Fill a 1099-MISC

For calendar year

VOID CORRECTED

Payer name/address/phone (multi-line) Payer TIN Recipient TIN Recipient name Recipient street address Recipient city/state/zip Account number (optional) 2nd TIN not. Box 1 — Rents Box 2 — Royalties Box 3 — Other income Box 4 — Federal income tax withheld Box 5 — Fishing boat proceeds Box 6 — Medical and health care payments Box 7 — Payer made direct sales totaling $5,000+ of consumer products to recipient for resale Box 8 — Substitute payments in lieu of dividends/interest Box 9 — Crop insurance proceeds Box 10 — Gross proceeds paid to an attorney Box 11 — Fish purchased for resale Box 12 — Section 409A deferrals Box 13 — FATCA filing requirement

Box 14 (Excess golden parachute payments) has no fillable field in the IRS's own PDF for this revision — not supported here because there is nothing to fill.

Box 15 — Nonqualified deferred compensation

Boxes 16–18 (state info) repeat once per state; fill the second set only if a second state applies.

Box 16 — State tax withheld

Box 16 — State tax withheld (2nd state)

Box 17 — State/Payer's state no.

Box 17 — State/Payer's state no. (2nd state)

Box 18 — State income

Box 18 — State income (2nd state)