Form 1099-B - Proceeds From Broker And Barter Exchange Transactions - 2014 Page 6
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9CORRECTED (if checked)
PAYER'S name, street address, city or town, state or province, country, ZIP
Applicable check box on Form 8949
OMB No. 1545-0715
Proceeds From
or foreign postal code, and telephone no.
2014
Broker and
Barter Exchange
Transactions
1099-B
Form
1a Description of property (Example 100 sh. XYZ Co.)
1b Date acquired
1c Date sold or disposed
Copy 2
PAYER'S federal identification number
RECIPIENT'S identification number
1d Proceeds
1e Cost or other basis
$
$
To be filed with
recipient's state
1f Code, if any
1g Adjustments
income tax return,
$
when required.
RECIPIENT'S name
2 Type of gain or loss:
3 If checked, basis reported
to IRS
Short-term
Long-term
Street address (including apt. no.)
4 Federal income tax withheld
5 If checked, noncovered
security
$
6 Reported to IRS:
7 If checked, loss is not allowed
based on amount in 1d
City or town, state or province, country, and ZIP or foreign postal code
Gross proceeds
Net proceeds
8 Profit or (loss) realized in
9 Unrealized profit or (loss) on
2014 on closed contracts
open contracts—12/31/2013
Account number (see instructions)
$
$
CUSIP number
10 Unrealized profit or (loss) on
11 Aggregate profit or (loss)
open contracts—12/31/2014
on contracts
$
$
14 State name
15 State identification no. 16 State tax withheld
$
12
13 Bartering
$
$
1099-B
Form
Department of the Treasury - Internal Revenue Service
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