Form 1099-Q - Payments From Qualified Education Programs (Under Sections 529 And 530) - 2013 Page 5
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6VOID
CORRECTED
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
PAYER’S/TRUSTEE'S federal identification no. RECIPIENT’S social security number
3 Basis
4 Trustee-to-trustee
Copy C
transfer
$
For Payer
RECIPIENT’S name
5 Check one:
6 Check if the recipient is
not the designated
For Privacy Act
• Qualified tuition program—
beneficiary
and Paperwork
or
Private
State
Reduction Act
Street address (including apt. no.)
• Coverdell ESA
Notice, see the
2013 General
City or town, province or state, country, and ZIP or foreign postal code
Instructions for
Certain
Information
Account number (see instructions)
Returns.
1099-Q
Form
Department of the Treasury - Internal Revenue Service
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