



RECIPIENT’S name





1 Original issue discount for 2016*



$


$5 Market discount

$


$ 7 Description

8 Original issue discount on U.S. Treasury obligations*

$

* This may not be the correct �gure to report on your income tax return. See instructions on the back.

9 Investment expenses

$

10 Bond premium


$$

Form 1099-OID (keep for your records) www.irs.gov/form1099oid

Form 1099-OID


Copy B

For Recipient


This is important tax

being furnished to


penalty or other



OMB No. 1545-0117



RECIPIENT’S name





1 Original issue discount for 2016*



$


$5 Market discount

$


$ 7 Description

8 Original issue discount on U.S. Treasury obligations*

$

* This may not be the correct �gure to report on your income tax return. See instructions on the back.

9 Investment expenses

$

10 Bond premium


$$

Form 1099-OID (keep for your records) www.irs.gov/form1099oid

Form 1099-OID


Copy C

For Payer


OMB No. 1545-0117



Instructions for

Certain Information

Returns.



RECIPIENT’S name








$


$5 Market discount

$


$7 Description



$

10 Bond premium


$$


Form 1099-OID


Copy C

For Payer


OMB No. 1545-0117



Instructions for

Certain Information

Returns.



RECIPIENT’S name








$


$5 Market discount

$


$7 Description



$

10 Bond premium


$$


Form 1099-PATR

Cat. No. 14435F

Taxable Distributions

Received From Cooperatives

Copy AFor




OMB No. 1545-0118



Instructions for


9797 VOID CORRECTEDPAYER'S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.


RECIPIENT’S name




1 Patronage dividends

$2 Nonpatronage distributions

$3 Per-unit retain allocations


$5 Redemption of nonquali�ed

notices and retain allocations

$

6 Domestic production activities deduction

$7 Investment credit

$8 Work opportunity credit

$9 Patron’s AMT adjustment

$10 Other credits and deductions

$Form 1099-PATR www.irs.gov/form1099patr


Form 1099-PATR

Cat. No. 14435F



Copy AFor




OMB No. 1545-0118



Instructions for




RECIPIENT’S name










$








Form 1099-PATR

Cat. No. 14435F



Copy AFor




OMB No. 1545-0118



Instructions for




RECIPIENT’S name










$








Form 1099-PATR



Copy BFor Recipient


OMB No. 1545-0118



Service. If you are required to �le 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 or town, state or province, country, ZIP or foreign postal code, and telephone no.


RECIPIENT’S name










$






$Form 1099-PATR (keep for your records) www.irs.gov/form1099patr

Form 1099-PATR



Copy BFor Recipient


OMB No. 1545-0118





reported.



RECIPIENT’S name










$







Form 1099-PATR



Copy BFor Recipient


OMB No. 1545-0118





reported.



RECIPIENT’S name










$







Form 1099-PATR



Copy C

For Payer


OMB No. 1545-0118



Instructions for


VOID CORRECTEDPAYER'S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.


RECIPIENT’S name










$







Form 1099-PATR



Copy C

For Payer


OMB No. 1545-0118



Instructions for




RECIPIENT’S name










$







Form 1099-PATR



Copy C

For Payer


OMB No. 1545-0118



Instructions for




RECIPIENT’S name










$







Form 1099-K

Cat. No. 54118B

Payment Card and Third Party

Network Transactions

Copy A For




OMB No. 1545-2205




Returns.

1010 VOID CORRECTED FILER'S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.

Check to indicate if FILER is a (an):

Payment settlement entity (PSE)

Electronic Payment Facilitator (EPF)/Other third party

Check to indicate transactions reported are:Payment card

Third party network PAYEE’S name



PSE'S name and telephone number


FILER’S federal identi�cation no.

PAYEE’S taxpayer identi�cation no.

1a Gross amount of payment card/third party network transactions

$ 1b Card Not Present

transactions

$

2 Merchant category code

3 Number of payment transactions


$5a January

$ 5b February

$ 5c March

$ 5d April

$ 5e May

$ 5f June

$ 5g July

$ 5h August

$ 5i September

$ 5j October

$ 5k November

$ 5l December

$ 6 State 7 State identi�cation no. 8 State income tax withheld

$$

Form 1099-K www.irs.gov/form1099k


Form 1099-K

Cat. No. 54118B



Copy A For




OMB No. 1545-2205




Returns.

1010 VOID CORRECTED FILER'S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.














transactions

$




$5a January

$ 5b February

$ 5c March

$ 5d April

$ 5e May

$ 5f June

$ 5g July

$ 5h August

$ 5i September

$ 5j October

$ 5k November

$ 5l December


$$



Form 1099-K



Copy B For Payee






imposed on you if taxable income

results from this transaction and the

IRS determines that it has not been

reported.


FILER'S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.














transactions

$




$5a January

$ 5b February

$ 5c March

$ 5d April

$ 5e May

$ 5f June

$ 5g July

$ 5h August

$ 5i September

$ 5j October

$ 5k November

$ 5l December


$$

Form 1099-K (Keep for your records) www.irs.gov/form1099k

Form 1099-K



Copy B For Payee






imposed on you if taxable income

results from this transaction and the

IRS determines that it has not been

reported.


FILER'S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.














transactions

$




$5a January

$ 5b February

$ 5c March

$ 5d April

$ 5e May

$ 5f June

$ 5g July

$ 5h August

$ 5i September

$ 5j October

$ 5k November

$ 5l December


$$

Form 1099-K (Keep for your records) www.irs.gov/form1099k

Form 1099-K



Copy C For FILER


OMB No. 1545-2205




Returns.

VOID CORRECTED FILER'S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.














transactions

$




$5a January

$ 5b February

$ 5c March

$ 5d April

$ 5e May

$ 5f June

$ 5g July

$ 5h August

$ 5i September

$ 5j October

$ 5k November

$ 5l December


$$


Form 1099-K



Copy C For FILER


OMB No. 1545-2205




Returns.

VOID CORRECTED FILER'S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.














transactions

$




$5a January

$ 5b February

$ 5c March

$ 5d April

$ 5e May

$ 5f June

$ 5g July

$ 5h August

$ 5i September

$ 5j October

$ 5k November

$ 5l December


$$



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This envelope works perfectly with 2UP printed forms and 2UP perforated paper for (1099 MISC, 1099-B, 1099-DIV-


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1099-K, 1099-R, 1099-INT, 1098, & 1099-OID) forms.

Form 1099-MISC


Copy CFor Payer


OMB No. 1545-0115




Certain Information

Returns.



RECIPIENT’S name




2nd TIN not.

1 Rents

$2 Royalties

$3 Other income



$



$





$11 12


$



$


$


$$


$$


Form 1099-MISC


Copy CFor Payer


OMB No. 1545-0115




Certain Information

Returns.



RECIPIENT’S name




2nd TIN not.

1 Rents

$2 Royalties

$3 Other income



$



$





$11 12


$



$


$


$$


$$


Form 1099-MISC


Copy BFor Recipient












RECIPIENT’S name




1 Rents

$2 Royalties

$3 Other income



$



$





$11 12


$



$


$


$$


$$


Form 1099-MISC


Copy BFor Recipient












RECIPIENT’S name




1 Rents

$2 Royalties

$3 Other income



$



$





$11 12


$



$


$


$$


$$


Form 1099-MISC

Cat. No. 14425J


Copy AFor




OMB No. 1545-0115



Instructions for

Certain Information

Returns.



RECIPIENT’S name




2nd TIN not.

1 Rents

$2 Royalties

$3 Other income



$



$





$11 12


$



$


$


$$


$$



Form 1099-MISC

Cat. No. 14425J


Copy AFor




OMB No. 1545-0115



Instructions for

Certain Information

Returns.



RECIPIENT’S name




2nd TIN not.

1 Rents

$2 Royalties

$3 Other income



$



$





$11 12


$



$


$


$$


$$



Form 1099-MISC


Copy 2





RECIPIENT’S name




1 Rents

$2 Royalties

$3 Other income



$



$





$11 12


$



$


$


$$


$$




Form 1099-MISC


Copy 2





RECIPIENT’S name




1 Rents

$2 Royalties

$3 Other income



$



$





$11 12


$



$


$


$$


$$




Form 1099-MISC


Copy 1For State Tax

Department





RECIPIENT’S name




1 Rents

$2 Royalties

$3 Other income



$



$





$11 12


$



$


$


$$


$$


Form 1099-MISC


Copy 1For State Tax

Department





RECIPIENT’S name




1 Rents

$2 Royalties

$3 Other income



$



$





$11 12


$



$


$


$$


$$


Form 1099-MISC


Copy CFor Payer


OMB No. 1545-0115




Certain Information

Returns.



RECIPIENT’S name




2nd TIN not.

1 Rents

$2 Royalties

$3 Other income



$



$





$11 12


$



$


$


$$


$$


Form 1099-MISC


Copy CFor Payer


OMB No. 1545-0115




Certain Information

Returns.



RECIPIENT’S name




2nd TIN not.

1 Rents

$2 Royalties

$3 Other income



$



$





$11 12


$



$


$


$$


$$


Form 1099-MISC


Copy BFor Recipient












RECIPIENT’S name




1 Rents

$2 Royalties

$3 Other income



$



$





$11 12


$



$


$


$$


$$


Form 1099-MISC


Copy BFor Recipient












RECIPIENT’S name




1 Rents

$2 Royalties

$3 Other income



$



$





$11 12


$



$


$


$$


$$


Form 1099-MISC

Cat. No. 14425J


Copy AFor




OMB No. 1545-0115



Instructions for

Certain Information

Returns.



RECIPIENT’S name




2nd TIN not.

1 Rents

$2 Royalties

$3 Other income



$



$





$11 12


$



$


$


$$


$$



Form 1099-MISC

Cat. No. 14425J


Copy AFor




OMB No. 1545-0115



Instructions for

Certain Information

Returns.



RECIPIENT’S name




2nd TIN not.

1 Rents

$2 Royalties

$3 Other income



$



$





$11 12


$



$


$


$$


$$



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OMB No. 1545-0108

FILER'S name







$



W-2G 32

1097-BTC 50

1098 81

1098-C 78

1098-E 84

1098-Q 74

1098-T 83

1099-A 80

1099-B 79

1099-C 85

1099-CAP 73

1099-DIV 91

1099-G 86

1099-INT 92

1099-K 10

1099-LTC 93

1099-MISC 95

1099-OID 96

1099-PATR 97

1099-Q 31

1099-R 98

1099-S 75

1099-SA 94

3921 25

3922 26

5498 28

5498-ESA 72

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Cat. No. 14400O Form 1096


OMB No. 1545-0008



d Control number









12bCo d e

12cCo d e

12dCo d e


Retirement plan


14 Other





OMB No. 1545-0008



d Control number









12bCo d e

12cCo d e

12dCo d e


Retirement plan


14 Other





OMB No. 1545-0008



d Control number









12bCo d e

12cCo d e

12dCo d e


Retirement plan


14 Other





OMB No. 1545-0008



d Control number









12bCo d e

12cCo d e

12dCo d e


Retirement plan


14 Other





OMB No. 1545-0008



d Control number









12bCo d e

12cCo d e

12dCo d e


Retirement plan


14 Other





OMB No. 1545-0008



d Control number









12bCo d e

12cCo d e

12dCo d e


Retirement plan


14 Other





OMB No. 1545-0008



d Control number









12bCo d e

12cCo d e

12dCo d e


Retirement plan


14 Other





OMB No. 1545-0008



d Control number









12bCo d e

12cCo d e

12dCo d e


Retirement plan


14 Other





OMB No. 1545-0008



d Control number









12bCo d e

12cCo d e

12dCo d e


Retirement plan


14 Other





OMB No. 1545-0008



d Control number









12bCo d e

12cCo d e

12dCo d e


Retirement plan


14 Other





OMB No. 1545-0008



d Control number









12bCo d e

12cCo d e

12dCo d e


Retirement plan


14 Other





OMB No. 1545-0008



d Control number









12bCo d e

12cCo d e

12dCo d e


Retirement plan


14 Other





OMB No. 1545-0008



d Control number









12bCo d e

12cCo d e

12dCo d e


Retirement plan


14 Other





OMB No. 1545-0008



d Control number









12bCo d e

12cCo d e

12dCo d e


Retirement plan


14 Other





OMB No. 1545-0008



d Control number









12bCo d e

12cCo d e

12dCo d e


Retirement plan


14 Other





OMB No. 1545-0008



d Control number









12bCo d e

12cCo d e

12dCo d e


Retirement plan


14 Other





OMB No. 1545-0008



d Control number









12bCo d e

12cCo d e

12dCo d e


Retirement plan


14 Other





Cat. No. 10134D



OMB No. 1545-0008



d Control number









12bCo d e

12cCo d e

12dCo d e


Retirement plan


14 Other





Cat. No. 10134D



OMB No. 1545-0008



d Control number









12bCo d e

12cCo d e

12dCo d e


Retirement plan


14 Other





Cat. No. 10134D



OMB No. 1545-0008



d Control number









12bCo d e

12cCo d e

12dCo d e


Retirement plan


14 Other





Cat. No. 10134D


DO NOT STAPLE


OMB No. 1545-0008



CT-1Hshld. emp.

Medicare govt. emp.





(Check if

applicable)



f Employer’s name





















W-2 Online �ll-in forms or �le uploads will be on time if submitted by www.socialsecurity.gov/

employer . First time �lers, select “ Go to Register ”; returning �lers select “Go To Log In .”








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