EFTA01222604.pdf

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