Form 1099-S - Proceeds From Real Estate Transactions - 2012 Page 2
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67575
VOID
CORRECTED
FILER'S name, street address, city, state, ZIP code, and telephone no.
1 Date of closing
OMB No. 1545-0997
Proceeds From Real
2012
Estate Transactions
2 Gross proceeds
1099-S
$
Form
Copy A
FILER'S federal identification number
TRANSFEROR'S identification number
3
Address or legal description (including city, state, and ZIP code)
For
Internal Revenue
TRANSFEROR'S name
Service Center
File with Form 1096.
For Privacy Act
and Paperwork
Street address (including apt. no.)
Reduction Act
Notice, see the
2012 General
4 Check here if the transferor received or will receive
City, state, and ZIP code
Instructions for
property or services as part of the consideration
▶
Certain
Account or escrow number (see instructions)
5 Buyer's part of real estate tax
Information
$
Returns.
1099-S
Form
Cat. No. 64292E
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
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