DS9 Document EFTA01222604

K CORRECTED (if checked) PAYER'S name. street address. city or town. state or province. country. ZIP or foreign postal code. and telephone no. 1 Original issue discount for 2018' OMB No. 1545-0117 $ • INS may not be the cooed figure to roux, on pair income tax return See Instructions on the back. 2 Other periodic interest $ 3 Early withdrawal penalty 2018 Form 1099-OID Original Issue Discount PAYER'S TIN RECIPIENTS TIN 4 Federal income tax withheld RECIPIENT'S name Street address (including apt. no.) City or town, state or province. country. and ZIP or foreign postal code 5 Market discount 6 Acquisition premium 7 Description 8 Original issue discount on U.S. Treasury obligations' 9 Investment expenses FATCA Ring requirement 10 Bond premium 11 Tax-exempt OID Account number (see instructions) 12 %fie 13 State identification no. 14 State tax withheld $ Copy B For Recipient This is important tax information and is being furnished to the IRS. If 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. Form 1099-OID (keep for your records) www.irs.gov/Form10990ID Department of the Treasury - Internal Revenue Seance EFTA01222604