Federal Miscellaneous Income (Info Copy Only)

Miscellaneous Income (Info Copy Only)
Form 1099-MISC (Rev. January 2024)
Attention:
Copy A of this form is provided for informational purposes only. Copy A appears in red,
similar to the official IRS form. The official printed version of Copy A of this IRS form is
scannable, but the online version of it, printed from this website, is not. Do not print and file
copy A downloaded from this website; a penalty may be imposed for filing with the IRS
information return forms that can’t be scanned. See part O in the current General
Instructions for Certain Information Returns, available at IRS.gov/Form1099, for more
information about penalties.
Please note that Copy B and other copies of this form, which appear in black, may be
downloaded and printed and used to satisfy the requirement to provide the information to
the recipient.
If you have 10 or more information returns to file, you may be required to file e-file. Go to
IRS.gov/InfoReturn for e-file options.
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you want to file them on paper, you can place an order for the official IRS information
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their instructions, as well as any publications you may order.
See Publications 1141, 1167, and 1179 for more information about printing these forms.

9595

VOID

CORRECTED

PAYER’S name, street address, city or town, state or province, country, ZIP
or foreign postal code, and telephone no.

1 Rents

$
2 Royalties

OMB No. 1545-0115
Form 1099-MISC
(Rev. January 2024)

Miscellaneous
Information

For calendar year

$

PAYER’S TIN

RECIPIENT’S TIN

3 Other income

4 Federal income tax withheld

$

$

5 Fishing boat proceeds

6 Medical and health care
payments

Copy A
For
Internal Revenue
Service Center

$

$

File with Form 1096.

RECIPIENT’S name

7 Payer made direct sales
totaling $5,000 or more of
consumer products to
recipient for resale

8 Substitute payments in lieu
of dividends or interest

Street address (including apt. no.)

9 Crop insurance proceeds

For Privacy Act
and Paperwork
Reduction Act
Notice, see the
current General
Instructions for
Certain
Information
Returns.

$
11 Fish purchased for resale

City or town, state or province, country, and ZIP or foreign postal code

$
13 FATCA filing 14 Excess golden parachute
requirement
payments

$
Account number (see instructions)

2nd TIN not.

16 State tax withheld

$
$
Form 1099-MISC (Rev. 1-2024)

Cat. No. 14425J

www.irs.gov/Form1099MISC

$
10 Gross proceeds paid to an
attorney

$
12 Section 409A deferrals

$
15 Nonqualified deferred
compensation

$
17 State/Payer’s state no.

18 State income

$
$
Department of the Treasury - Internal Revenue Service

Do Not Cut or Separate Forms on This Page — Do Not Cut or Separate Forms on This Page

VOID

CORRECTED

PAYER’S name, street address, city or town, state or province, country, ZIP
or foreign postal code, and telephone no.

1 Rents

$
2 Royalties

OMB No. 1545-0115
Form 1099-MISC
(Rev. January 2024)

Miscellaneous
Information

For calendar year

$

PAYER’S TIN

RECIPIENT’S TIN

3 Other income

4 Federal income tax withheld

$

$

5 Fishing boat proceeds

6 Medical and health care
payments

$

$

RECIPIENT’S name

7 Payer made direct sales
totaling $5,000 or more of
consumer products to
recipient for resale

8 Substitute payments in lieu
of dividends or interest

Street address (including apt. no.)

9 Crop insurance proceeds

$
City or town, state or province, country, and ZIP or foreign postal code

11 Fish purchased for resale

$
13 FATCA filing 14 Excess golden parachute
requirement
payments

$
Account number (see instructions)

16 State tax withheld

$
$
Form 1099-MISC (Rev. 1-2024)

www.irs.gov/Form1099MISC

Copy 1
For State Tax
Department

$
10 Gross proceeds paid to an
attorney

$
12 Section 409A deferrals

$
15 Nonqualified deferred
compensation

$
17 State/Payer’s state no.

18 State income

$
$
Department of the Treasury - Internal Revenue Service

CORRECTED (if checked)
PAYER’S name, street address, city or town, state or province, country, ZIP
or foreign postal code, and telephone no.

1 Rents

$
2 Royalties

OMB No. 1545-0115
Form 1099-MISC
(Rev. January 2024)

Miscellaneous
Information

For calendar year

$

PAYER’S TIN

RECIPIENT’S TIN

3 Other income

4 Federal income tax withheld

$

$

5 Fishing boat proceeds

6 Medical and health care
payments

$

$

RECIPIENT’S name

7 Payer made direct sales
totaling $5,000 or more of
consumer products to
recipient for resale

8 Substitute payments in lieu
of dividends or interest

Street address (including apt. no.)

9 Crop insurance proceeds

$
City or town, state or province, country, and ZIP or foreign postal code

11 Fish purchased for resale

$
13 FATCA filing 14 Excess golden parachute
requirement
payments

$
16 State tax withheld

Account number (see instructions)

$
$
Form 1099-MISC (Rev. 1-2024)

(keep for your records)

www.irs.gov/Form1099MISC

$
10 Gross proceeds paid to an
attorney

$
12 Section 409A deferrals

$
15 Nonqualified deferred
compensation

$
17 State/Payer’s state no.

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.
18 State income

$
$
Department of the Treasury - Internal Revenue Service

Instructions for Recipient
Recipient’s taxpayer identification number (TIN). For your protection, this
form may show only the last four digits of your social security number (SSN),
individual taxpayer identification number (ITIN), adoption taxpayer identification
number (ATIN), or employer identification number (EIN). However, the payer has
reported your complete TIN to the IRS.
Account number. May show an account or other unique number the payer
assigned to distinguish your account.
Amounts shown may be subject to self-employment (SE) tax. Individuals
should see the Instructions for Schedule SE (Form 1040). Corporations,
fiduciaries, or partnerships must report the amounts on the appropriate line of
their tax returns.
Form 1099-MISC incorrect? If this form is incorrect or has been issued in error,
contact the payer. If you cannot get this form corrected, attach an explanation
to your tax return and report your information correctly.
Box 1. Report rents from real estate on Schedule E (Form 1040). However,
report rents on Schedule C (Form 1040) if you provided significant services to
the tenant, sold real estate as a business, or rented personal property as a
business. See Pub. 527.
Box 2. Report royalties from oil, gas, or mineral properties; copyrights; and
patents on Schedule E (Form 1040). However, report payments for a working
interest as explained in the Schedule E (Form 1040) instructions. For royalties on
timber, coal, and iron ore, see Pub. 544.
Box 3. Generally, report this amount on the “Other income” line of Schedule 1
(Form 1040) and identify the payment. The amount shown may be payments
received as the beneficiary of a deceased employee, prizes, awards, taxable
damages, Indian gaming profits, or other taxable income. See Pub. 525. If it is
trade or business income, report this amount on Schedule C or F (Form 1040).
Box 4. Shows backup withholding or withholding on Indian gaming profits.
Generally, a payer must backup withhold if you did not furnish your TIN. See
Form W-9 and Pub. 505 for more information. Report this amount on your
income tax return as tax withheld.
Box 5. Shows the amount paid to you as a fishing boat crew member by the
operator, who considers you to be self-employed. Self-employed individuals
must report this amount on Schedule C (Form 1040). See Pub. 334.

Box 6. For individuals, report on Schedule C (Form 1040).
Box 7. If checked, consumer products totaling $5,000 or more were sold to you
for resale, on a buy-sell, a deposit-commission, or other basis. Generally, report
any income from your sale of these products on Schedule C (Form 1040).
Box 8. Shows substitute payments in lieu of dividends or tax-exempt interest
received by your broker on your behalf as a result of a loan of your securities.
Report on the “Other income” line of Schedule 1 (Form 1040).
Box 9. Report this amount on Schedule F (Form 1040).
Box 10. Shows gross proceeds paid to an attorney in connection with legal
services. Report only the taxable part as income on your return.
Box 11. Shows the amount of cash you received for the sale of fish if you are in
the trade or business of catching fish.
Box 12. May show current year deferrals as a nonemployee under a
nonqualified deferred compensation (NQDC) plan that is subject to the
requirements of section 409A plus any earnings on current and prior year
deferrals.
Box 13. If the FATCA filing requirement box is checked, the payer is reporting
on this Form 1099 to satisfy its account reporting requirement under chapter 4
of the Internal Revenue Code. You may also have a filing requirement. See the
Instructions for Form 8938.
Box 14. Shows your total compensation of excess golden parachute payments
subject to a 20% excise tax. See your tax return instructions for where to report.
Box 15. Shows income as a nonemployee under an NQDC plan that does not
meet the requirements of section 409A. Any amount included in box 12 that is
currently taxable is also included in this box. Report this amount as income on
your tax return. This income is also subject to a substantial additional tax to be
reported on Form 1040, 1040-SR, or 1040-NR. See the instructions for your tax
return.
Boxes 16–18. Show state or local income tax withheld from the payments.
Future developments. For the latest information about developments related to
Form 1099-MISC and its instructions, such as legislation enacted after they
were published, go to www.irs.gov/Form1099MISC.
Free File Program. Go to www.irs.gov/FreeFile to see if you qualify for no-cost
online federal tax preparation, e-filing, and direct deposit or payment options.

CORRECTED (if checked)
PAYER’S name, street address, city or town, state or province, country, ZIP
or foreign postal code, and telephone no.

1 Rents

$
2 Royalties

OMB No. 1545-0115
Form 1099-MISC
(Rev. January 2024)

Miscellaneous
Information

For calendar year

$

PAYER’S TIN

RECIPIENT’S TIN

3 Other income

4 Federal income tax withheld

$

$

5 Fishing boat proceeds

6 Medical and health care
payments

$

$

RECIPIENT’S name

7 Payer made direct sales
totaling $5,000 or more of
consumer products to
recipient for resale

8 Substitute payments in lieu
of dividends or interest

Street address (including apt. no.)

9 Crop insurance proceeds

$
City or town, state or province, country, and ZIP or foreign postal code

11 Fish purchased for resale

$
13 FATCA filing 14 Excess golden parachute
requirement
payments

$
Account number (see instructions)

16 State tax withheld

$
$
Form 1099-MISC (Rev. 1-2024)

www.irs.gov/Form1099MISC

Copy 2
To be filed with
recipient’s state
income tax return,
when required.

$
10 Gross proceeds paid to an
attorney

$
12 Section 409A deferrals

$
15 Nonqualified deferred
compensation

$
17 State/Payer’s state no.

18 State income

$
$
Department of the Treasury - Internal Revenue Service