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2010 IRS Form 1099-MISC

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2010 IRS Form 1099-MISC Powered By Docstoc
					                    9595                      VOID               CORRECTED
 PAYER’S name, street address, city, state, ZIP code, and telephone no.       1   Rents                      OMB No. 1545-0115


                                                                                                                                                   Miscellaneous
                                                                              $
                                                                              2   Royalties                       2010                                    Income
                                                                              $                              Form   1099-MISC
                                                                              3   Other income                4 Federal income tax withheld
                                                                                                                                                             Copy A
                                                                              $                               $                                                  For
 PAYER’S federal identification         RECIPIENT’S identification            5   Fishing boat proceeds       6 Medical and health care payments    Internal Revenue
 number                                 number                                                                                                        Service Center

                                                                                                                                                   File with Form 1096.
                                                                              $                               $
 RECIPIENT’S name                                                             7   Nonemployee compensation    8 Substitute payments in lieu of
                                                                                                                dividends or interest                For Privacy Act
                                                                                                                                                     and Paperwork
                                                                              $                               $                                       Reduction Act
 Street address (including apt. no.)                                          9   Payer made direct sales of 10 Crop insurance proceeds              Notice, see the
                                                                                  $5,000 or more of consumer                                          2010 General
                                                                                  products to a buyer
                                                                                  (recipient) for resale      $                                     Instructions for
 City, state, and ZIP code                                                   11                              12                                              Certain
                                                                                                                                                        Information
 Account number (see instructions)                            2nd TIN not. 13     Excess golden parachute 14 Gross proceeds paid to                        Returns.
                                                                                  payments                   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                                                          Cat. No. 14425J                     Department of the Treasury - Internal Revenue Service
Do Not Cut or Separate Forms on This Page                                         —       Do Not Cut or Separate Forms on This Page
                                                                 CORRECTED (if checked)
 PAYER’S name, street address, city, state, ZIP code, and telephone no.       1   Rents                      OMB No. 1545-0115


                                                                                                                                                   Miscellaneous
                                                                              $
                                                                              2   Royalties                       2010                                    Income
                                                                              $                              Form   1099-MISC
                                                                              3   Other income                4 Federal income tax withheld                     Copy B
                                                                                                              $                                          For Recipient
                                                                              $
 PAYER’S federal identification         RECIPIENT’S identification            5   Fishing boat proceeds       6 Medical and health care payments
 number                                 number


                                                                              $                               $
 RECIPIENT’S name                                                             7   Nonemployee compensation    8 Substitute payments in lieu of
                                                                                                                dividends or interest               This is important tax
                                                                                                                                                       information and is
                                                                                                                                                       being furnished to
                                                                                                                                                    the Internal Revenue
                                                                              $                               $                                        Service. If you are
 Street address (including apt. no.)                                          9   Payer made direct sales of 10 Crop insurance proceeds                  required to file a
                                                                                  $5,000 or more of consumer                                         return, a negligence
                                                                                  products to a buyer                                                     penalty or other
                                                                                  (recipient) for resale      $                                          sanction may be
 City, state, and ZIP code                                                   11                              12                                        imposed on you if
                                                                                                                                                            this income is
                                                                                                                                                     taxable and the IRS
 Account number (see instructions)                                           13   Excess golden parachute 14 Gross proceeds paid to                     determines that it
                                                                                  payments                   an attorney                                     has not been
                                                                                                                                                                  reported.
                                                                              $                               $
15a Section 409A deferrals             15b Section 409A income               16   State tax withheld         17 State/Payer’s state no.            18 State income

                                                                              $                                                                     $
 $                                      $                                     $                                                                     $
Form   1099-MISC                                                     (keep for your records)                  Department of the Treasury - Internal Revenue Service

				
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