Fill a 1099-NEC

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 — Nonemployee compensation Box 2 — Payer made direct sales totaling $5,000+ of consumer products to recipient for resale Box 3 — Excess golden parachute payments Box 4 — Federal income tax withheld

Boxes 5–7 (state info) repeat once per state; fill the second set only if a second state applies.

Box 5 — State tax withheld

Box 5 — State tax withheld (2nd state)

Box 6 — State/Payer's state no.

Box 6 — State/Payer's state no. (2nd state)

Box 7 — State income

Box 7 — State income (2nd state)