Form 1099-A - Acquisition Or Abandonment Of Secured Property - 2013 Page 5
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6VOID
CORRECTED
city or town, province or state, country, ZIP or
OMB No. 1545-0877
LENDER’S name, street address,
foreign postal code,
and telephone no.
Acquisition or
2013
Abandonment of
Secured Property
1099-A
Form
Copy C
1 Date of lender's acquisition or
2 Balance of principal
knowledge of abandonment
outstanding
For Lender
LENDER’S federal identification number
BORROWER’S identification number
$
BORROWER’S name
3
4 Fair market value of property
For Privacy Act
and Paperwork
$
Reduction Act
Notice, see the
5 Check here if the borrower was personally liable for
Street address (including apt. no.)
2013 General
repayment of the debt
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▶
Instructions for
Certain
6 Description of property
City or town, province or state, country, and ZIP or foreign postal code
Information
Returns.
Account number (see instructions)
1099-A
Form
Department of the Treasury - Internal Revenue Service
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