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Payer Type of TIN
(1=EIN, 2=SSN)		Payer TINPayer First name or Business namePayer Middle initial (optional)Payer Last nameSuffix (Jr,Sr,I,II,III,IV,V,VI,VII )
(optional)		DBA/Trade name
(optional)		Payer countryPayer Address line 1Payer Address line 2 (optional)Payer City / TownPayer State / ProvinceZip code / Postal codeRecipient Type of TIN
(1=EIN, 2=SSN, 3=ITIN, 4=ATIN, 5=TIN not provided)		Recipient TINRecipient First name / Business NameRecipient Middle initial
(optional)		Recipient Last nameSuffix (Jr,Sr,I,II,III,IV,V,VI,VII) (optional)DBA/Trade name (optional)Recipient countryRecipient Address line 1Recipient Address line 2 (optional)Recipient City / TownRecipient State / ProvinceZIP code / Postal codeRecipient Email address (optional)Account number (optional)Second TIN not. (Yes/No or 1/0 or True/False)1 Rents2 Royalties3 Other income4 Federal income tax withheld5 Fishing boat proceeds6 Medical and health care payments7 Payer made direct sales totaling $5,000 or more of consumer products to recipient for resale8 Substitute payments in lieu of dividends or interest9 Crop insurance proceeds10 Gross proceeds paid to an attorney11 Fish purchased for resale12 Section 409A deferrals13 FATCA filing requirement14 Excess golden parachute payments15 Nonqualified deferred compensationFile directly with state16 State 1 tax withheld17 State 117 Payer's State 1 No.18 State 1 income16 State 2 tax withheld17 State 217 Payer’s State 2 No.18 State 2 income
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Enter 1 for EIN, 2 for SSNEnter Payer's Tax ID in 9 digits, format as EIN XX-XXXXXXX or SSN XXX-XX-XXXXEnter the payer's First Name if the payer is an individual (TIN type is SSN).

Enter the payer's Business Name (full legal name) if the TIN type is EIN.		Enter the payer's Last Name only if the payer is an individual (TIN type is SSN)Choose from Jr, Sr, I, II, III, IV, V, VI, VII if applicable or leave the field emptyPayer's Business name if different from personal nameEnter 2 letter Country code. Use US for United StatesEnter 2 letter code for state or US territoryEnter 1 for EIN, 2 for SSN, 3 for ITIN, 4 for ATIN, or 5 if TIN is not providedEnter Recipient's Tax ID in 9 digits, format as EIN XX-XXXXXXX or SSN XXX-XX-XXXXEnter the recipient's Business Name (full legal name) if the TIN type is EIN.

Enter the recipient's First Name if the TIN type is SSN or any other type.		Enter the recipient's Last Name only if the TIN type is SSN or a type other than EINChoose from Jr, Sr, I, II, III, IV, V, VI, VII if applicable or leave the field emptyRecipient's Business name if different from personal nameEnter 2 letter Country code. Use US for United StatesState Code must contain only 2 alpha charactersIf a recipient email address is provided, we will email the recipient with a Copy B of the form after submissionRequired if there are multiple accounts for the recipient and more than one 1099 is filed for themEnter Yes/No, or 1/0, or True/False if the IRS notified you that the payee used an incorrect TIN twice in the last 3 yearsReport any payments of $600 or more for all kinds of rent, like office space rent, machine rent, or pasture rentReport royalty payments of $10 or more, such as those from oil, gas, or minerals, before taking out any taxes like severance taxes. Do not report royalties from land surface useIncome that is not reportable in one of the other boxes, like prizes and awardsEnter the tax backup withholding amount (24% flat rate in 2024), in case the receipient hasn't provided their TIN or it's incorrectIf you run a fishing boat, write down each crew member's share of the money from selling the catch or the fair market value of any goods given to them. This is for boats that usually have fewer than 10 crew membersReport any payments of $600 or more that you made in your business to each doctor, rovider of medical services or health insurance providerEnter Yes/No, or 1/0, or True/False Report total payments of $10 or more that a broker received for a customer instead of dividends or tax-free interest. These payments are made when a customer's securities are loaned outReport crop insurance payments of $600 or more given to farmers by insurance companiesReport any payments of $600 or more made to an attorney for legal servicesIf your business involves buying fish to resell, you need to report any total cash payments of $600 or more made in a year to anyone whose business is catching fishDeferrals and earnings for the nonemployee under all nonqualified plans.Enter Yes/No, or 1/0, or True/False Report any excess golden parachute payments. These are payments that exceed the base amount, which is the average yearly pay received over the last five tax yearsReport all deferred amounts (and earnings on those amounts) that are included in income under section 409A. This happens when the non-qualified deferred compensation (NQDC) plan does not meet the requirements of section 409A.You may enter up to 2 states per form.

If we support the state, and you want us to file directly with the State, enter Yes, 1 or True. If not, enter No, 0, or False or leave this field blank.

States NOT supported: AL, WV		If you held back state income tax from the payment, write that amount in this field blankState Code must contain only 2 alpha charactersEnter Taxpayer ID Number assigned to an entity by stateReport the amount of the state paymentIf you held back state income tax from the payment, write that amount in this field blankState Code must contain only 2 alpha charactersEnter Taxpayer ID Number assigned to an entity by stateReport the amount of the state payment
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Please do not change this row. Put your data below. Also, please do not make any changes in the Rows above.
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