Attention: This form is provided for informational purposes only. Copy A appears in red, similar to the official IRS form. Do not file copy A with the IRS. The official printed version of this IRS form is scannable, but the online version of it, printed from this website, is not. A penalty of $50 per information return may be imposed for filing forms that cannot be scanned. To order official IRS forms, call 1-800-TAX-FORM (1-800-829-3676) or Order Information Returns and Employer Returns Online, and we’ll mail you the scannable forms and other products. See IRS Publications 1141, 1167, 1179 and other IRS resources for information about printing these tax forms. 8080 VOID CORRECTED LENDER’S name, street address, city, state, ZIP code, and telephone no. OMB No. 1545-0877 STRAWMAN Acquisition or ADDRESS 2008 Abandonment of Secured Property CITY STATE ZIP Form 1099-A (XXX) 123 4567 1 Date of lender’s acquisition or 2 Balance of principal knowledge of abandonment outstanding Copy A LENDER’S federal identification number BORROWER’S identification number For 123-45-6789 ask or W9 or "refused" Date of case or orig note $ 36,545.00 Internal Revenue BORROWER’S name 3 4 Fair market value of property Service Center File with Form 1096. ACME WIDGETS, LLC $ 36,545.00 For Privacy Act Street address (including apt. no.) 5 Was borrower personally liable for repayment of the debt? and Paperwork ADDRESS STREET ADDRESS Yes No Reduction Act City, state, and ZIP code 6 Description of property Notice, see the 2008 General CITY STATE [ ZIP ] STRAWMAN'S NAME Instructions for Account number (see instructions) Forms 1099, 1098, Case (or mortg acct) No. _____________ Case (or mortg acct) No. _________ 5498, and W-2G. Form 1099-A Cat. No. 14412G 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 .STRAWMAN FULL NAME Do Not Staple 6969 OMB No. 1545-0108 Form 1096 Annual Summary and Transmittal of Department of the Treasury Internal Revenue Service U.S. Information Returns 2006 FILER’S name .STRAWMAN FULL NAME Street address (including room or suite number) STREET ADDRESS City, state, and ZIP code CITY STATE AND ZIP Name of person to contact Telephone number For Official Use Only YOUR NAME ( ) ---------------------- Email address Fax number ------------------------ ( ) ----------------------- 1 Employer identification number 2 Social security number 3 Total number of 4 Federal income tax withheld 5 Total amount reported with this Form 1096 forms TOTAL # OF PAGES W/O DASHES XXXXXXXXX W/DASHES XXX-XXX-XXXX $ -------- $ ------- Enter an “X” in only one box below to indicate the type of form being filed. If this is your final return, enter an “X” here W-2G 1098 1098-C 1098-E 1098-T 1099-A 1099-B 1099-C 1099-CAP 1099-DIV 1099-G 1099-H 1099-INT 1099-LTC 32 81 78 84 83 80 79 85 73 91 86 71 92 93 X 1099-MISC 1099-OID 1099-PATR 1099-Q 1099-R 1099-S 1099-SA 5498 5498-ESA 5498-SA 95 96 97 31 98 75 94 28 72 27 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 By: YOUR NAME Title AUTHORIZED REPRESENTATIVE Date DATE Instructions When to file. File Form 1096 as follows. ● With Forms 1099, 1098, or W-2G, file by February 28, 2007. Purpose of form. Use this form to transmit paper Forms 1099, 1098, 5498, and W-2G to the Internal Revenue Service. Do not ● With Forms 5498, 5498-ESA, or 5498-SA, file by May 31, 2007. use Form 1096 to transmit electronically or magnetically. For Where To File magnetic media, see Form 4804, Transmittal of Information Returns Reported Magnetically; for electronic submissions, see Except for Form 1098-C, send all information returns filed on Pub. 1220, Specifications for Filing Forms 1098, 1099, 5498, and paper with Form 1096 to the following: W-2G Electronically or Magnetically. If your principal business, Use the following Who must file. The name, address, and TIN of the filer on this office or agency, or legal Internal Revenue form must be the same as those you enter in the upper left area residence in the case of an Service Center of Forms 1099, 1098, 5498, or W-2G. A filer includes a payer; a individual, is located in address recipient of mortgage interest payments (including points) or student loan interest; an educational institution; a broker; a barter exchange; a creditor; a person reporting real estate Alabama, Arizona, Arkansas, Connecticut, transactions; a trustee or issuer of any individual retirement Delaware, Florida, Georgia, Kentucky, arrangement, a Coverdell ESA, an HSA, an Archer MSA Louisiana, Maine, Massachusetts, (including a Medicare Advantage MSA); certain corporations; Mississippi, New Hampshire, New Jersey, Austin, TX 73301 certain donees of motor vehicles, boats, and airplanes; and a New Mexico, New York, North Carolina, lender who acquires an interest in secured property or who has Ohio, Pennsylvania, Rhode Island, Texas, reason to know that the property has been abandoned. Vermont, Virginia, West Virginia Preaddressed Form 1096. If you received a preaddressed Form 1096 from the IRS with Package 1099, use it to transmit paper Alaska, California, Colorado, District of Forms 1099, 1098, 5498, and W-2G to the Internal Revenue Columbia, Hawaii, Idaho, Illinois, Indiana, Iowa, Service. If any of the preprinted information is incorrect, make Kansas, Maryland, Michigan, Minnesota, corrections on the form. Missouri, Montana, Nebraska, Nevada, North Kansas City, MO If you are not using a preaddressed form, enter the filer’s Dakota, Oklahoma, Oregon, South Carolina, 64999 name, address (including room, suite, or other unit number), and South Dakota, Tennessee, Utah, Washington, TIN in the spaces provided on the form. Wisconsin, Wyoming For more information and the Privacy Act and Paperwork Reduction Act Notice, Cat. No. 14400O Form 1096 (Rev. 7-2006) see the 2006 General Instructions for Forms 1099, 1098, 5498, and W-2G. CORRECTED (if checked) LENDER’S name, street address, city, state, ZIP code, and telephone no. OMB No. 1545-0877 Acquisition or 2008 Abandonment of Secured Property Form 1099-A 1 Date of lender’s acquisition or 2 Balance of principal knowledge of abandonment outstanding Copy B LENDER’S federal identification number BORROWER’S identification number For Borrower $ This is important tax BORROWER’S name 3 4 Fair market value of property information and is being furnished to the Internal Revenue Service. If you $ are required to file a 5 Was borrower personally liable for repayment of the debt? return, a negligence Street address (including apt. no.) penalty or other Yes No sanction may be City, state, and ZIP code imposed on you if 6 Description of property taxable income results from this transaction and the IRS determines Account number (see instructions) that it has not been reported. Form 1099-A (keep for your records) Department of the Treasury - Internal Revenue Service Instructions for Borrower Certain lenders who acquire an interest in property that was security for a ownership were transferred to the lender. This may be the date of a loan or who have reason to know that such property has been foreclosure or execution sale or the date your right of redemption or abandoned must provide you with this statement. You may have objection expired. For an abandonment, the date shown is the date on reportable income or loss because of such acquisition or abandonment. which the lender first knew or had reason to know that the property was Gain or loss from an acquisition generally is measured by the difference abandoned or the date of a foreclosure, execution, or similar sale. between your adjusted basis in the property and the amount of your debt Box 2. Shows the debt (principal only) owed to the lender on the loan canceled in exchange for the property, or, if greater, the sale proceeds. If when the interest in the property was acquired by the lender or on the you abandoned the property, you may have income from the discharge of date the lender first knew or had reason to know that the property was indebtedness in the amount of the unpaid balance of your canceled debt. abandoned. You also may have a loss from abandonment up to the adjusted basis of Box 4. Shows the fair market value of the property. If the amount in box the property at the time of abandonment. Losses on acquisitions or 4 is less than the amount in box 2, and your debt is canceled, you may abandonments of property held for personal use are not deductible. See have cancellation of debt income. If the property was your main home, Pub. 544, Sales and Other Dispositions of Assets, for information about see Pub. 523, Selling Your Home, to figure any taxable gain or ordinary foreclosures and abandonments. income. Property means any real property (such as a personal residence); any intangible property; and tangible personal property that is held for Box 5. Shows whether you were personally liable for repayment of the investment or used in a trade or business. loan when the debt was created or, if modified, when it was last modified. If you borrowed money on this property with someone else, each of you should receive this statement. Box 6. Shows the description of the property acquired by the lender or abandoned by you. If “CCC” is shown, the form indicates the amount of Account number. May show an account or other unique number the any Commodity Credit Corporation loan outstanding when you forfeited lender assigned to distinguish your account. your commodity. Box 1. For a lender’s acquisition of property that was security for a loan, the date shown is generally the earlier of the date title was transferred to the lender or the date possession and the burdens and benefits of VOID CORRECTED LENDER’S name, street address, city, state, ZIP code, and telephone no. OMB No. 1545-0877 Acquisition or 2008 Abandonment of Secured Property Form 1099-A 1 Date of lender’s acquisition or 2 Balance of principal LENDER’S federal identification number BORROWER’S identification number knowledge of abandonment outstanding Copy C $ For Lender BORROWER’S name 3 4 Fair market value of property For Privacy Act and Paperwork $ Reduction Act Street address (including apt. no.) 5 Was borrower personally liable for repayment of the debt? Notice, see the Yes No 2008 General City, state, and ZIP code 6 Description of property Instructions for Forms 1099, 1098, 5498, Account number (see instructions) and W-2G. Form 1099-A Department of the Treasury - Internal Revenue Service Instructions for Lenders General and specific form instructions are provided as File Copy A of this form with the IRS by March 2, separate products. The products you should use to 2009. If you file electronically, the due date is March complete Form 1099-A are the 2008 General 31, 2009. To file electronically, you must have software Instructions for Forms 1099, 1098, 5498, and W-2G, that generates a file according to the specifications in and the 2008 Instructions for Forms 1099-A and Pub. 1220, Specifications for Filing Forms 1098, 1099, 1099-C. A chart in the general instructions gives a 5498, and W-2G Electronically. IRS does not provide a quick guide to which form must be filed to report a fill-in form option. particular payment. To order these instructions and Need help? If you have questions about reporting on additional forms, visit the IRS website at www.irs.gov Form 1099-A, call the information reporting customer or call 1-800-TAX-FORM (1-800-829-3676). service site toll free at 1-866-455-7438 or Caution: Because paper forms are scanned during 304-263-8700 (not toll free). For TTY/TDD equipment, processing, you cannot file Forms 1096, 1098, 1099, or call 304-267-3367 (not toll free). The hours of operation 5498 that you download and print from the IRS are Monday through Friday from 8:30 a.m. to 4:30 p.m. website. Eastern time. Due dates. Furnish Copy B of this form to the borrower by February 2, 2009.
Pages to are hidden for
"Template 1099 Preprinted Forms"Please download to view full document