Form 1099-S - Proceeds From Real Estate Transactions - 2016 Page 5
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5
6VOID
CORRECTED
FILER'S name, street address, city or town, state or province, country, ZIP
1 Date of closing
OMB No. 1545-0997
or foreign postal code, and telephone number
Proceeds From Real
2016
Estate Transactions
2 Gross proceeds
1099-S
$
Form
Copy C
FILER'S federal identification number
TRANSFEROR'S identification number
3
Address or legal description (including city, state, and ZIP code)
For Filer
TRANSFEROR'S name
For Privacy Act
and Paperwork
Reduction Act
Street address (including apt. no.)
Notice, see the
2016 General
Instructions for
4 Check here if the transferor received or will receive
City or town, state or province, country, and ZIP or foreign postal code
Certain
property or services as part of the consideration
▶
Information
Account or escrow number (see instructions)
5 Buyer's part of real estate tax
Returns.
$
1099-S
Form
Department of the Treasury - Internal Revenue Service
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