Form 1098 - Mortgage Interest Statement - 2016 (Page 3 of 6) in pdf

CORRECTED (if checked)

RECIPIENT'S/LENDER'S name, street address, city or town, state or

OMB No. 1545-0901

*Caution: The amount shown may

not be fully deductible by you.

province, country, ZIP or foreign postal code, and telephone no.

Mortgage

2016

Limits based on the loan amount

and the cost and value of the

Interest

secured property may apply. Also,

you may only deduct interest to the

Statement

extent it was incurred by you,

actually paid by you, and not

1098

reimbursed by another person.

Form

1 Mortgage interest received from payer(s)/borrower(s)*

Copy B

For Payer/

2 Outstanding mortgage

Borrower

RECIPIENT'S/LENDER'S federal

PAYER'S/BORROWER'S taxpayer

3 Mortgage origination date

principal as of 1/1/2016

identification number

identification no.

The information in boxes 1

through 9 is important tax

4 Refund of overpaid

5 Mortgage insurance

information and is being

interest

premiums

furnished to the Internal

PAYER'S/BORROWER'S name

Revenue Service. If you are

6 Points paid on purchase of principal residence

required to file a return, a

negligence penalty or other

sanction may be imposed

Street address (including apt. no.)

7 Is address of property securing mortgage same as

on you if the IRS determines

PAYER'S/BORROWER'S address?

that an underpayment of

If Yes, box is checked .

tax results because you

If No, see box 8 or 9, below

overstated a deduction

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

for this mortgage interest

8 Address of property securing mortgage

or for these points, reported

in boxes 1 and 6; or

because you didn't report

10 Other

the refund of interest

9 If property securing mortgage has no address, below is the

(box 4); or because you

description of the property

claimed a non-deductible

item.

Account number (see instructions)

1098

Form

(Keep for your records)

Department of the Treasury - Internal Revenue Service

Form 1098 - Mortgage Interest Statement - 2016 Page 3

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