Form 1099-K - Payment Card And Third Party Network Transactions

Form 1099-K - Payment Card And Third Party Network Transactions - 2012 Page 5

VOID

CORRECTED

FILER’S name, street address, city, state, ZIP code, and telephone no.

FILER’S federal identification no.

OMB No. 1545-2205

Payment Card

and Third Party

2012

Network

PAYEE’S taxpayer identification no.

Transactions

1099-K

Form

1 Gross amount of payment card/

2 Merchant category code

Copy C

third party network transactions

For Filer

Check to indicate transactions

Check to indicate if FILER is a (an):

reported are:

3 Number of purchase

Payment settlement entity (PSE)

transactions (optional)

Payment card

Electronic Payment Facilitator

(EPF)/Other third party

Third party network

PAYEE’S name

5a January

5b February

For Privacy Act

and Paperwork

5c March

5d April

Reduction Act

Street address (including apt. no.)

Notice, see the

2012 General

5e May

5f June

Instructions for

Certain Information

5g July

5h August

Returns.

City, state, and ZIP code

5i September

5j October

PSE'S name and telephone number

5k November

5l December

Account number (see instructions)

1099-K

Form

IRS.gov/form1099k

Department of the Treasury - Internal Revenue Service

Form 1099-K - Payment Card And Third Party Network Transactions - 2012 Page 5

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