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Form 1099-Q - Payments From Qualified Education Programs (Under Sections 529 And 530) - 2013 Page 3

CORRECTED (if checked)

PAYER’S/TRUSTEE'S name, street address, city or town, province or state, country,

1 Gross distribution

OMB No. 1545-1760

Payments From

ZIP or foreign postal code, and telephone no.

Qualified

2013

Education

Programs

2 Earnings

(Under Sections

529 and 530)

1099-Q

Form

Copy B

PAYER’S/TRUSTEE'S federal identification no. RECIPIENT’S social security number

3 Basis

4 Trustee-to-trustee

transfer

For Recipient

This is important tax

RECIPIENT’S name

5 Check one:

6 If this box is checked, the

information and is

recipient is not the

• Qualified tuition program—

being furnished to the

designated beneficiary

Internal Revenue

Private

State

Service. If you are

Street address (including apt. no.)

required to file a return,

• Coverdell ESA

a negligence penalty or

If the fair market value (FMV) is shown below, see Pub. 970,

other sanction may be

Tax Benefits for Education, for how to figure earnings.

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

imposed on you if this

income is taxable and

the IRS determines that

Account number (see instructions)

it has not been

reported.

1099-Q

(keep for your records)

Form

Department of the Treasury - Internal Revenue Service

Form 1099-Q - Payments From Qualified Education Programs (Under Sections 529 And 530) - 2013 Page 3

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