Case File
efta-efta01222598DOJ Data Set 9OtherK CORRECTED Of checked)
Date
Unknown
Source
DOJ Data Set 9
Reference
efta-efta01222598
Pages
1
Persons
0
Integrity
Extracted Text (OCR)
Text extracted via OCR from the original document. May contain errors from the scanning process.
K CORRECTED Of checked)
PAYER'S name. street address. city or town. state or province. country, ZIP
or foreign postal code. and telephone no.
Payer's RTN (optional)
OMB No. 1545.0112
018
Form 1099-INT
1 Interest income
$
2Earlywithdrawalperially
$
PAYERS TIN
RECIPIENT'S 11N
3 Interest on U.S. Savings Bonds and Treas. obligations
$
RECIPIENT'S name
Street address gncludirg apt. no.)
City or town. state or province. country. and ZIP or foreign postal code
4 Federal income tax withheld
$
S Investment expenses
$
6 Foreign tax paid
$
7 Foregn cowry or U.S. possession
8 Tax-exempt interest
$
9 Speofied private activity bond
'rarest
$
10 Market discount
$
11 Bond premium
$
FATCA Sing
requirement
0
12 Barxl premum al Tieasw otOgitris
$
13 Bond fawn 0.1 tax-exempt had
$
Account number (see instructions)
14 Tax-exempt and tax credit
bond CUSIP no.
15 State 16 Slate dentdcai,on no.
Form 1099-INT
(keep for your records)
www.irs.gov/Forrn1099INT
Interest
Income
Copy
For Recipient
This is important tax
information and is
being furnished to the
IRS. II you are
required to file 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.
17 State tax withheld
$
S
Department of the Treastay - Internal Revenue Sews
EFTA01222598
Technical Artifacts (2)
View in Artifacts BrowserEmail addresses, URLs, phone numbers, and other technical indicators extracted from this document.
Domain
www.irs.govPhone
1545.0112Forum Discussions
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